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Pitter-patter (and post-baby bladder)

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Woman struggling with bladder incontinence after birth.

Some women’s bodies are forever changed by pregnancy, and not only by stretch marks.
Pregnancy and vaginal delivery are stressful on the body and can cause pelvic-related issues and incontinence, says Dr. Eduardo Martinez, an OB-GYN who specializes in urogynecology at Tidelands Health Women’s Center.
Hormone changes and baby weight pushing on the bladder can cause incontinence during and after pregnancy. Vaginal delivery can stress the pelvic support structure that holds the bladder in place, Dr. Martinez says.
“With vaginal delivery, you see more pelvic floor issues and the weakening of those muscles and ligaments,” he says. “You have three or so kids and weeks or even years after the delivery you can have stress incontinence with activity.”
Symptoms to look for include an increase in urgency or frequency of urination, urinating in spurts or leakage of urine. Some women are embarrassed and avoid seeking help for it, which can interfere with quality of life, Dr. Martinez says. But bladder leaking is very common and there are numerous effective treatments.

Treatment in steps

Dr. Martinez generally recommends women start conservatively by considering lifestyle changes and physical therapy.
Pelvic floor exercises such as Kegels can improve stress incontinence after giving birth, he says.
“Start the flow of urine and then stop it. That’s a Kegel,” Dr. Martinez says. “The idea is to rebuild strength in those pelvic floor muscles so you regain more control.”
Dietary changes can also help because foods such as coffee, tea, sodas, artificial sweeteners, tomato-based dishes, citrus fruits and chocolate are bladder irritants that cause the urge to go more frequently. Losing weight and quitting smoking can also reduce symptoms for some women.

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When conservative measures aren’t effective, medication and other options are available, he says.
Stress incontinence, which is when coughing, laughing, jumping or other pressure on the abdomen cause an involuntary emission of urine, can be treated through an injection of a “bulking agent” around the urethra to increase the pressure around the urethra. This requires more exertion for urine to come out.
A sling can be inserted to support the bottom of the urethra and kink it when you exert yourself. Options also include an injection of Botox into the bladder or a pacemaker for your bladder.

Benefits

Dr. Martinez says the procedures are fairly straightforward yet can be quite rewarding considering the improvement to quality of life and (of course) the benefit of having had children.
“It’s pretty common for us to see patients who, for example, are embarrassed because they’re having issues while they’re in Zumba at the gym,” he says. “It’s important that those women realize they aren’t alone and we can help them address the issue.”

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