Why Does Post-natal Incontinence Happen?

In many cases incontinence is something which occurs during pregnancy, but for some mums the issue can linger long after childbirth. Post-natal incontinence is actually very common among mums, especially for women who have delivered their baby vaginally.

It is estimated that incontinence following pregnancy and childbirth affects up to 50 percent of women. Although most problems resolve themselves within a year of giving birth, there are many women who suffer with lingering issues. Fortunately, there are treatment options available to solve the issue, including sacrohysteropexy surgery and intensive courses of physiotherapy from a qualified pelvic floor physiotherapist.

Why do some women suffer from post-natal incontinence?

Incontinence is caused either by an increased urge to urinate or through stress from laughing, sneezing, coughing, running or jumping. In the third trimester of pregnancy the growing uterus starts to put increased pressure on the bladder, the body also begins to release hormones to improve the elasticity of joints for delivery. Together these changes in the body reduce the support provided to the bladder, so occasionally it can begin to leak.

Many of the women who suffer from stress incontinence also suffer from urge incontinence, which is caused by an overactive bladder. Those who are over 35 or obese are at a greater risk of developing both stress and urge incontinence during pregnancy. But, following childbirth the most likely sufferers are those who have delivered vaginally or suffered with uterine prolapses, especially following delivery interventions such as forceps which can damage pelvic muscles.

When should treatment be sought?

Incontinence is something which can interfere very quickly with your daily life, impacting everything from your career to your love life. If you notice even a small amount of urine leaking while coughing or sneezing, it is worth talking to your doctor as it’s rare that the issue will cure itself.

How do the pelvic floor muscles work?

The first step to curing incontinence is to establish the cause, which in most cases is weakened pelvic floor muscles. The pelvic floor is a set of muscles which are located in the pelvis between the frontal pubic bone and the base of the spine. The muscles create a hammock to hold the uterus, vagina, bowel and bladder in place, and they also provide control to the bladder during urination. During urination the muscles relax to release urine, they then tighten to re-close the bladder.

What are the treatment options?

For those who suffer from stress incontinence due to uterine prolapse or pelvic floor weakness, it may seem like there are no options. In mild cases, many professionals will recommend working on behaviour and lifestyle choices, such as examining your activities and losing weight if you BMI is higher than it should be. In all cases, physiotherapy is always recommended this can positively impact the pelvis floor muscles. In the first three months post delivery, it is always beneficial to seek help with pelvic floor physiotherapy.

If after three months of daily physiotherapy, there seems to be little difference, then this is the time to come and see Mr Broome. He is a gynaecologist specialising in pelvic floor repair and has had many ladies visit him due to incontinence after delivery. He can advise a way forward to regain your quality of life. Nobody wants to be young, with young children and suffering from incontincence. Mr Broome, at a consultation, will examine you for the causes of your incontinence and also check to see if uterine prolapse  might be a factor. If so, he will talk through the prospect of having sacrohysteropexy surgery, which is a permanent solution to repositioning the uterus and subsequently enabling other organs in the abdomen to realign.

What is sacrohysteropexy surgery?

Sacrohysteropexy surgery is a highly effective solution for those who have suffered a uterine prolapse. As it is such a delicate procedure it is essential that patients choose a qualified and experienced surgeon. There are many women who fear the only option is to undergo a hysterectomy, but Mr Broome has enabled many young women to have more children with no further prolapses or incontinence issues.

The procedure involves using a strip of synthetic mesh to hold and lift the uterus in place. This is NOT vaginally inserted but instead carefully inserted via tiny keyhole wounds in the stomach wall as it is a keyhole procedure. Sacrohysteropexy surgery has significantly less side effects as a consequence and Mr Broome will be happy to talk these through with you. During the procedures, Mr Broome will attach one end of the mesh to the sacral bone, with the other end attached to the cervix or top of the vagina.

How can a physiotherapist help?

By working on strengthening the pelvic floor muscles, the root cause of post-natal incontinence can often be removed. It is very common for women to perform pelvic floor exercises at home, but for many people there is a lack of knowledge which can prevent results. A qualified physiotherapist will have the skills needed to assess, treat and educate women so they are cured of post-natal incontinence.

The sessions would start with an initial consultation to establish whether the patient is ready to begin a physiotherapy programme. The physiotherapist will then assess strength, flexibility and posture, which could all have an impact on muscle control following pregnancy. A programme will then be established which teaches the patient how to perform exercises which safely and effectively improve pelvic floor strength.

Mr Jonathan Broome is a highly regarded surgeon who regularly carries out pelvic floor repairs through physiotherapy and Sacrohysteropexy. To find out more about how Mr Broome can help you with your incontinence problem, please contact our team.


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