Mom's Health Class: Understanding and Dealing with Stress Urinary Incontinence

Author: Zeng Lu, The First Affiliated Hospital of Nanchang University

Reviewer: Zhu Jiaojiao, deputy chief nurse, the First Affiliated Hospital of Nanchang University

Dear mothers, have you ever experienced such an embarrassing moment: when you laugh, cough or sneeze, urine "runs out" uncontrollably? This is not a rare thing. Many mothers may have had such an experience after giving birth. This situation is often caused by postpartum urinary incontinence. Today we will talk about this "embarrassing" topic - postpartum stress urinary incontinence (the most common type of postpartum urinary incontinence), and tell you how to deal with it easily and regain your confidence!

1. What is postpartum stress urinary incontinence?

Postpartum stress urinary incontinence is caused by excessive stretching of the pelvic floor muscles, fascia, ligaments and other tissues during pregnancy and childbirth, which damages the pudendal nerve and leads to insufficient pelvic floor muscle strength, resulting in urine leakage. It is mainly manifested as uncontrolled urine leakage when the abdominal pressure increases sharply, such as coughing, sneezing, laughing, jumping or lifting heavy objects.

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2. What are the main risk factors for postpartum stress urinary incontinence?

(1) Reproductive factors: The age of first childbirth, mode of delivery, size of the fetus, and the incidence of urinary incontinence during pregnancy are all related to the occurrence of postpartum stress urinary incontinence. In addition, the older the childbearing age, the worse the body function related to childbearing. The pelvic floor muscles of older mothers aged ≥35 years are looser and less flexible than those of younger mothers, and the pelvic floor muscles are more easily damaged. Therefore, older mothers are more likely to suffer from urinary incontinence after childbirth.

(2) Obesity

Obese women have greater abdominal pressure, and the abdominal cavity is adjacent to the pelvic cavity. The increased pressure in the abdominal cavity compresses the pelvic cavity for a long time, causing the pelvic floor muscles to relax. Therefore, the probability of obese women developing stress urinary incontinence after childbirth is significantly increased.

3. How to determine whether postpartum stress urinary incontinence is serious?

(1) Mild: Urinary incontinence occurs when coughing or sneezing, and no urine pad is required.

(2) Moderate: Urinary incontinence occurs during daily activities such as brisk walking, running, and jumping, and requires the use of a urine pad.

(3) Severe: Urinary incontinence occurs with slight activity or change in lying position, and urine pads need to be used for a long time.

4. How to avoid postpartum stress urinary incontinence?

(1) Pelvic floor muscle exercise: also known as "Kegel exercise". Kegel exercise is a simple and effective way to exercise the pelvic floor muscles. It can strengthen the motor ability of the pelvic floor muscles. The specific method is to imagine that you are trying to stop urination, tighten your muscles, hold for 5 to 10 seconds, and then relax. This is a set of movements. Do it several times a day, and repeat about 10 sets each time. It may not feel easy at first, but if you stick to it, mothers will gradually feel the improvement. The cat-cow exercise is also helpful for repairing the pelvic floor muscles!

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Tips for pelvic floor muscle training: ① Before doing pelvic floor muscle training, it is best to consult a doctor; ② If you often experience urinary incontinence when coughing or sneezing, you may need to increase the intensity of the exercise.

(2) Return to normal weight after childbirth: Being overweight will put unnecessary pressure on the pelvic floor, so returning to normal weight after childbirth is very important for preventing postpartum urinary incontinence. Healthy eating habits and moderate exercise can help mothers recover their body shape faster and reduce the pressure on the pelvic floor. However, it is important to take it step by step and not rush for quick results.

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(3) Avoid excessive exertion after childbirth: In addition to pelvic floor muscle exercises and restoring normal weight, you also need to pay attention to avoiding excessive exertion in your daily life. For example, try to avoid lifting heavy objects, as this will increase abdominal pressure and add unnecessary pressure to the pelvic floor.

(4) Others

For mothers, standing or squatting for a long time will also increase the burden on the pelvic floor. They should change their posture in time and take proper rest. In addition, when mothers cough or sneeze, they can gently press the lower abdomen to help reduce the risk of accidental leakage of urine.

(5) Seek medical help: If the above methods cannot avoid urinary incontinence, mothers must seek medical attention in time. Doctors will usually recommend physical therapy, such as electrical stimulation or biofeedback training, to help you better control your pelvic floor muscles. In some cases, doctors will also consider medication or surgery. No matter which method you use, the key is to find the solution that suits you best and be patient, because recovery may take some time!

When facing postpartum urinary incontinence, mothers do not need to be shy or worried. Through proper exercise and lifestyle adjustments, most people can effectively relieve the symptoms!

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