effect of spinal during CS on continence?

[3goingon4]

Hi, I am having a CS next week as a result of damage sustained during DC1's birth including urinary incontinence and faecal urgency and problems with controlling wind.

I just had some questions about the effect of the spinal if anyone can help...

1. I know you have a catheter in for about 24 hours - do you know that you need to go and then just go or do you not realise when you are weeing?

1. Does the spinal mean that I will poo myself/fart because I can't feel when I need to go? Or can you feel when you need to go? At the moment I am getting about 30 seconds warning that I need to get to the loo.

TIA

I know a catheter drains your bladder as the wee goes in. I pooed myself during the natural birth of ds1 so it won't be anything they haven't seen before! Good luck!

Hi 3goingon4

I am an anaesthetist so hope this helps :

1. The urge to wee is (normally) caused by bladder distension so when a catheter is in the urine just trickles out as and when. You'll probably feel a bit of an urge to wee once the spinal wears off but it'll just be a bit of minor irritation caused by the catheter.

1. Although all sensation is removed with a spinal, there's normally not much gut transit going on so we don't see much farting and pooing . However, in your situation it's not impossible that in the period where your normal sensation is gradually returning (between about 2 and 8 hours after the spinal is put in) you'll find it a bit difficult to tell what's happening. Please rest assured that the midwives have seen it all and won't bat an eyelid.

I found I had problems controlling wind immediately after the birth of both my children (especially the first one - rotational forceps).

Hope that answers your questions. Shout if you want me to clarify anything.

thanks both.

zulu - that's really helpful, thanks. i guess i would be unlucky if it happened on the operating table then. fingers crossed i manage to maintain that shred of dignity during the c section at least!

I reckon you've got close to the same odds as anyone else with a spinal on board. All the best and enjoy your lovely snuggly baby!

OP deffo not an anaesthetist like zulu but I have had renal surgeries recently so have experienced catheters. I thought I would need to tell them when I needed to have a wee but the urine just basically flows out of you and into an attractive little handbag type affair that hangs on the side of your bed. It's a kind of talking point for visitors, I found

I felt no irritation and really didn't know it was there. Mind you I was out of my mind on OraMorph for quite a lot of it. The only annoying thing is it limits mobility a bit as you have to carry it with you if you are going walkabout.

I might ask my DH to speak to the midwife about it before - I am very anxious about the CS and find it hard to talk about the problems I have without crying at the best of times so not sure I will be able to blubber the words out on the morning!

Thanks for your responses.

Hello, as it's mn, no such thing as tmi right? ;)

I had an elcs last Monday. The catheter was put in pre-spinal which was not pleasant - my husband said as soon as it went in I started to fill my yellow handbag.

I had been a bit bunged up on sat so had taken some laxatives Sunday but the poo did not come before the op.

Tuesday afternoon the catheter was removed but because I'd been on nil-by-mouth followed by limited fluids there wasn't really much to come out. I was vaguely aware of my bladder.

I came home on Thursday and was told to urinate regularly even if I didn't feel it because this was a repeat section the entire area was quite numb. I didn't quite make it to the toilet a few times, I didn't feel my bladder sitting down or lying, but as soon as I started walking to the toilet I started leaking. And every time I tried to step out of the shower I leaked... Eventually calling it a day and getting out and using babywipes to clean (again!) ;).

On Saturday I had my first poo - I'd eaten rye bread in hospital as it's good roughage. I didn't strain or force myself to go at all, I just waited until my body needed a poo. An impressive size - and let's leave it at that! ;)

Yesterday morning was the first time I felt I had 100% control of my bladder in that I sat on the loo and I chose when to empty it! So I hope for you it's very much a temporary thing, but just wanted to let you know that even for me with no prior birth trauma, it's been a week to get control.

Good luck! :)

PS I had the same poo thing with my first section, totally closed for business for 3 days and then a ginopoo.

If there were any accidents I was never made aware of them and the staff were perfectly discrete.

I was wondering if you could ask to keep your yellow handbag a day longer in light of your current problems - it seems a little barmy to remove it after 24 hours just because that's average - it would probably just add stress to your situation. You don't feel anything once it's in and if you're uncomfortable about visitors seeing it you can always pop it under your sheets for an hour or two, nobody would know!

Thanks Alpine - that's a good idea about asking the catheter to stay in a bit longer. I've never had one in for a long time before so I guess I will see how much it is annoying me or not bothering me. I hadn't thought that the spinal could affect things for that long so thanks for the heads up on that.

Why did they put the catheter in before your spinal? That sounds grim.

Congrats on your new baby.

I've had an EMCS, and had an epidural whilst in labour about 2 hours before the EMCS. I also have IBS, which emans that I can need to go to the loo many times a day.

The catheter was inserted as part of the CS, not as part of the epidural. It stayed in until just less than 24 hours after the CS. I wasn't aware of the need to wee at all when the catheter was in. And I didn't feel the need to wee for hours after it was taken out. Its as if my bladder was emptier than it had ever been. But 'feeling the need to wee' did come back the next day.

As for the need to poo, it had never occurred to me until I read your post that I might have had a bowel movement whkilst the epidural was in place. It took me about 2 or 3 days after the CS to feel the need to poo again, and it was quite hard to go. I took peppermint oil to help with the wind.

Hi, unfortunately for me it was new hospital policy as per last Monday morning. The catheter would previously have been inserted after the spinal but it needs to be done 'flat on the back', the surgeons became reluctant to allow any extra time to be spent on the back as a baby had gone in to distress the week previous. Perhaps zulu could elaborate on that point?

It seems a bit mean to put the catheter in before the spinal but it sounds like it was a reaction to an emergency the week before. I guess they wanted to get the baby out as quickly as possible and the catheter insertion just delayed that.

This is certainly not standard practice in my hospital though, and I wouldn't imagine many places do it! However, catheters are placed in plenty of people who don't have spinals in, for other reasons, and the local anaesthetic jelly they use should make it relatively comfortable . I had one put in while 8cm dilated last year, and it seemed fine, although I was in transition meltdown mode slightly distracted at the time...

Well I had the CS last week and just wanted to report back that so far as I was aware there was no farting or pooing!

I had the catheter in for 24 hours and thankfully when it was removed I was able to feel when I needed the loo so no accidents then.

Thanks again for your advice.