How is it managed?
On rare occasions the nerves to the bladder can be injured from pressure placed onto the bladder during a vaginal or caesarean birth or from the bladder being overstretched after the birth and not being emptied adequately. Signs of nerve damage are normally evident in the first 2 days after the birth. Your caregiver may suspect this has happened if:
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You are having difficulty passing urine, or |
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You are not able to sense or feel that you need to go to the toilet, or |
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Urine is dribbling away in small amounts uncontrollably, or |
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Your bladder feels full even though you have just been to the toilet. |
The nerves to the bladder usually allow the woman to sense when she needs to pass urine. If these nerves have been injured, they will not send the message and the woman is unable to sense when she needs to empty her bladder, allowing it to overfill.
The woman's bladder increases its capacity up to 1000mls in late pregnancy (from 500 to 700mls), although it rarely reaches this level with a baby pressing on it! If the nerves are not sensing the need to empty the bladder after the birth then it can easily become overstretched.
The nerves can be injured after an uncomplicated vaginal birth, but it is more likely to occur with women who have had a forceps birth. Reduced sensation of a full bladder is also more likely for women who have had an epidural or spinal (for either a vaginal birth or a caesarean birth), or if the woman has allowed her bladder to overfill because she is reluctant to pass urine, due to it feeling painful or stinging.
How is it managed?To help the nerves to heal and to stop the bladder from becoming overstretched a urinary catheter is normally inserted for a few days, to keep the bladder empty.