Generally, during pregnancy itself, a lady can experience incontinence. It’s because of the heavy uterus with the baby pressing down – the gravity of it and second because of the hormones which actually loosens the urethra and all the muscles.
KPJ Tawakkal Specialist Hospital Obstetrician and Gynaecologist consultant Dr Patricia Lim Su Lyn disclosed that it is quite common for some ladies to experience stress incontinence when they sneeze, or when they cough.
“They may leak a bit of urine, which is a good indicator. If someone has that during pregnancy, it is very likely that they may experience the same after pregnancy. Generally when I have patients complaining of that, I tell them to start their pelvic floor exercises.”
Pelvic floor exercises
The way to do pelvic floor exercises is what we call kegels – which is as if you’re trying to stop the urine half way, which we are supposed to do for at least 80 times a day.
“Some ladies my not know how to do it especially older women. So, what we have is a ‘bio-feedback’ which is a probe that is inserted into the vagina and we make them squeeze to see whether the pressure is good enough.”
In the market, there are few devices that helps with pelvic floor exercises.
“Biofeedback is not encouraged during pregnancy as anything inserted into the vagina is discouraged as we do not want to introduce infections. But after pregnancy, they can use that.”
“Generally we give six weeks for the hormones to get out of the system and the body to reverse back to normal after pregnancy to see if the incontinence still persist.
“If it’s still present, then obviously after making sure she doesn’t have any anatomical problems, or infections, then she would be given few options.”
“Kegel exercises is very good but it demands a lot of dedication and they would only start to see some effect after three to six months. For quick
measures, it would be the feminine laser that helps to strengthen the bladder neck by stimulating the collagen.”
This however would only last if she doesn’t get pregnant again. In the event where she does, symptoms may return, and she might need to do the treatment
again.
“In cases where incontinence is very bad and very stressing and if she has already completed her family, then she might consult an urogynaecologist.”
Options could be a sling that is a surgical procedure where it is inserted to hitch up the bladder neck again. But it is an operation done under anesthesia and done from the vagina. The other method would be through a tummy laparoscopy or open surgery. – The Health
