Some women suffer from unexpected bladder problems after hysterectomy, like a weak bladder or repeated infections.
We all know that having problems with our bladder is a part of getting old.
But, if you have to face problems like incontinence in your early forties, that is hard to accept.
It is not uncommon that post-hysterectomy women complain about a lack of bladder control, bladder spasms, a burning feeling and frequent visits to the bathroom.
Though there is often no need for concern, as most of these problems will resolve themselves in time.
A hysterectomy is a major operation that will weaken the pelvic muscles.
After the hysterectomy your bladder will miss the support it had from your uterus and its place in the pelvis will be different. During your hysterectomy recovery period, the pelvis will heal and your feeling and control of the bladder will gradually return.
Sometimes these bladder problems insist. Bladder problems after hysterectomy that may need medical attention are bladder injury, overactive bladder, stress incontinence, and bladder infections.
Potential bladder problems after hysterectomy
1. Bladder injury
With every operation, there is a risk of complications. One of the risks of a hysterectomy is that the surgeon can accidentally injure the bladder with one of the instruments. Usually, when this happens the surgeon will try to repair it. But if the injury goes unnoticed, one may suffer very uncomfortable complications.
For instance, when urine is leaking from the bladder in the abdomen, it may cause peritonitis, a life-threatening condition.
When your bladder problems after hysterectomy begin with urine leaking from the vagina, it is likely that a hole (fistula) exists between the bladder and the vagina. Such a vesicovaginal fistula is often the result of untreated bladder injury and rarely closes spontaneously. This means the woman will need a second surgery to close this abnormal passage.
They may say bladder injuries are rare, as they happen in only 2% of all hysterectomy surgeries. In the US they do yearly 600.000 hysterectomies, this means that 12.000 women will suffer bladder injury.
2. Overactive bladder problems after hysterectomy
Sometimes nerve damage or infections are the reason for an overactive bladder after surgery.
This crazy, unstoppable feeling that you have to go to the toilet, even if you have little or no urine in the bladder is because of a malfunctioning of the bladder’s Detrusor muscle.
Overactive bladder problems after hysterectomy include frequent visits to the bathroom, even during the night (nocturia) and leaking urine.
What can you do about it?
• Strengthen the pelvic muscles with Kegel exercises.
• Avoid substances that will irritate the bladder like coffee, alcohol, carbonated drinks and spicy meals.
• Get rid of the extra pounds, as your extra weight can have a notable impact on the pelvic floor muscles that support your bladder.
• There are several medications (anticholinergics ) that can help to relax the Detrusor muscle. Common side effects of these medications are a dry mouth, constipation and sometimes confusion.
3. Weak bladder
The inability to hold urine when you cough or laugh one calls stress incontinence, or as many women call it, a weak bladder. In fact, it is a weakness of the muscles and the tissues that support the uterus and bladder. These are better known as the pelvic floor muscles.
During a surgery, there is an increased risk of damage to these pelvic floor muscles which often results in bladder problems after hysterectomy.
If during surgery they remove the ovaries, estrogen levels in the body will drop. Low estrogen levels cause weak and less flexible tissues in the pelvic area. You can correct a lot with pelvic floor exercise but sometimes it is so severe that a dropped bladder occurs (prolapse) and a woman needs surgical treatment.
A Swedish study shows, that women that underwent a hysterectomy were 2.7 times more at risk of having urinary incontinence surgery within the next 5 years.
4. Bladder infection
Infections are common bladder problems after hysterectomy surgery. Usually, they insert a catheter before or during a hysterectomy operation. With catheterization comes an increased risk of bacteria entering the urinary tract.
This may cause an infection of the urethra or bladder which can, if not taken care of, eventually spread to the kidneys.
Normally the catheter stays in for one or two days and then they remove it before you go home.
Though, women often develop a UTI after they have gone home. First signs that show you may have a urinary tract infection are:
• a burning feeling or pain when urinating
• a feeling you need to urinate but you can’t
• urinating more than usual
• that the urine smells bad and is dark or cloudy
Your doctor may want you to have a urine test to confirm that you have a urinary tract infection. You will soon feel better when you start antibiotic treatment and pain relieving medication.
Most common bladder problems after hysterectomy are recurring urinary tract infections. The sudden drop of the hormone estrogen is responsible for the weakening of the tissues of the urethra and vagina, making women more susceptible to UTIs. Low-dose vaginal creams containing estrogen are in some cases beneficial in recurring infections.
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