Common Types Of Bladder Dysfunction
We’ve all heard it from older generations of women who have had babies, and even our friends. “Oh I just leak when I cough or sneeze, but it’s no big deal!” There is no doubt that this is really common. And there are lots of reasons for that! But it definitely is not an acceptable standard! During pregnancy and postpartum bladder dysfunction can be resolved, and in most cases, pretty easily!
So first, lets break it down. What is urinary or bladder dysfunction and what causes it?
Urinary dysfunction is any change in bladder function that interrupts normal life. I like to think of it as, if you are always thinking or worrying about how your bladder will function, that is dysfunction. Our bowel and bladder systems should be automatic and trustworthy.
But here’s what happens. We get pregnant and our uterus grows…so much. The uterus lives just behind the bladder, and paired with hormonal changes, the pressure on the bladder causes us to pee more frequently. Especially at the beginning and end of pregnancy. Sometimes after we deliver our babies, as our uterus shrinks, we need to re-learn to trust our bladder again to be able to fill fully. Additionally, during pregnancy our pelvic floor and deep core, the muscles responsible for managing pressure and supporting bladder function, get really stretched out. This weakens them and makes them less responsive to pressure changes. So when we have an increase in pressure like a cough, sneeze or jump on a trampoline, we overload the pelvic floor. If we don’t actively retrain the muscles of the pelvic floor and core to tolerate that load, then we leak!
Here are some common types of urinary dysfunction you may have heard of but not known quite what they meant.
Frequency
***This one is somewhat unavoidable during pregnancy but should not persist postpartum
Voiding a lot! More than 5-8 times/day
Voiding very often for just a few seconds, indicating that the bladder did not truly need to be emptied
Voiding at night - some people have always voided once at night, but this should be max Going “just in case” all the time
Urge urinary incontinence
Feeling sudden severe urgency to need to pee
Feeling the urge to pee as soon as you see your house or the toilet
Feeling the urge to pee as soon as you hear running water
Leaking as soon as you feel severe urgency
This urgency may or may not be associated with a full bladder
Stress urinary incontinence
Leakage with “stress” on the pelvic floor
Leakage with running, jumping, sneezing, coughing
Insensible leakage
Leaking when you first stand up from sitting or change positions
Leaking while walking
Realizing pad or underwear are wet without ever feeling the sensation of having to go to the bathroom or leaking
Incomplete voiding
Feeling that you still have to pee as soon as you stand up
May be accompanied by “post micturition dribble” where you leak when you stand up after voiding
You may find that you have to strain to empty your bladder
Mixed urinary incontinence
A combination of any of the above symptoms
All of these types of bladder dysfunction are common during pregnancy and really common postpartum, but they can all be managed. The problem is that most people are not referred to a trained provider with expertise in managing these issues. Meeting with a skilled pelvic floor PT is so vital because there is no “one size fits all” approach to treatment, but there are some generalized strategies that help most people. For some of those pearls, check out the next post.
