Treating urinary incontinence-Don’t Be Pampered by Pampers

Many women experience incontinence after childbirth. Fortunately, most women have a temporary problem that usually subsides with time. However, there some women that have a persistent problem that lasts for a longer period of time.

After nine months of pregnancy and a rollercoaster of experiences with a changing body, it’s easy to chalk up bladder leaks after delivery to one more outcome of childbirth. While that’s true for many women, other conditions could be responsible for urinary incontinence —the inability to control the release of urine from one’s bladder —if a woman is having difficulties controlling urination two months post pregnancy or more.

The problem is common and nothing to be embarrassed about since many new moms experience urinary incontinence after baby’s arrival.

The condition is caused by the stretching and tearing of supporting structures including ligaments, tendons, nerves and muscles, resulting in a weakened pelvic floor. The extent of the stretching or tearing varies in each person. Incontinence often resolves itself within a couple months after delivering the baby when the structures have repaired themselves naturally.

According to the National Association for Continence, approximately 25 million adult Americans experience temporary or chronic urinary incontinence. UI can strike at any age, although women over age 50 are the most likely to develop the condition. In many cases, UI is often temporary—such as during or after pregnancy for a short while — or results from an underlying medical condition.

The most common form of incontinence in women post pregnancy is stress incontinence, which consists of losing urine when pressure is exerted on the bladder by coughing, sneezing, laughing, exercising or lifting something heavy. Another common form of urinary incontinence post pregnancy is known as urge incontinence —described as an intense urge to urinate, followed by an involuntary loss of urine. Many women will experience a mixture of both forms, which medical professionals refer to as mixed incontinence.

Urinary incontinence can affect a woman in many different ways. It’s more than just an awkward issue that makes it hard to not leak urine. The impact of incontinence on a woman’s personal life can be distressing. Women often avoid going out because they are embarrassed by their frequent bathroom usage. The problem can greatly affect a woman’s sex life, especially when suffering from stress incontinence. Many patients will talk to providers about the changes in relationships that take place in their intimate lives as a result of urinary incontinence.

Women with incontinence have to rearrange their lives. They have to buy pads, which can be expensive. It can irritate their skin. They are all emotionally challenging things to deal with especially after just having a baby. It has added to the stress of having a baby in general.

There are several different ways to treat urinary incontinence.

The most important thing is to allow the muscles to repair themselves. While some cases of urinary incontinence will disappear a few weeks after a woman gives birth, women should seek medical treatment if they are still experiencing leakage after two months.

Pelvic floor exercises, commonly known as Kegal exercises, can often improve urinary incontinence. The exercises strengthen the urinary sphincter and the muscles that help control urination. A physical therapist or professional recommended by a physician can provide insight on whether a patient is properly contracting muscles to help improve the condition.

I also recommend keeping a bladder diary for those dealing with urinary incontinence, which can help normalize fluid intake. Often times women, out of wanting to remain hydrated, can drink several liters more than is necessary causing their bladders to remain over filled. A bladder diary can help to realize this problem, she says.

Another option available to treat urinary incontinence is what’s known as a vaginal pessary. The device can be put in the vagina to support the structures that help prevent urinary continence. The device can serve as a bridge to allow activities like walks and hikes while a woman rehabilitates her muscles.

It takes only one baby for the problem to occur, and the subject of urinary incontinence should not be taboo. I suggest that women ask their physicians about the problem

Bottom line: Urinary incontinence is common after childbirth. Most women will have the problem resolve without any treatment. If the problem persists after several months, then medical attention is recommended.

Losing Your Urine When You Cough Or Sneeze-Treating Incontinence With a Pessary

Pessary For Treating Mild Stress Incontinence

Stress urinary incontinence or loss of urine with coughing, sneezing, or even bending over to put on your shoes affects millions of American women. Often times a woman is looking for a treatment that does not involve medication or surgery. For certain women a vaginal pessary is an option. A pessary is a removable device placed into the vagina. It is designed to support areas of the pelvis such as occurs with pelvic organ prolapse.
There are a variety of pessaries available, made of rubber, plastic, or silicone-based material. Among common types of pessaries are the inflatable , the doughnut, and the Gellhorn.

Frequent Urination: Causes and Treatments
Gotta go all the time? The technical name for your problem is frequent urination or overactive bladder. In most people the bladder is able to store urine until it is convenient to go to the toilet, typically four to eight times a day. Needing to go more than eight times a day or waking up in the night to go to the bathroom could mean you’re drinking too much and/or too close to bedtime. Or it could signal a health problem.

Why It Is Done
Pessaries are used as a nonsurgical approach to the treatment of pelvic organ prolapse. They are frequently used to treat uterine prolapse in young women during pregnancy. In this instance, the pessary holds the uterus in the correct position before it enlarges and becomes trapped in the vaginal canal.
Pessaries are also used when symptoms of pelvic organ prolapse are mild or when childbearing is not complete. They can be used in women who have other serious chronic health problems, such as heart or lung disease, that make a surgical procedure more dangerous.

Pessaries are sometimes used to see what the effect of surgery for pelvic organ prolapse will be on urinary symptoms. This is called a “pessary test.” If you have a problem with incontinence with a pessary inserted, a separate surgery to fix the incontinence problem may be done at the same time as a prolapse surgery
How Well It Works
Pessaries do not cure pelvic organ prolapse but help manage and slow the progression of prolapse by adding support to the vagina and increasing tightness of the tissues and muscles of the pelvis. Symptoms improve in many women who use a pessary, and for some women symptoms go away.

You will need to see a doctor to be fitted for a pessary which will hold the pelvic organs in position without causing discomfort. Pessaries come in a variety of sizes and should be fitted carefully.

What To Expect After Treatment
Your pessary will be fitted in your doctor’s office. You may need to experiment with different kinds of pessaries to find one that feels right. The pessary needs to be remove, clean, and reinsert the pessary on a regular schedule. Most often this is done by the doctor or his\her staff but some women prefer to do this themselves. The cleaning schedule is determined by the type of pelvic organ prolapse and the specific brand of pessary.

Risks
Possible complications from wearing a pessary include:
• Open sores in the vaginal wall.
• Bleeding.
• Wearing away of the vaginal wall. In severe cases, an opening can form between the vagina and the rectum.
• Bulging of the rectum against the vaginal wall (rectocele formation).

Complications can be minimized by having a pessary that fits correctly and that does not put too much pressure on the wall of the vagina.
In post menopausal women, estrogen (cream, ring, or tablets) is sometimes used with a pessary to help with irritation caused by the pessary.
What To Think About

Pessaries often are an effective tool for managing pelvic organ prolapse without surgery. They may be the best choice if you are a young woman who has not finished having children, if you have been told that surgery would be risky for you, or if you do not wish to have surgery for other reasons.
A pessary may not be a good choice after having a hysterectomy. This is because the walls of the vagina are no longer held in place by the uterus and cervix. Women with severe prolapse following a hysterectomy may have difficulty keeping the pessary in place.
Many women can have sexual intercourse with their pessary in place. But you cannot insert a diaphragm (a round rubber device used as a barrier method of birth control) while wearing a pessary. If you have not reached menopause, you may want to discuss birth control with your doctor.


Bottom Line: Stress incontinence is common condition affecting millions of American women. The treatment with a pessary is an option that does not require the use of medication or surgery.

For more information on women’s health, I suggest my new book, What’s Going On Down There-Everything You Need To KnowAbout Your Pelvic Health. the book is available from Amazon.com

New book on women’s health