Causes urinary incontinence during pregnancy?
Urinary incontinence is generally the case of incontinence. Urinary incontinence is one of the most common problems during pregnancy. Questions such as urinary incontinence during pregnancy, whether urinary incontinence during pregnancy can harm the baby Gynecologist and obstetrician Assoc. Dr. We asked Serdar Aydın. Here are all the unknowns about the problem of urinary incontinence during pregnancy…
Causes urinary incontinence during pregnancy?
Urinary incontinence is the inadvertent incontinence. Although it is an important social and hygienic problem, it is known that one in three women involuntarily leak urine during their lifetime. We know that 65% of them start during and after pregnancy. Urinary incontinence during pregnancy is estimated to occur in 35-65% of pregnant women. The bladder for painless storage of urine is filled to a certain capacity, and when it reaches a certain pressure, the bladder muscle is contracted by the discharge command from the central nervous system. The urethra, which serves to drain urine from the bladder to the external environment, acts as a tap that allows us to hold the urine in cases of increased intra-abdominal pressure, such as coughing, sneezing or removing something. The bladder, intestines in the abdomen are adjacent to the uterus and are affected by the pressure of neighboring organs in cases where intra-abdominal pressure increases. The most important reason of urinary incontinence during pregnancy is the increase of the intrauterine pressure in the growing uterus and the compression of the bladder. Both the capacity of the bladder decreases and the pressure increases. Another reason is physiological changes in pregnancy. Increased progesterone and relaxin hormones contribute to the emergence of urinary incontinence complaints in pregnancy by causing relaxation of the muscle and mesh tissue that support the bladder from the bottom.
Gynecology and obstetrics specialist Assoc. Dr. Example: serdar aydın
2) What are the conditions that increase urinary incontinence during pregnancy?
• Smoking causes cough and increases intra-abdominal pressure and is a risk factor for urinary incontinence during pregnancy.
• Age at first pregnancy is a risk factor for incontinence. Muscle mass lost with advancing age causes both the supportive tissues to weaken and the sphincter mechanism at the bladder entrance.
• Being overweight causes an increase in intra-abdominal pressure and a stretching and weakening of the support structure we call the pelvic floor.
• Constipation also increases urinary pressure by straining and contributes to urinary incontinence.
• Diabetes during pregnancy causes a lot of urine production and a lot of urination.
• Pre-pregnancy urinary incontinence symptoms indicate weakness of supportive tissues and increased intra-abdominal pressure during pregnancy and weakening of supportive tissue causes increased incontinence during pregnancy.
• Failure to work and strengthen the pelvic floor muscles prior to pregnancy also leads to increased incontinence during pregnancy.
• Finally, a common urinary tract infection during pregnancy causes increased incontinence complaints.
Does incontinence harm the baby during pregnancy?
Urinary incontinence during pregnancy does not harm the baby. Urinary incontinence is a social and hygienic problem that reduces the quality of life.
Medications used in non-pregnant people for incontinence can harm the baby when used in pregnancy. In addition, urinary incontinence associated with difficulty in urination and sagging of the pelvic organs can lead to urinary tract infection. Urinary tract infection can cause premature birth and miscarriage by disrupting maternal health.
Does urinary incontinence during pregnancy continue after birth?
Urinary incontinence is not as common as in pregnancy when the changes in pregnancy that cause urinary incontinence return to normal. Approximately 6% of women who do not have urinary incontinence before pregnancy continue to have urinary incontinence after pregnancy. This risk is higher in women with multiple births and pregnant women over 30 years of age. Normal birth, birth pain, intervening birth, prolongation of birth, are factors that increase the risk.
Do Kegel exercises prevent urinary incontinence?
Of course, strengthening the pelvic floor muscles is one of the most effective ways to prevent urinary incontinence. Methods to strengthen the pelvic floor muscles are called pelvic floor muscle exercises. The efficacy of pelvic floor muscle exercises in urinary incontinence has been proven both during and after pregnancy. The best known pelvic floor muscle exercises are Kegel exercises. It was described by Arnold Kegel, a gynecologist and obstetrician in 1948, in the treatment of patients with urinary incontinence.
Before you do your Kegel exercises, it is important to find your pelvic muscles. These are the muscles that make up the pelvic floor. The most common way to find them is to try to stop the middle flow of your urine. The muscles that you run and squeeze are the pelvic floor muscles and the muscles that we try to tighten with Kegel exercises. This is Kegel's basic motion.
Before starting Kegel exercises, it is important that a doctor assesses and informs you of any medical problems that may interfere.
Warning:
Do not stop medium flow urination in your normal Kegel exercise routine. Squeezing these muscles while urinating can have the opposite effect. It can also damage your bladder and kidneys.
How is it done?
Tighten your pelvic floor muscles for 5 seconds, then rest for 10 seconds. Repeat the exercise 10 times. You can call it a set of Kegel Exercises. You should do this set 3-4 times a day. With the Kegel exercises, the pelvic floor muscles and the vaginal muscles around the urethra are strengthened, the sphincter contracts more effectively and the downward displacement of the urethra is reduced.
How is incontinence treated during pregnancy?
The pelvic floor muscle exercises are the most effective way to lose urine during pregnancy.
Other methods used in the treatment of urinary incontinence;
• Smoking cessation in smokers
• Controlled weight gain, prevention of excess weight gain
• Correction of stress-increasing problems such as constipation
• Treatment of cough causes such as asthma.
• Reduction of caffeine and tea intake.
• Bladder training, which is based on intermittent toilet and delayed urination when urine arrives, is effective in urgent urge incontinence.
• Regular application of aerobic and similar physical activities has been shown to be effective in correcting urinary incontinence during pregnancy.
• It has been experienced that crossing the legs works for coughing and urinary incontinence. However, there are no scientific studies showing whether this method works in pregnancy.
• Vaginal cones and electrical stimulation that facilitate pelvic floor exercise are known to be effective in the treatment of urinary incontinence in non-pregnant women. Interest in use in pregnant women is limited. It can be used during pregnancy because of its potential side effects.
Because of the possible negative effects of drugs used to treat urinary incontinence during pregnancy, medication has no place in incontinence during pregnancy.
The surgical method may be effective, especially in the case of stress incontinence in a restricted patient who has incontinence with coughing, sneezing. Postponing surgery to postpartum would be a more rational way.
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