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 Wang Shuai
Urology
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How is stress urinary incontinence treated?

Stress urinary incontinence primarily occurs when activities like coughing, sneezing, lifting heavy objects, or jumping rope cause a sudden increase in negative pressure, leading to urine leakage from the urethral opening. For the treatment of stress urinary incontinence, it is important to determine the severity of the condition. For mild stress urinary incontinence, improvement can be achieved through exercises that strengthen the urinary sphincter and the pelvic floor muscles. For moderate to severe stress urinary incontinence, surgical intervention is recommended, mainly through mid-urethral sling procedures to manage urination. Patients should also take care to minimize activities that suddenly increase abdominal pressure, such as lifting heavy objects, laughing heartily, or sneezing.

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

"Fecal incontinence requires registration at a colorectal surgery department for consultation. The causes of fecal incontinence mainly include neurogenic and local organic lesions of the anus. If it is due to neurogenic reasons, then it is necessary to coordinate with a neurology department to examine whether the local contraction function of the anus has deteriorated, leading to relaxation of the anal sphincter or incontinence during defecation. If there is an organic lesion in the anal sphincter, especially when the tightness of the sphincter increases leading to excessive relaxation of the anal sphincter, this can also cause fecal incontinence. To treat fecal incontinence, one can opt for local surgery to tighten the relaxed anal sphincter, thereby preventing feces from involuntarily leaking out of the anus."

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Written by Zhou Yan
Geriatrics
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What causes urinary incontinence in the elderly?

Urinary incontinence in the elderly varies due to different mechanisms and types, with the two most common categories being genuine urinary incontinence, which is due to neurogenic bladder dysfunction or overactive detrusor muscles, damage to the urethral sphincter, or loss of bladder storage function. These are commonly seen in conditions like chronic stroke, dementia, Parkinson's disease, and psychiatric diseases. The other major category is caused by relaxation of the urethral sphincter or pelvic floor muscles surrounding the urethra, leading to reduced urethral pressure. Incontinence in this category may occur when negative pressure increases, such as during coughing, sneezing, straining during bowel movements, or changing body position. This type of urinary incontinence is more common in elderly women and in elderly men who have had prostate removal, leading to damage to the external urethral sphincter.

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Written by Yang Dong
Colorectal Surgery Department
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How to recover from fecal incontinence?

For fecal incontinence, we must first conduct an effective evaluation and complete relevant examinations. For instance, we need to perform anal canal pressure measurements and examine the anal sphincter muscle imaging. Through these examinations, we can determine the extent of fecal incontinence and then adopt corresponding treatment methods. For fecal incontinence, we can initially choose conservative treatments, such as treatment with biofeedback therapy.

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Written by Du Rui Xia
Obstetrics
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Can you have intercourse with postpartum urinary incontinence?

Postpartum urinary incontinence should preclude sexual intercourse, as intercourse can exacerbate the condition. It is necessary to wait until recovery is achieved before resuming sexual activities. It is advised that patients promptly seek hospital treatment for pelvic floor muscle rehabilitation, which can generally bring effective relief within six months. If recovery begins after more than six months, the results can be poor. It is also important to develop good living habits, ensuring adequate sleep, avoiding fatigue, and refraining from heavy physical labor. Proper bowel movements should be maintained to prevent constipation, which can increase abdominal pressure and worsen urinary incontinence.