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Incontinence After Pregnancy

Nearly four in ten women will experience some degree of incontinence after giving birth. For some, this bothersome condition will go away on its own within the first six weeks after birth. But what if the problem persists?

Dr. Robert Chan, a urologist at MarinHealth Urology | A UCSF Health Clinic, specializes in incontinence and pelvic reconstruction. Here, he discusses the causes of post-pregnancy incontinence and what can be done to treat the condition so it does not become a problem long-term.
Incontinence After Pregnancy
Featuring:
Robert Chan, MD
Dr. Robert Chan recently moved from Texas to join MarinHealth Urology | A UCSF Health Clinic. Dr. Chan attended Stanford University and graduated with Distinction in the top 15% of his class. He majored in Biology. He attended medical school at Vanderbilt University School of Medicine in Nashville, Tennessee. 

Learn more about Robert Chan, MD
Transcription:

Bill Klaproth Host): Incontinence can be a physical issue after pregnancy. So, what causes it and how can it be resolved? Let's find out what Dr. Robert Chan, a Urologist at MarinHealth Urology, a UCSF Health Clinic.

This is the Healing Podcast brought to you by MarinHealth. I'm Bill Klaproth. Dr. Chan, thank you so much for your time. It is great to talk with you. So, first off can you give us a bit of background on yourself and your credentials?

Robert Chan, MD (Guest): Thanks for having me Bill. I'm a Urologist over at MarinHealth Urology, UCSF's Health Clinic. I specialize in neurourology, urinary incontinence and pelvic reconstruction.

Host: So, women can often have physical issues after giving birth, and incontinence is one of them, is that correct Dr. Chan?

Dr. Chan: Yes. It's something that's really common. During pregnancy and after women give birth, many women experience, some degree of urinary incontinence or leakage of urine. It might be a little bit. And then some women, it might be a lot.

Host: And do we know what causes this in women during or after pregnancy?

Dr. Chan: Yeah. The actual part of pregnancy when the uterus gets a lot bigger, it puts a lot of strain on the pelvic floor muscles and weakens them. And then giving birth with like a vaginal delivery ends up weakening those muscles even more. Now there are some like risk factors for women who develop urinary incontinence, such as the length of the delivery, if they needed to have like forceps used during delivery, high body mass index and smoking just because it causes people to cough more.

Host: So, you said this is pretty common. At what point should a woman decide to go see her physician about this?

Dr. Chan: This is something that almost four in 10 women end up experiencing as part of the pregnancy process. If urinary incontinence is still present after about six weeks after the delivery, it's a good idea to reach out to their physician, whether it be their primary care doctor or their OB GYN. It's one of those things that I think the sooner you take care of it and treat it, it prevents it from developing into a long-term problem.

Host: So, in addition to pregnancy, giving birth and now having a newborn, now here comes incontinence. Women have a lot to deal with. This added stress really is not good, right?

Dr. Chan: Yeah, definitely. I have a four year old. And so I'm not too far removed from seeing my wife kind of go through this part of life and, you know, it's very stressful and just having to deal with urinary incontinence issues and kind of the changes in their bodies, just adds a lot more stress for sure.

Host: Well, it's easy to see how this does add a lot of stress. I have two kids and I've seen what my wife has gone through. These issues can cause stress and anxiety and sleep issues and other functionality issues, and interfere with day-to-day tasks. This really is bothersome. And I'm sure you hear these concerns all the time from women is that right, Dr. Chan?

Dr. Chan: Yeah, definitely. It's not uncommon to hear the things. Sometimes women are a little embarrassed, about kind of bringing these things up. They think that maybe it's not that big of a deal or that it's just sort of part of the process. And then some other women think that, well, there's not like an easy fix for it. So, they may not talk about it. But I think one of the things I want to kind of emphasize, if it's impacting their quality of life, you know, whether it be not being able to sleep through the night very well or not being able to have intercourse because of fear of leakage, then those are all things that are fixable and fixing them can really improve the quality of their life.

Host: So, you've been talking about how this can be fixed, how incontinence can be resolved. Does it generally go away on its own and if not what are the solution options available?

Dr. Chan: Sometimes they can go away on their own, just not having that huge uterus there pushing down on the pelvic muscles helps relieve it. But if it doesn't, then it's best to kind of be proactive to help speed up the process of recovery and healing. There's two types of urinary incontinence, like stress incontinence, which is the coughing, laughing, sneezing incontinence. And an easy way to kind of help improve upon this is something called Kegel exercises or pelvic floor muscle exercises. And then if that doesn't fix it, there's like a short, surgical procedure that we can do as urologists. That is just an outpatient procedure. It takes about 15 minutes. The recovery is pretty quick.

Host: So, this sounds promising this can be resolved, but I would imagine it requires taking that first step and having a conversation to get the help needed, right? So, should a woman speak first to her OB GYN or her primary care physician, or should they call a urologist? What is that first step they should do?

Dr. Chan: I think the best first step is reaching out to whoever they already have a relationship with. Usually for a woman it might be their gynecologist. They'll be seeing them after the pregnancy, and they can bring up these issues. Now, if it's been a more prolonged time since the delivery, like maybe a year or two, and they haven't been as much in touch, they can reach out to their primary care doctor or come directly to urologists. Especially if they've already tried some things, like the simple things, like the pelvic floor exercises, and it seems like it's not working.

Host: Well, this is really important to have a discussion on this. Some women, like you say, feel like, oh, I can't do anything about it, but yes you can. And it's good to go check and see, talk with your physician about this and get some help to get it resolved. Dr. Chan, this has really been interesting and informative. Thank you so much, for your time. We appreciate it.

Dr. Chan: Yeah. Thank you so much, Bill.

Host: That's Dr. Robert Chan. And for more information, please visit mymarinhealth.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is the Healing Podcast brought to you by MarinHealth. I'm Bill Klaproth. Thanks for listening.