How To Prevent And Treat Early Postpartum Urinary Incontinence In Women

From the moment a woman confirms her pregnancy, she begins to analyze every little change her body experiences. While some of the symptoms, such as dizziness, nausea, or cravings for certain foods are some of the most common, there are others that, at least until recently, have not been talked about as much.

We refer to urinary incontinence, the involuntary loss of urine caused by pelvic floor dysfunction. And it is that many women can lose a little urine every time they cough, sneeze or even when they laugh. Why happens?

Urinary incontinence, an underdiagnosed problem

When a growing uterus puts pressure on the bladder, therefore, it can cause the need to urinate frequently and, sometimes, urinary incontinence, which can become a loss in the quality of life of the person who suffers from it. As recognized by the International Continence Society , any involuntary loss of urine is a social and hygienic problem .

As the baby grows, it pushes down on the muscles of the bladder, urethra, and pelvic floor. And it is this pressure that can weaken the pelvic floor muscles and cause incontinence, which has a prevalence that ranges between 3% and 67%.

The good news in all of this is that many of these bladder control problems go away after childbirth and, most importantly, can be prevented with an effective prevention strategy , especially during pregnancy. Although until recently, and despite the fact that 55% of women of reproductive age suffer from some type of urinary incontinence, few seek medical help.

As recognized by Dr. Carmen Urbaneja, assistant to the Rehabilitation Service of the Fundación Jiménez Día z, the trend is changing and the number of people who are beginning to report their problem to seek help is increasing.

Act before, during and after pregnancy to treat urinary incontinence

The Jiménez Díaz Foundation, aware of the importance of helping women to prevent this problem and of raising awareness of the relevance of this pathology, develops a Postpartum Incontinence Prevention project that offers specific information, diagnosis and treatment to help reduce incontinence urinary 

“We intend to detect risk groups and act on them before the appearance of symptoms,” specifies the specialist. And do it before the problem appears, not after, as has traditionally been done. Pelvic floor muscle training helps prevent incontinence in late pregnancy and after childbirth. 

Pelvic floor physiotherapy, with a healing rate of between 50% and 70% of cases, is the first technique of choice in mild and moderate cases of pelvic floor pathology. A rigorous training plan is not necessary.

The practice of simple and personalized exercises allows the body to adapt to the changes experienced during pregnancy, reinforcing the structures that will have to work harder, especially during childbirth.

Its effectiveness is also demonstrated by a Cochrane review , according to which pelvic floor muscle exercises in the first stage of pregnancy can prevent urinary incontinence after childbirth, especially if these exercises are personalized. 

“The exercises work on posture, the location of the pelvic floor muscles, the learning of the perineal block and the activation and work of the abdominolumbopelvic component,” admits Silvia Calvo, physiotherapy coordinator of the Rehabilitation Unit of the Jiménez Díaz Foundation.

Thanks to the project implemented by the Foundation’s Gynecology and Rehabilitation services, in which 300 women have already participated, they have a series of videos and explanatory documents, available on the Patient Portal, which allow them to better understand the exercises for execute them correctly during pregnancy.

Experts assess the status of women “during the first and third trimesters of pregnancy through questionnaires to find out their situation and possible risks of developing urinary incontinence,” admits Almudena Prieto, physiotherapist of the Rehabilitation Service. Pelvic floor exercises, Kegel exercises , can improve urinary incontinence by up to 60%.

But the job doesn’t end when the pregnancy ends. She continues after giving birth, for about six months, in order to control the evolution of incontinence. Projects such as that of the Jiménez Díaz Foundation allow not only to offer a complete service to prevent the problem, but also “contribute to making women and professionals aware of the relevance of this pathology”, highlights Dr. Manuel Albi, head of the Department of Gynecology and Hospital Obstetrics, and opens the door to developing strategies aimed at preventing and treating early urinary incontinence in women.

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