Persistent Urgency: 24/7 Urination After Childbirth

Persistent urge to urinate for 24 hours?

Hello, doctor.
I gave birth on April 10, 2015, and on April 18, I underwent a surgical procedure to remove retained blood clots.
Since then, I have experienced a nearly constant urge to urinate, especially when lightly touching my clitoris and genital area, which intensifies the urge.
I have been feeling the need to urinate almost 24 hours a day and frequently run to the bathroom, accompanied by persistent lower abdominal pain.
This issue has not improved and has been ongoing.
I have been consulting both obstetrics and gynecology as well as urology, but my condition remains unresolved.
I am unsure what to do next, and this has been a significant source of distress, severely impacting my life and leaving me feeling like it has turned black and white.
What could be the underlying issue?

Yu, 20~29 year old female. Ask Date: 2015/08/11

Dr. Xu Weikai reply Urology

Hello, after the initial response, I would like to add that if there are no other issues requiring special treatment after examination, you may consider using a pelvic floor magnetic therapy chair.
This can strengthen the pelvic floor muscles after childbirth and may also help improve frequent urination.
Many medical facilities offer this type of equipment.
If you have any concerns, you can visit a nearby medical institution for relevant tests.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Online responses should only be used as a reference; it is still necessary to seek medical care at a healthcare facility.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/08/11

More Info

Persistent urgency to urinate after childbirth can be a distressing experience for many women, and it is essential to understand the potential causes and implications of this condition. After giving birth, a woman's body undergoes significant changes, and various factors can contribute to urinary urgency, especially following surgical interventions like a dilation and curettage (D&C) for retained blood clots.

Firstly, it is important to recognize that the pelvic floor muscles, which support the bladder and other pelvic organs, can be weakened during pregnancy and childbirth. This weakening can lead to urinary incontinence or urgency. Additionally, hormonal changes post-delivery can affect bladder function. The body is still adjusting to the absence of pregnancy hormones, which can influence the bladder's sensitivity and capacity.

In your case, the urgency began after the D&C procedure. This surgical intervention can sometimes lead to irritation or trauma to the bladder or urethra, resulting in heightened sensitivity and the sensation of needing to urinate frequently. The surgical instruments used during the procedure may inadvertently affect nearby structures, leading to inflammation or spasms in the bladder.
Moreover, if there was any trauma during delivery, such as tearing or the use of forceps, this could also contribute to pelvic floor dysfunction, leading to persistent urinary symptoms. It is also worth considering the possibility of a urinary tract infection (UTI), which is common after childbirth and can cause increased urgency and discomfort.
Given that you have been experiencing these symptoms for an extended period and have consulted both obstetricians and urologists without resolution, it may be beneficial to explore a few additional avenues:
1. Pelvic Floor Physical Therapy: A specialized physical therapist can help strengthen the pelvic floor muscles and improve bladder control. They can provide exercises tailored to your specific needs and help address any dysfunction.

2. Bladder Training: This involves gradually increasing the time between bathroom visits to help retrain your bladder. A healthcare provider can guide you through this process.

3. Medication: If the urgency is due to overactive bladder symptoms, medications may be prescribed to help manage the condition. Discuss this option with your healthcare provider.

4. Further Diagnostic Testing: If not already done, consider asking for a urodynamic study, which assesses how well the bladder and urethra are functioning. This can help identify any underlying issues that may not have been apparent in previous examinations.

5. Counseling and Support: Chronic urinary issues can significantly impact mental health and quality of life. Seeking support from a counselor or joining a support group for new mothers experiencing similar issues can provide emotional relief and coping strategies.

In conclusion, persistent urinary urgency after childbirth can stem from various factors, including pelvic floor dysfunction, surgical trauma, hormonal changes, or infections. It is crucial to continue working closely with your healthcare providers to explore all possible avenues for diagnosis and treatment. Your symptoms are valid, and with the right approach, there is hope for improvement and a return to a more comfortable and fulfilling life.

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