What causes postpartum urinary incontinence?

Written by Du Rui Xia
Obstetrics
Updated on September 29, 2024
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Postpartum urinary incontinence in women often occurs after vaginal delivery. Clinically, postpartum urinary incontinence is relatively common and is mostly due to the stretching or injury of certain muscle groups in the pelvic floor as the baby passes through the birth canal during delivery. This can also occur due to surgical intervention affecting the nerves and blood vessels that support the pelvic floor, leading to relaxation or atrophy of the levator ani muscle. Postpartum urinary incontinence typically occurs about a week after delivery, and timely treatment is necessary. During the treatment period, bed rest is advised, which can alleviate some of the discomforts and possibly avoid the need for surgery.

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Written by Zou De Bo
Urology
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"What tests should be done for urinary incontinence?"

Urinary incontinence is due to damage to the bladder sphincter or nerve dysfunction, resulting in the loss of voluntary control over urination, causing involuntary leakage of urine. This condition is more common in females than males, especially in women over fifty years of age. Some routine examinations for this condition include: First, urinalysis. Second, measuring residual urine volume, cystourethrography, bladder pressure tests, and then standing cystography. Additionally, tests such as urodynamic studies are helpful.

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Written by Wang Shuai
Urology
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What are the characteristics of the various types of urinary incontinence?

There are several types of urinary incontinence, common ones include stress incontinence, urge incontinence, overflow incontinence, and true incontinence. Stress incontinence, which is common in clinical practice, primarily occurs in women, especially in those who have given birth, are obese, or are elderly. It is characterized by the involuntary leakage of urine through the urethra during coughing, laughing, or sneezing. Urge incontinence, often seen in acute bladder inflammation, usually presents with symptoms such as frequent urination, urgency, painful urination, and pain in the lower abdomen before the onset of incontinence. Overflow incontinence is more common in elderly men, caused by urinary obstructions, such as those resulting from prostatic hyperplasia compressing the urethra, leading to urinary retention. In this case, the patient's bladder area may exhibit significant distension and tenderness. True incontinence is often seen in cases of neurological damage, such as from spinal injury or intracranial disorders.

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Written by Guan Hai Fang
Urology
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Where is there a specialty for urinary incontinence?

Generally speaking, urinary incontinence falls under the category of urology, though some aspects could also be seen by specialists in men's health, who can effectively treat symptoms of urinary incontinence. Generally, it is recommended that patients seek examination and treatment in public hospitals, as the treatment provided in private hospitals is often not as reliable. For patients with urinary incontinence, it is advisable to consult the urology department if visiting a hospital. The urology department primarily deals with diseases of the kidneys, ureters, bladder, and urethra. Typically, urinary incontinence involves issues with the urethra or bladder, which can lead to incontinence. Therefore, it is advisable for patients to visit a reputable public hospital and consult the urology department.

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Written by Zhang Lu
Obstetrics
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Will urinary incontinence heal itself after a vaginal delivery?

During natural childbirth, because it can damage pelvic floor function, causing issues such as bladder prolapse, uterine prolapse, and a series of other pelvic floor dysfunctions, some women may experience urinary incontinence after giving birth. If urinary incontinence occurs after natural childbirth, it suggests that the damage to the pelvic floor functions is quite severe, and these conditions generally cannot heal on their own. First, a pelvic floor function test should be conducted to assess the condition of the pelvic floor. If the damage to the pelvic floor is minor, it can be improved through machine-assisted treatment and performing Kegel exercises, which also help enhance pelvic floor functions. If the evaluation reveals severe prolapse, pelvic floor reconstructive surgery is required to suture the prolapsed bladder or uterus back into place, which can improve urinary incontinence. Therefore, urinary incontinence after natural childbirth generally does not heal on its own.

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Written by Chen Tian Jing
Colorectal Surgery
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What department should I go to for fecal incontinence?

If there is fecal incontinence, it is first necessary to determine the cause. If the incontinence is due to general neurological symptoms and neuropathy, then it is necessary to register for a neurology department consultation. If it is due to relaxation of the local anal sphincter, then registration with the proctology department is needed. Generally, for local sphincter relaxation causing fecal incontinence, an anal sphincter tightening procedure can be opted for, to provide local symptom relief. Additionally, it is important to also consider coordinating with traditional Chinese medicine enemas, which can enhance the mucosa within the rectum.