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Diseases & Conditions

Urinary Incontinence & Pregnancy

During pregnancy, many women experience at least some degree of urinary incontinence (involuntary loss of urine). The incontinence may be mild and infrequent for some pregnant women, but can be more severe for others. Incontinence can continue after pregnancy and may not be present right after childbirth. Some women may not develop bladder problems until many years later.

What causes incontinence during and after pregnancy?

The bladder sphincter, a muscular valve that lies at the bottom of the bladder, works to control the flow of urine. During pregnancy, the expanding uterus puts pressure on the bladder. The muscles in the bladder sphincter and in the pelvic floor can be overwhelmed by the extra stress or pressure on the bladder. Urine may leak out of the bladder when there is an additional pressure exerted; for example, when a pregnant woman coughs or sneezes.

After pregnancy, incontinence problems may continue because childbirth weakens the pelvic floor muscles and nerves.

Pregnancy and childbirth also may contribute to bladder control problems because of the following conditions:

  • Damage to the nerves that control the bladder
  • The fact that the urethra and bladder have moved during pregnancy
  • An episiotomy, a cut made in the pelvic floor muscle during delivery of a baby to allow the fetus to come out more easily

What types of incontinence are experienced during and after pregnancy?

The kind of incontinence experienced during pregnancy is usually stress incontinence, the loss of urine caused by increased pressure on the bladder. In stress incontinence, the bladder sphincter does not function well enough to hold in urine. The symptoms of stress incontinence include leakage with coughing, sneezing, exercise, etc. – anything that increases the pressure within the abdomen.

Urinary incontinence during pregnancy can also be the result of an overactive bladder, a condition in which irregular nerve signals cause the bladder muscles to tighten at inappropriate times. Women who have an overactive bladder need to urinate more often than they normally would. They frequently have to run to get to the bathroom in a hurry and may start to urinate before they get to the toilet.

How is urinary incontinence during pregnancy treated?

Behavioral methods such as timed voiding and bladder training can be helpful in treating urinary incontinence during and after pregnancy. These techniques are often used first. The changes in habits that behavioral methods involve do not have serious side effects and can be done at home.

To practice timed voiding, you use a chart to record the times that you urinate and when you leak urine. This will give you an idea of your leakage "patterns," so that you can avoid leaking in the future by going to the bathroom at those times.

In bladder training, you "stretch out" the intervals at which you go to the bathroom by waiting a little longer before you go. For instance, to start, you can plan to go to the bathroom once an hour. You follow this pattern for a period of time, and then you change the schedule to going to the bathroom every 90 minutes, and then eventually every two hours, and so on, until you are up to three or four hours between bathroom visits.

What are Kegel exercises?

Kegel exercises are another method that can be used to help control urinary incontinence. These exercises help tighten and strengthen the muscles in the pelvic floor. Strengthening the pelvic floor muscles can improve the function of the urethra and rectal sphincter. One way to help locate the Kegel muscles is to insert a finger into the vagina and try to make the muscles around your finger tighter.

To perform Kegel exercises, you should:

  • keep your abdominal, thigh, and buttocks muscles relaxed
  • tighten the pelvic floor muscles; hold the muscles until you count to 10
  • relax the pelvic floor muscles until you count to 10

Do 10 Kegel exercises in the morning, afternoon, and at night. In addition, those with urinary frequency or urgency can tighten the pelvic floor muscles when they get the urge to void – this may make the urgency resolve and allow them to go to the bathroom at a normal pace. Women who do Kegel exercises tend to see results in four to six weeks.

When should you consult a health care professional?

Talk to your doctor if you still have bladder problems after 6 weeks. Accidental leaking of urine may mean that you have another medical condition. The loss of bladder control should be treated or it can become a long-term problem.

References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 8/23/2012…#14325