Overactive bladder

Happypoppy, do you have any known pelvic organ prolapse? For the sake of avoiding a UTI (I assume that’s been ruled out) you must do whatever moves you need to do in order to get your bladder empty, including getting down on hands and knees in the shower if that’s what it takes. Not being able to empty completely on the first try is typical of some types of prolapse, but you don’t mention any bulges or heaviness. I don’t know. Maybe some other suggestions will follow…… Surviving

Hmmm, I agree with Surviving that it would be worth getting a culture done to rule out a bladder infection of some sort. While the oxybutynin may have helped slightly it sounds like the side effects are pretty horrible. It still doesn't get at the cause, though.

Once you have ruled out a bladder infection you could try bladder training, which is really brain training, as much as anything. It involves making your bladder go for progressively longer between emptying, until you can go for a couple of hours without emptying. It works on the principle of ignoring signals that you would normally interpret as needing to go, and attuning your brain to only listen to the signals when your bladder really is full. There are so many signals happening in our bodies at any one time, initiating and stopping processes, interpreting and responding, etc. When you have had a baby it is a big upset to your whole body, and bits that were big start to shrink back again. The bladder is no longer underneath a big, heavy uterus. Is it any wonder that the signals get crossed sometimes. sometimes at the end of a pregnancy there isn't much room for any urine in the bladder and we get into the habit of emptying frequently. Then we cannot go back to holding on, especially if the urethra has been beaten up a bit during the birth. You might like to get a physical therapist to help you to do bladder training in a formal way. Otherwise, just try to hold on for a bit longer than you normally would, before visiting the loo. then making it a bit longer again the following day or couple of days.

It would also be potentially useful to diary when you empty, so you can follow your progress. We have had quite a few women on the Forums who have managed to overcome an overactive bladder in similar ways.

If this continence issue is bothering you sufficiently that you cannot drink before going out, it is serious enough to do something about it. Getting into the habit of restricting your fluid intake will not do your kidneys any good at all, and your urine will become more concentrated, which in itself can inflame your urethra and bladder and make it feel worse than it is. I am wondering if this indeed is another factor in your discomfort. You could also try using some zinc cream around your urethra if you think the area is getting 'burnt'.

How are your pelvic floor muscles? Can you get some movement out of them?

You say you had been 'sweeping your incontinence under the carpet'. Did you ask your obstetrician about it during the pregnancy or at the six week postpartum check?

In a woman who has had a baby the bladder tends to sag backwards a bit into the vagina and it kinks the urethra, effectively making a passive sphincter which will hold up until you sneeze or cough or jump. This stress incontinence usually goes away as a women gets older, as the action of the kink becomes more pronounced and keeps the urethra shut.

OK, now what to do about it? You can use your posture to move your bladder forwqards onto your pubic bones, rather than on top of your vagina. You can increase the lumbar curve in your spine by lifting your chest and making your abdominal cavity turn towards the back when it changes into the pelvic cavity. If you relax your belly at the same time it will tilt your bladder and uterus tilt forward into this new space in your lower belly, and it will redirect the intraabdominal forces that are generated during breathing, coughing, sneezing, etc , onto your loosened belly instead of onto the top of your vagina. Your bladder will be safely 'around the corner' of this new bend in your spine. Intraabdominal forces cannot travel around corners so your bladder will have less pressing on it.

You have another 12 months of reversion post-pregnancy still to go. I am sure you can help it along by paying some attention to your posture and teaching your bladder to hang on for longer. Actually a full bladder will help to support your uterus by taking up space, whereas an habitually empty bladder is not much help at all. Emptying your bladder from full will also help to flush out stale urine which may have a buildup of bacteria. Keep leaning forward when emptying, but make sure your belly is relaxed and between your thighs, rather than sucked in or compressed, which will both push it back further and engage that passive sphincter, which will prevent emptying. All fours in the shower can help. Standing up when you have finished, then sitting down and standing up again will often get a bit more out. Just make forward that whenever you empty your bladder your belly is loose and you are leaning forward, which stretches the urethra out lengthways for unimpeded flow.

Have a look at the FAQ's under the tab at the top of the page, and check out the Pelvic position video at the Wholewoman Center. See if any of this makes sense to you.

Use the search box to search for 'stress incontinence', and 'postpartum' Call back with more questions.