Incontinence After Surgery

If you’ve had pelvic, abdominal, or spinal surgery, it’s likely you’re now dealing with some incontinence.

It’s a complication that’s not often discussed but can significantly impact daily life. From your hobbies and clothing choices to your morning coffee and social life, it might seem like it affects everything.

This guide aims to tackle that. It covers everything you need to know about postoperative urinary incontinence, including strategies, innovative therapies, and tips for managing the condition comfortably and confidently.

What Causes Incontinence After Surgery?

Incontinence is common after surgery because it can be triggered by many different things, from medication side effects to surgical trauma.

Working with your doctor or surgeon to figure out the root cause of your issue is essential. It will allow you to make informed decisions, seek the most effective treatment, and prevent further issues.

Some of the most common causes of incontinence after surgery include:

• Side Effects of Medication. Medications administered during or after surgery can contribute to bladder leakage. Diuretics, for example, increase the amount of urine that is produced, while narcotic painkillers make it harder to sense when the bladder is full.

• Urinary Retention. The inability to pass urine after surgery, or postoperative urinary retention, is extremely common. A number of things contribute to it, including anesthesia which affects the body’s ability to urinate normally. Pain after surgery can also cause the bladder to overfill and then leak. (1).

• Nerve Damage. A potential complication of pelvic surgery (a hysterectomy for example) is damage to the nerves that control bladder function. When this type of injury occurs, incontinence can develop. (2).

• Pelvic Floor Injury. Surgery can damage the muscles, ligaments, and connective tissues responsible for supporting the bladder and urethra (the tube that carries urine out of the body). . When these supports are injured or weakened, symptoms of incontinence can develop.

• Anatomic Changes. Some surgeries, like hysterectomies (removal of the uterus) or prostatectomies (removal of the prostate), involve the removal or repositioning of pelvic organs or structures. These anatomic changes can affect bladder function and cause urine leakage.

• Post-Surgical Complications. Complications of surgery like infection, inflammation, and scarring can contribute to incontinence.

• Bladder or Urinary Tract Trauma. Damage to the bladder or urethra during surgery can affect the way they function and cause incontinence.

• Hormonal Changes. Some surgeries, like removal of the ovaries, can trigger hormonal changes leading to weakness of the pelvic floor and incontinence.

What Types of Surgeries Are Most Likely to Cause Incontinence?

Incontinence is most likely to occur as the result of pelvic surgery, however, lower abdominal surgery and low back operations also carry some degree of risk. This is simply because, with these types of procedures, there is an increased likelihood that the urinary tract and the nerves controlling it will be injured. Urinary incontinence is commonly reported as a side effect after the following procedures:

• Prostate surgery
• Cesarean section (C-section)
• Spinal surgery

In some cases incontinence symptoms are short-lived while in others they are long lasting or even permanent. Short-term incontinence may last weeks or months, and symptoms frequently improve gradually as the body recovers from the operation. Long-term incontinence on the other hand can last years and is often the result of irreversible trauma to the pelvic organs and nerves.

Lifestyle Adjustments for Managing Incontinence

Recovering from surgery is hard all on its own. But recovering when you’re faced with a leaky bladder makes feeling better that much more challenging. Fortunately, there are things you can do–things to help manage your incontinence and improve your quality of life as you heal.hat

Tips for Adjusting Your Lifestyle to Manage Incontinence Effectively

1. Stay Hydrated. Drink small amounts frequently throughout the day rather than consuming a lot of fluid all at once. Also, consider tracking the amount of fluid you drink along with the number of trips you make to the toilet. Tracking can help you figure out how to balance your need to stay hydrated with your desire to manage bladder leakage.
2. Avoid Bladder Irritants. Some foods and drinks–like caffeine, alcohol, acidic foods, spicy foods, artificial sweeteners, and carbonated drinks–can irritate your bladder. Try cutting each out one by one and see if it affects the urgency or frequency of your bathroom visits.
3. Scheduled Toileting. Make a plan to visit the bathroom every 2 to 3 hours. This will ensure your bladder doesn’t get overfull and can reduce the risk of leaks.
4. Avoid Constipation. Being constipated can put pressure on your bladder and pelvic floor and contribute to incontinence. Unfortunately, constipation is a very common side effect of painkillers which are frequently given after surgery. To help prevent your bowels from slowing down post-operatively, be sure to drink plenty of fluids, get up and move around when your doctor says it is safe to do so, and talk to your care team about use of a stool softening medication if it becomes necessary.
5. Quit Smoking. Smoking can cause bladder irritation and contribute to some types of incontinence. (Also, if you need another reason to kick the habit: smoking is never healthy but postoperatively it carries the additional risk of slowing healing.)
6. Maintain a Healthy Weight. Carrying extra weight can put pressure on the pelvic floor and worsen incontinence. Speak to your doctor about the right time to begin losing weight safely after surgery.

Strategies for Protecting Your Home and Belongings From Leaks

As you recover from surgery and regain bladder control, you’ll want to protect your clothes and furnishings against unexpected leaks. Thankfully, there are now lots of discreet, comfortable, and stylish products available to do just that:

• Waterproof Mattress Protectors. Investing in a waterproof mattress protector will prevent damage caused by nighttime leaks. The good news is that they’re not sweaty or crinkly like they used to be. Actually, most now look and feel just like normal sheets, only a bit thicker.

• Absorbent Underpads. Protect chairs, couches, beds, and car seats from unexpected leaks with absorbent underpads. Underpads come in a range of sizes and absorbencies. Plus, there are even stylish options available to complement your home.

• Incontinence Pads. Incontinence pads can be worn inside underwear to catch leaks. They look a lot like pads used for menstruation, however, they tend to be significantly more absorbent.

• Absorbent Underwear. If you find pads uncomfortable or are looking for a reusable solution, consider absorbent underwear. Although they look and feel just like regular underwear, they quickly absorb small bladder leaks, locking moisture away from the skin and protecting clothing and surfaces. .

• Medical Urinals. Use a stylish medical urinal if your post-surgery mobility means it’s hard to reach the bathroom. Boom Home Medical has two sleek, discreet urinals available: Loona portable urinal for women and Tanker portable urinal for men.

Understanding Absorbency Levels

When selecting incontinence protection, you’ll notice products often list their absorbency in cups or milliliters or describe it in somewhat vague terms like “light” or “moderate.”

Very Light	Wetness in underwear only.
Light	Wetness in underwear, with a few drops reaching clothes.
Moderate	Wetness in underwear and clothes.
Heavy	Wetness that saturates clothes and spreads to furniture or the floor.

Managing Incontinence on the Go

Dealing with bladder leaks when you’re at home–near your bathroom and all your supplies–is certainly achievable. But what about when you’re out of the house? Here are some tips that can help:

• Schedule bathroom breaks every 2 to 3 hours.
• Map out rest stops using an app like Toilet Finder, and plan your route accordingly.
• Carry a portable toilet or urinal, like the Loona, in case of an emergency.
• Take extra supplies like a change of clothes in your bag or car.
• Pace yourself when it comes to drinking fluids – don’t drink too much at once.

Hygiene and Skincare for Incontinence

Frequent, prolonged contact with urine can leave the skin susceptible to irritation, rashes, and even infection. The condition, known as moisture-associated skin damage (MASD) (3), can be painful and lead to complications that are often difficult to treat.

To protect your skin, try these tips:

• Clean your skin frequently with mild soap and water or handy personal wipes.
• Use a barrier cream or ointment.
• Change your absorbent products as soon as they’re wet.
• Wear breathable, moisture-wicking fabrics.
• Speak to your doctor if you develop a rash, sore, or infection.

6 Exercises and Therapies to Improve Bladder Control

There are several targeted exercises and therapies that have been shown to help improve symptoms of incontinence.

1. Kegels. To perform Kegels (4), tighten and lift your pelvic floor muscles as if you’re trying to stop a pee mid-flow. Hold this for 3 seconds, relax for 3 seconds, and repeat 10 times. It’s important to perform Kegels correctly (and they’re easy to get wrong) so, if you’re at all uncertain, talk to your healthcare provider.
2. Core Strengthening Exercises Bodyweight or weighted exercises like squats, bridges, and lunges are an effective way to strengthen your pelvic floor (5).
3. Pilates or Yoga. Yoga and pilates both strengthen the core and pelvic floor.
4. Biofeedback Therapy (6). Biofeedback can be helpful in teaching how to properly do Kegels and other exercises that strengthen the pelvic floor.
5. Bladder Training (7). You can train your bladder to hold more urine for longer by gradually increasing the amount of time between visits to the toilet. Before you start a bladder training regimen, discuss your plan with your doctor.
6. Electrical Stimulation (8). Some healthcare providers use low-voltage electrical currents to stimulate and strengthen your pelvic floor muscles.

What to Do Now

Hopefully, we’ve given you some ideas on the best ways to manage incontinence after surgery comfortably and confidently. But, there’s one more very important thing to keep in mind: you don’t have to do it alone.

• Even if you feel you’re managing well, talk to your doctor about what you’re going through. They might identify a problem that’s easily remedied or be able to offer additional ideas on management and treatment.

• Consider opening up to friends or family or finding a support group. Others might have tips and tricks that you haven’t considered.

• Keep coming back to Boom Home Medical. We’re dedicated to providing you with the science-backed information you need. Plus, we’re committed to developing a range of stylish incontinence products that will help make life with incontinence a bit easier.

References

1. AJ Pomajzl; Larry E. Siref, Postoperative Urinary Retention
https://www.ncbi.nlm.nih.gov/books/NBK549844/

2. Tahira Naru, Fauzia Haq, Javed H. Rizvi, Urinary incontinence following gynecological surgery
https://www.sciencedirect.com/science/article/abs/pii/S1751721407001261

3. Kevin Y. Woo et al, Management of Moisture-Associated Skin Damage: A Scoping Review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5657465/

4. Cleveland Clinic, Kegel Exercises
https://my.clevelandclinic.org/health/articles/14611-kegel-exercises

5. American Journal of Obstetrics and Gynecology, Pelvic floor muscle motor unit recruitment: Kegels vs specialized movement
https://www.ajog.org/article/S0002-9378(16)00035-1/

6. Marta Kopańska et al, Urinary incontinence in women: biofeedback as an innovative treatment method
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325537/

7. NIH, Bladder Training
https://www.ncbi.nlm.nih.gov/books/NBK279430/

8. Ana Lúcia Carneiro Sarmento et al, Perspectives on the Therapeutic Effects of Pelvic Floor Electrical Stimulation: A Systematic Review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9658412/