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What is urinary incontinence?
Normally, the urine that your kidneys produce goes into a reservoir called the bladder. It is thanks to a circular muscle called the sphincter that the bladder remains closed. When your bladder is full, the sphincter is stimulated and you feel the urge to urinate. The sphincter opens and urine flows out through a duct called the urethra. Sometimes this muscle does not work well and there may be uncontrolled urine leakage during exertion, for example.
The different forms of urinary incontinence
Among young mothers, we talk aboutincontinence d’effort. Leaks can occur when coughing or sneezing, but also when laughing. It is common for physical or sports activity to trigger them. For example if you run or climb stairs. Sometimes a change in position, such as getting up suddenly, can cause leakage. In all these situations, urine leaks happen without you having felt the need to urinate.
Sometimes urine leakage is preceded by a frequent, urgent and irrepressible urge to urinate. You can’t hold back. We then speak ofurge incontinence or bladder incontinence. If the two forms of incontinence are combined, this is calledmixed incontinence.
Urinary incontinence favored by pregnancy and childbirth
Blame it on hormones: many factors come into play, but the main one is pregnancy. The hormonal upheavals during this period act on the tone of the small muscles enclosing the urethra. Suddenly it does not contract sufficiently and it is the leak. In addition, when standing, the uterine volume “crushes” the bladder and amplifies the problem.
The fault also with childbirth. It can cause lesions in the muscles around the urethra but also in the perineum, promoting relaxation of the pelvic floor. You are more at risk if you have given birth to a large baby, had a torn perineum, or the doctor used forceps.
Other elements also predispose future or new mothers to incontinence: overweight, constipation, a chronic cough or certain sports encourage too much pressure in the abdomen (aerobics, tennis, jogging). If you are prone to UTIs you are also at greater risk. Ditto for moms who smoke.
Can we prevent urinary incontinence?
There are no “miracle” solutions: the best is toas much as possible mimic drinks that excite the bladder, such as tea or coffee. And continue to hydrate yourself properly with 1,5 to 2 liters of water per day. Delegate to your companion the port of the water pack or basket on return from the market. Walk, swim, but stop rebounding sports or sit-ups that put too much pressure on the pelvic floor.
Pregnant urinary leaks and incontinence: who to talk to?
A small occasional urine leak during pregnancy is often harmless and everything is usually fine after childbirth. Sometimes the problem persists after the baby is born. Do not hesitate to talk about it very quickly from the stay in the maternity ward to the midwives or the obstetrician. Also take advantage of the postnatal visit to discuss the problem. The professional you will see, after a brief review and a few questions on the importance of leaks, will offer you suitable solutions.
Treatments to fight urinary incontinence
The good news is that there is a solution for every case. First of all, you have to re-educate your perineum. This set of muscles and ligaments forms a kind of hammock that supports the bladder, uterus and rectum. In the event of too much slackening, it is necessary re-muscle it with appropriate exercises. This is the purpose of the sessions that will be prescribed for you. Usually ten is enough.
Note that even if some women have more resistant perineum than others, it is strongly recommended to all young mothers to follow a perineal rehabilitation 6 to 8 weeks after childbirth. You can then resume sports activity (on the advice of your doctor) and strengthen your muscles. Small precision: at the beginning, you will have to avoid violent sports such as running or jumping rope.
Your perineum is even more weakened if:
- Baby weighs more than 3,7 kg at birth
- his head circumference exceeds 35 cm
- you used a forceps for childbirth
- it is not the first pregnancy.
If, despite everything, the leaks persist, your gynecologist may suggest simple surgery. It consists in setting up a small polypropylene strip (TVT) under the urethra to support it. The results are very fast. For cases of urge incontinence, specific treatment is needed that will regulate the uncontrolled contractions of the bladder.