Please help me empty my bladder ?

Body: 

Good Evening,
I`m 40 yrs old and have 4 children-18 15 7 and 6 months.
After 2nd child about 13 years ago i had a posterior repair and perineal refashioning-very successful.
Then went on and had 2 further pregnancies-both labours were very difficult with several hours of pushing for both.
I now have a confirmed rather bad rectocele cystocele and uterine prolapse.
Declined surgery about 4 years ago as 2 surgeons both wanted to do hysterectomy at same time-fortunately i disagreed and went on to have my little girl !
Was entirely happy to postpone surgery for as long as pos as very mild symptoms-except progressively worsening slow urine flow.
Last year or so i`m having to push to finish the wee.
Have been on maintainence dose of antibiotics for 2 years due to recurrent urine infections caused by not emptying bladder.
This last week or so i am REALLY struggling to empty my bladder.
I feel unwell.Upping my antibiotics has made little difference.
I have persistant rt. sided kidney pain and now this dragging pain in my bladder.
My vagina feels like i`m in labour !
I`ve tried standing up, and hands and knees-however i pee i can only to the last 30 % ish by pushing-not a gentle push like i`ve got away with for ages-i mean going red in the face deep breath and really pushing down and eliminating probably another 300 mls !
Kidney scan 15 mths ago confirmed that i`m not emptying bladder however i couldnt continue with urodynamics investigations as was then 6 weeks pregnant.
I know my kidneys are now sufferring because i`ve had dull pain in same kidney for about 15 mths and now i`m itching all over. My urine is stale smelling and although specimens are almost always negative they always report debris +++ with protein and leucocytes on urinalysis.
Its going to be Friday before i see my doc and i have nt even had appt thro yet to see specialist so i really wanted to ask if i could try any position to pee-i do have a retroverted uterus btw.
Am i ok pushing this much-i have to empty my bladder to stop backflow right ? Its just that my prolapse is now bad again ?
Sorry its so long.
x

Hi sleepymum,
So sorry you are going through this. I see you said you've tried hands and knees -- do you get any relief with this? That would seem to be the best position to aid voiding, and if you find it does help, you may wish to wee over a bowl or in the shower whenever possible. I think your straining to void is not doing your prolapses any favors and could very well be contributing to their worsening. But you need to get the wee out . . . Have you been offered the option to self- catheterize? You would do it intermittently, with a straight cath. Not super fun, but seems preferable to straining and/or kidney infection. Call your doc about it, or even consider seeing an urgent care provider to get started with instruction and supplies. Hope things resolve for you soon. Also look at adopting whole woman posture to help reposition your bladder and uterus normally. I used to also have a retroverted uterus, but after almost 2 years of this work, it is now corrected.

While on the toilet to pee, I usually stand up for the last few seconds before the pee stops, and tilt forward a little with my knees bent to keep the flow going, and I always feel empty afterwards. For me, this works better than peeing on all fours.

Hi, Sleepymum,

When I pee, either sitting on the toilet or bending forward in the shower, I insert my two middle fingers into my vagina and press the bladder forward. You will know when you are holding the bladder at the correct angle because the urine will flow out easily. You can follow the bladder with your fingers while it empties and reduces in size, and squeeze it a little to make sure everything is out. Yes, you will pee on your hand. You can figure out the best ways to keep yourself and your surroundings clean. It's not difficult. I have had no urinary tract infections.

Best of luck to you on healing from this long and painful problem.

Ellen

something else to try in the shower--instead of just all fours, put your chest towards the ground and bum up to create more of an angle for your bladder to fall fowards. someone mentioned that once. Other people pee, stick bum up and wiggle, pee again, do the wiggle again, and then pee. christine talks about lifting your whole self off the toilet to create a force without pushing to get the last pee out, which is only going to make your pop worse. so keep experimenting--i'd feel confident you can find a position. and, lifting your bladder up, is another option. maybe not fun, but i'd rather do that than have surgery. (have you gotten Christine's book as yet? very informative re surgery!)

i'm also wondering what your diet is like. When I went on a strict anti inflammatory diet (put into WW search engine) about 18 months ago, my bladder symptoms got soooo much better. i had less frequency, and instead more proper peeing. in fact, over the last couple months i've been eating HORRIBLY. and i've noticed the frequency and irritation returning. last few days i'm slowly improving, and already noticing my bladder holds more, and i pee like normal.

christine did a post on prolapse as an inflammatory disease, as she felt such a huge impact of going anti inflammatory--did it for other things, but her POP really felt the difference.

have you started the posture, nauli and firebreathing? it is possibly to start to reverse your POP through WW techniques--the posture is key, and nauli and firebreathing really really help to lift things up. if you can get the DVD the other excercises are great, and just building in little bits into your day can make a big difference.

Kiki

I wouldn't mind guessing that your uterus has got itself jammed under your sacrum and is pushing the top of your vagina forward. This causes your cervix to point forwards. Your bladder will not be held down and forward so it can slip backwards more easily and get squashed downwards.

I would be inclined to re-do the urinalyisis fully, now you have had your baby. There may be some test that will show where the blockage is. Kidney is not liking this. That is not a good sign.

What sort of surgery does the doctor want to do? Where does he think the problem is?

I don't know much about this, but I imagine your bladder lining and urethra do not like stale urine and may be very inflamed. Perhaps you could catheterise for a while, just to allow the urine to flow better and become less concentrated, and allow the bladder and urethra lining to heal and settle down. Perhaps you could discuss with the doctor the less invasive options as well as the more invasive options.

You could also get a second opinion. Whatever happens it is your body, not theirs!

At 6 months postpartum you have not anywhere near returned your insides to their old size. You will have at least another 18 months of reversion, during which time you will notice a lot of improvement.

Louise