Bladder Weakness In Pregnancy
During pregnancy, childbirth and the months that follow, your body goes through huge changes, physically and hormonally. Not surprisingly, your bladder is put under a lot of stress. Bladder weakness during and after this time is very common. Dr. Boniface Muiru enlightens us more
1 What is bladder weakness?
Bladder weakness is described as when the bladder leaks involuntarily. The medical term for this is incontinence. It can empty completely or just leak small quantities at certain times.
2 How common is it?
It is very common affecting over two million Kenyans.
Four out of ten women have experienced bladder weakness In connection to pregnancy and childbirth.
Twenty five per cent of women who are 35 years and above have experienced bladder weakness problems at certain points in their lives.
Fifteen per cent of women who are 40 years and above have regular or daily bladder weakness problems.
Prevalence is much lower with first time pregnancies compared to the ones that follow which have more urinal incontinence.
As pregnancy advances, the probability of bladder weakness also increases.
Nearly all post delivery bladder weakness is stress related. Any bladder weakness is reported by 15 to 30 per cent during the first year. It has a lower occurrence to those delivering by Caesarean section.
During pregnancy
Prevalence is higher during pregnancy after first child than during first pregnancy
Prevalence of bladder weakness is low in first three months of pregnancy (first trimester), increasing in second trimester and increasing rapidly in third trimester
Severity of bladder weakness increases during pregnancy.
After pregnancy
» Nearly all post delivery bladder weakness is stress related
» Any bladder weakness is reported by 15 per cent to 30 per cent during 1st year
» Weekly or greater bladder weakness is reported by 5 per cent to 10 per cent.
» Daily bladder weakness is less than 5 per cent
» Excluding bladder weakness before pregnancy reduces above figures by 3-4 per cent in one study
» Lower prevalence by those delivering by Caesarean section vs. vaginal delivery
3. Bladder weakness types
There are three common types of bladder weakness: Stress, Urge and Overflow.
Stress Incontinence
This is urine leaking of as a result of sudden stress on the bladder. It is usually caused by coughing, laughing exercising or lifting a heavy object.
Urge Incontinence
This is a sudden urge to urinate even if the bladder is not full. The urge is so strong it can’t be held back, and may for example result m not reaching the bathroom in lime after the urge strikes because of decreased muscle control.
Overflow Incontinence
This is uncontrollable peeing because the bladder is filled beyond capacity. The pressure on the bladder easily makes the muscles surrounding the bladder unable to hold in the urine.
It is possible experience symptoms or more than one type of bladder weakness. A complete examination by your healthcare provider can determine the appropriate method of treatment.
4. Coping with it
Bladder weakness often places some stigma on people. Some would rather stay home than risk the embarrassment of having an accident in public. This Isolation can lead to withdrawal from social activities and eventually depression Medication, behavior modification and use Of absorbent products will make it easier.
Pelvic floor exercises
One of the best ways to prevent bladder weakness is to keep your pelvic floor muscles toned and strong during and after pregnancy because they strengthen the muscles that support the bladder. They also help firm up your tummy.
Your health care provider will guide you on when to start these exercises. Here is the simple procedure.
Sit comfortably on a stool or chair with your knees apart and feet flat on the floor. Lean forward and rest your forearms on your thighs.
Begin by drawing up in the back passage, as it you are trying to stop yourself passing wind, hold onto this while you draw up the muscles around the vagina and then draw up around the front passage, as if you are trying to stop yourself passing urine.
You should try holding on while you count to two gradually increasing to count 10 as your muscles become stronger.
5 Remember…
1. Keep breathing in and out normally;
2. Do not push down when you are squeezing:
3. Try not to tighten your tummy, buttocks or thighs:
4. Do not pull your knees together,
Qualities of a good product for bladder weakness
■ Absorbent – to avoid risk of leakage into the underwear
■ Odour protection – to protect from the distinctive smell of urine that comes from bacteria that produce ammonia
■ Thin and discreet
■ Secure fit – so that it is comfortable when worn
■ Portable and easily disposable
■ No skin irritation
The writer is a practicing community pharmacist & Incontinence care educator
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