Incontinence Care After a Hysterectomy
A surgical procedure called a hysterectomy treats chronic or severe issues such as endometriosis, abnormal bleeding, uterine fibroids, cervical cancer, and uterine prolapse. The procedure removes one or more of the following parts: the uterus, cervix, fallopian tubes, or ovaries.
Women who undergo a hysterectomy may experience side effects, and one of the most
common is urinary incontinence, or a loss of bladder control that leads to leaking urine. Incontinence may develop immediately, or it might manifest years following the hysterectomy. The reason for this potential complication is that the surgical procedure greatly impacts the pelvic muscles that support the bladder.
It’s important to talk to your doctor about available treatments for incontinence instead of ignoring the problem. There are a number of ways to improve incontinence and more comfortably deal with the symptoms. If you ignore it, though, the issue may continue to worsen.
Is Incontinence Common After Hysterectomy?
Incontinence is one of the most common symptoms women experience after having a hysterectomy. Women who undergo this procedure are more than twice as likely to develop incontinence than those who haven’t had the surgery.
What Causes Bladder Leakage After Hysterectomy?
Nerve damage, decreased support of the pelvic floor muscles, and decreased estrogen levels can all contribute to the likelihood of having urinary incontinence following a hysterectomy. The types and severity of incontinence you experience depends on what type of hysterectomy you have. Some women have a total abdominal hysterectomy, while others only have a partial.
The types of incontinence most prevalent in women following a hysterectomy are:
- Urge incontinence or overactive bladder (OAB): This type of incontinence presents as a sudden, strong, and uncontrollable urge to urinate, along with a frequent urge to void. Leakage is a typical symptom.
- Stress urinary incontinence (SUI): Stress incontinence refers to leaking urine during certain activities that put stress on the bladder. These include things like coughing, sneezing, laughing, exercising, and lifting heavy items.
How Long Does It Take for Bladder to Heal After Hysterectomy?
Average recovery times to heal after a hysterectomy range from two to six weeks. However, your specific circumstances and surgery will influence how long your healing process lasts. It’s important to attend follow-up appointments with your doctor and report any symptoms you are having to get the best recommendations for a swift recovery.
It’s possible to develop a problem with a leaking bladder anytime after surgery. Some women don’t notice anything unusual for years. This is why it’s so important to take care of yourself and adopt a healthy lifestyle to minimize your risk of developing complications such as urinary incontinence.
What Holds Your Bladder Up After a Hysterectomy?
The bladder is held in place by the muscles of the pelvic floor. These same muscles support the uterus and intestines. A hysterectomy is just one of the ways the pelvic floor muscles may weaken, sag, and lead to urinary incontinence.
Causes of Incontinence After a Hysterectomy
The surgical procedure of a hysterectomy can sometimes cause damage to the urinary tract. The following are the main reasons behind bladder leakage problems following a hysterectomy.
Changes in Pelvic Floor Muscles and Bladder Support
The pelvic floor muscles help support the uterus, bowel, and bladder. If the uterus is removed, the muscles around it may sag and leave your bladder less supported. The surgical procedure can also cause damage to the urethral sphincter, which is responsible for holding urine and preventing leaks.
Damage to Nerves that Control Bladder Function
The uterus is located near the bladder nerves, making it common for these nerves to sustain damage during surgery to remove the uterus.
The hormone estrogen helps to support the pelvic floor muscles. If you have your ovaries removed, the drop in estrogen levels can weaken the pelvic floor and make you more likely to experience incontinence issues.
Tips for Managing Incontinence After a Hysterectomy
There are plenty of ways to treat incontinence after a hysterectomy. Many of them can be done in the privacy of your own home.
Kegels are a great way to strengthen your pelvic floor muscles unless your doctor recommends avoiding these exercises. They are simple to perform and can be done sitting, standing, or lying down. To do Kegel exercises, concentrate on tightening your pelvic floor muscles. These are the same muscles that stop the flow of urine. Hold the contraction for three to five seconds. Repeat the exercise 10 to 15 times, and do them three times throughout the day.
You can also slowly retrain your bladder to hold your urine for increasingly longer periods of time through bladder training. Try visiting the bathroom on a set schedule and gradually increasing the time between trips. When you feel the urge to urinate, hold it for five minutes if you can. Slowly add time until you can control your urine for longer periods and reduce the risk of leakage.
Diet and Fluid Management
Managing your food and beverage selection is another important way you can adjust your daily lifestyle to manage symptoms of incontinence. A simple thing to try is limiting your fluid intake in the evening to lower the incidence of nighttime incontinence. Don’t restrict your water intake too much, as not getting enough water can also be irritating to the bladder and lead to dehydration. Instead, you may want to drink water on a schedule to help time your bathroom trips and manage your incontinence.
Some foods and drinks are known bladder irritants that can actually contribute to incontinence. Several of these are caffeine, alcohol, spicy food, and some citrus. It’s best to avoid these foods and focus on eating lots of fresh fruits and vegetables and other healthy, whole foods packed with fiber.
Medications and Medical Devices
Medications used to treat urinary incontinence include anticholinergics like Ditropan XL, Detrol, and Enablex. Mirabegron and topical estrogen are also commonly prescribed.
If medications are insufficient, your healthcare provider may recommend a medical device. A urethral insert is a disposable device similar to a tampon that gets inserted into the urethra before triggering activities such as active sports. The insert is essentially a plug that you wear to temporarily stop leaks. Another device is called a pessary, which is a silicone ring worn in the vagina to support the urethra and lower the risk of leaks.
Electrical stimulation is another possible treatment to try. Other therapies include nerve stimulators and Botox injections.
If your incontinence is severe, you may want to talk to your doctor about your options for surgery:
- Prolapse surgery: Repairs to pelvic organ prolapse often help urinary incontinence.
- Artificial urinary sphincter: This is a fluid-filled ring implanted around the neck of the bladder to keep the sphincter shut. When you need to urinate, you press the implanted valve to deflate the ring and allow urine to pass.
- Sling procedure: A synthetic mesh material or tissue from your own body is used to make a sling underneath your bladder to help keep the urethra from leaking urine.
- Bladder neck suspension: This procedure supports the urethra and bladder neck.
Only your doctor can evaluate your symptoms and prescribe the best course of action. Always speak freely to your healthcare team, and be sure to clearly describe all your symptoms and their severity.
Urinary incontinence products such as protective underwear and bladder control pads are excellent tools to help you discretely manage leakage without changing your lifestyle and favorite activities. Products come in a broad range of sizes, styles, and absorbances so you can find one that works for you.
Coping With the Emotional Impact of Incontinence
Despite how common urinary incontinence is, many women still feel some level of embarrassment. This is not necessary. Incontinence is a widespread issue. By being more open and talking to others, you can eliminate the stigma and get the support you need to manage your condition.
Discuss Your Concerns With a Healthcare Provider
Talk to your doctor if you experience any new or unusual symptoms such as urine leakage, frequent urination, or a strong and uncontrollable urge to void. Incontinence is a widespread issue that doctors are familiar with, and they can offer you support and treatment methods to help. If necessary, they can refer you to a specialist who understands how to treat incontinence after a hysterectomy. Try keeping a journal of your symptoms and their severity to help yourself and your doctor discover patterns to better inform your treatment. Taking control of your symptoms gives you back the freedom to live your life as you choose.
Seek Support from Loved Ones or a Therapist
If you are experiencing stress or any negative emotional states from your incontinence, you need to seek out support. Talk to a trusted friend or family member, or schedule an appointment with a therapist. Speaking about your concerns is a great way to stop feeling alone. You may even discover that others have the same experience and can offer you advice.
Maintain a Positive Attitude and Prioritize Self-Care
Don’t let urinary incontinence stop you from living your life on your terms. Stay positive, and remember to take care of yourself. Keep in mind there are many treatment options available and it’s highly likely you will find one that works great for you. Remember that you may need to try a few different methods to find one that suits you, so stay upbeat and don’t get discouraged.
There is help for urinary incontinence after a hysterectomy. If you notice any changes in your urinary habits or experience leakage, talk to your doctor to discover more about the available treatments. Take action to make lifestyle changes that will improve your quality of life and allow you to continue doing what you enjoy most.