This is the happiest part of your life. Unfortunately some women may experience symptoms of postpartum urinary and bowel incontinence, perineal or pelvic pain, caesarean section or perineal wound issues or sexual dysfunction. Those who had 3rd or 4th degree tears do need further review and if necessary specialised investigations to reduce the risk of long term consequences. Timely intervention is the key here.
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Pregnancy and childbirth is known to put significant strain on pelvic floor and in some cases it leaves some symptoms which could be difficult to cope with. If you had a cut (episiotomy) or a tear, you may experience pain, sexual difficulty or painful bowel movements. Some women may experience urine or bowel incontinence, prolapse, sexual problems or vaginal pain.
Women may experience a wide range of postpartum problems, some more serious than others and each with its own symptoms. Some of the more common problems include postpartum infections, (including uterine, bladder, or kidney infections), pain in the perineal area (between the vagina and the rectum), vaginal discharge, constipation, urinary or faecal (stool) incontinence and discomfort during sex.
Some women experience healing problems with tear or episiotomy cut. Those who might have had extensive tears going in to rectum (called 3rd or 4th degree tears) may have other issues like faecal and flatal incontinence. Timely help is very important in such a situation.
Specialised investigations are required to know about healing of the tear and to assess how the pelvic floor and bowel muscles are functioning. Early intervention in such cases with measures like targeted physiotherapy and appropriate counselling regarding future pregnancies is very important.
For tender perineum, simple measures like use of local treatment, tender point injections, ultrasound treatment or minor surgical procedures can be considered.
For incontinence and prolapse soon after childbirth, timely assessment, use of pelvic floor exercises, vaginal pessaries and in very small number of cases, surgery are available options. In most of the cases, conservative treatment is sufficient. Once again, the treatment is decided on the basis of extent of problem, its impact on your quality of life and your expectations.
Please contact us. if you have such issues and you want to discuss more.
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Overactive Bladder (OAB) is a sudden and compelling need to relieve the bladder which is difficult to put off, often associated with the frequent need to go to the toilet during the night or the day, and may result in incontinence.
People experiencing these symptoms should not feel ashamed or embarrassed to talk to their doctor, because help is available. OAB can have a huge emotional and physical impact on people.
About 1 in 6 adults experience some symptoms of an overactive bladder. About 1 in 3 people with an overactive bladder have episodes of urge incontinence.
Normally, the bladder muscle stay relaxed as the bladder gradually fills up. However, in people with an overactive bladder, the bladder muscle seems to give wrong messages to the brain. The bladder may feel fuller than it actually is. The bladder contracts too early when it is not very full, and not when you want it to.
Untimely contractions lead to symptoms like Urgency where you cannot wait to go to urinate, increased frequency more than 7-8 times a day, Night time frequency (nocturia) of more than 1-2 times every night interfering with your sleep and Urinary leakage mainly happening on the way to the toilet or without any warning. You may pass quite small volumes of urine.
Try these top tips to help you control your symptoms:
Bladder training (sometimes called bladder drill)
Bladder training is a very simple but effective treatment. It works in up to half of cases and makes it important part of the treatment. The aim is to slowly stretch the bladder so that it can hold larger and larger volumes of urine. For more information see the “Bladder Drill” section on this website.
If there is not enough improvement with bladder training alone, medicines also help. There are number of medicines available. They work by blocking certain nerve impulses to the bladder, which relaxes the bladder muscle and so increases the bladder capacity. Medication improves symptoms in some cases, but not all. The amount of improvement varies from person to person. Click here to know about medication.
Posterior Tibial Nerve Stimulation
This treatment involves inserting a very fine needle (like acupuncture) into a specific point near the ankle. A specific kind of electrical impulse is delivered to the patient through the lead set. The electrical impulses travel along the tibial nerve to the nerves in the spine that control pelvic floor function. For more information on this treatment please look at the “Tibial nerve stimulation” section on this website.
Surgery is used in very limited cases of overactive bladder where symptoms have not responded to above mentioned treatments and symptoms are too bothersome.
Treatment with botulinum toxin A
This is an alternative treatment to surgery if other treatments including bladder training and medication have not helped your symptoms. It has not been licensed (approved) for the treatment of overactive bladder syndrome in the UK. Make sure that you discuss this procedure fully with your doctor and understand all of its risks and benefits before you go ahead with it. Click below to know more about this treatment.
Further help and information
www.bladderproblem.co.uk provides accessible information on how you can help to manage bladder conditions.
If you have any further questions, to make an appointment please contact.