Frequent Urination After Uterine Fibroid Surgery - Urology

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Frequent urination after uterine fibroid surgery can be a common concern for many patients, especially those who have undergone procedures that involve the uterus and surrounding structures. In your case, having had a traditional open surgery to remove fibroids while preserving the uterus can lead to various postoperative symptoms, including urinary frequency and, in some cases, urinary incontinence.


Understanding Frequent Urination Post-Surgery
After surgery for uterine fibroids, several factors can contribute to frequent urination. The surgery itself can affect the pelvic floor and bladder function. The bladder is located near the uterus, and any manipulation or trauma during surgery can lead to temporary changes in bladder sensitivity and capacity. Additionally, if the fibroids were pressing against the bladder prior to surgery, their removal may alter the bladder's position and function, leading to a sensation of increased urgency or frequency.


Is Urinary Incontinence Normal?
Urinary incontinence, particularly stress urinary incontinence (SUI), can occur after pelvic surgeries, including those for fibroids. This condition is characterized by involuntary leakage of urine during activities that increase abdominal pressure, such as coughing, sneezing, or exercise. The pelvic floor muscles may be weakened during surgery, contributing to this issue. While some degree of urinary incontinence can be expected postoperatively, it is essential to discuss these symptoms with your healthcare provider, especially if they persist or worsen.


Need for Internal Examination
Regarding the necessity of an internal examination, it often depends on the specific symptoms and the physician's assessment. An internal examination can help evaluate the pelvic organs, including the uterus and bladder, and assess any potential complications or changes that may have occurred post-surgery. If you are experiencing significant urinary issues, your doctor may recommend this examination to rule out any anatomical changes or complications.


Physical Examination Techniques
As for the physical examination techniques, it is not uncommon for physicians to perform abdominal palpation as part of a routine examination. This technique helps assess the size and position of the uterus and any potential masses or tenderness in the abdominal area. However, it is standard practice for healthcare providers to wear gloves during any internal examination to maintain hygiene and prevent infection. If you have concerns about the examination methods used by your physician, it is important to communicate these concerns directly with them.


Next Steps
If you feel that your current physician is not providing adequate explanations or care, seeking a second opinion is a reasonable approach. A different healthcare provider may offer new insights or treatment options for your symptoms. Additionally, consider discussing the following with your new physician:
1. Detailed History: Provide a comprehensive history of your symptoms, including the onset, frequency, and any associated pain or discomfort.

2. Urinary Symptoms: Discuss the specifics of your urinary frequency and any instances of incontinence.

3. Pelvic Floor Health: Inquire about pelvic floor rehabilitation or exercises, such as Kegel exercises, which can strengthen the pelvic muscles and improve urinary control.

4. Imaging Studies: Ask if any imaging studies, such as an ultrasound or MRI, are necessary to evaluate the status of your uterus and bladder post-surgery.

In conclusion, frequent urination after uterine fibroid surgery can be multifactorial, and while some symptoms may resolve over time, persistent issues warrant further evaluation. Open communication with your healthcare provider is crucial for addressing your concerns and ensuring appropriate management of your symptoms.