Loss of control over bladder after forceps delivery

[Lishhhh]

Hi all...looking for some answers here...I am 4 weeks post partum and had a forceps delivery and long labour...after the birth I lost complete control of my bladder. No sensation to pee and have been leaking urine constantly...bladder was retaining some urine as well due to which had an UTI. I am devastated and feel like I will never be normal again...I have been referred to physio and have been doing pelvic floor exercises but no signs of improvement. .I am hardly able to bind with my new born. This thing is killing me...has anyone ever faced this and if yes did you recover and how long it took.

I had similar. About a week after having my first baby (also long labour, forceps) I was in a shop and wondered why the floor was wet. It was me, I'd peed all over the place without realizing. Then I later did similar in the car. It was horrible. I'm now 3 years and a second (quick labour, no forceps) baby down the road and absolutely fine. If I cough while bouncing on the trampoline I'd definitely wet my pants but other than that, I have full bladder control. Physio are great, you will get there! Congratulations on your new baby.

@Mylittlepony374. Thank you for replying..Nice to hear you have recovered.. how long did it take for you to gain bladder control after your 1st delivery...and when did you stop leaking...just looking for a timeliness here to get some hope...

This was me... I had failed vontousse followed by forceps and eptiosomy. No bladder control and poor bowel control. No feeling, sensations or anything for several weeks.

I relied on TENA pads for a while and trained myself to toilet at regular intervals.

After approx 3 months I struggled with control but had sensation back.

I've had physio, there is an NHS pelvic floor app which I found useful as it would do short hold, long hold etc and I literally did them ten times a day.

I had a vaginal muscle trainer thing they gave me and you insert it and have to tense until the attached stick moves that helped me to see progress.

I'm two years down the line now and although I have some ongoing muscle pain memory issues I havnt had an accident for over a year.

Make sure you ask for help via physio and consultants... I had counselling partly due to birth trauma and partly due to recovery...

Stack up on TENA and big pants for now.

Hope toy recover soon xx

Just to add here..I am leaking all the time..as soon as I get up or walk...I leak...have no control over wee and no sensation to wee.

@BakewellGin1 thank you for your reply...wow 3 months is a long time...thank you for all your advices...I will try and keep my patience...I just hope I atleast get the sensation back and can control my wee to some extent..at the minute I can't even think of going to the shops...

I'm so sorry this is happening in your life
I had similar after being left to push on an epidural for far to long followed by forceps; poor bladder control and completely dysfunctional bowel with zero sensation so had to manually evacuate poo a couple of times a day to ensure there was no compaction. I thought my life as I'd known it was pretty much over. But, with physio and taking care of my pelvic floor, things returned to normal. It was gradual and required some work, but it got there, with the added bonus of even better orgasms (God knows how that happened, but seems fair!).
DC2 was a much quicker, unassisted birth, and despite my fears that it would put me back to square one again, my pelvic floor pinged back into shape quite quickly.
Please feel reassured that you'll be OK again, and make time and space for bonding, knowing that all shall be well.

@YouWereGr8InLittleMenstruators
Thank you so much....I feel so much better now that this is not going to last forever...
How much time did it take to recover atleast 50%.

Hard to say. I also had shocking diastasis recti, but believe many of the strategies I used to alleviate that helped with my pelvic floor too. I think lots of things played a part; allowing for the natural healing process which, despite being slow, passive and 'invisible', was still very much operational. Also all the things I was not doing really helped: absolutely NO strenuous or high / medium impact exercise, no lifting (tried to be really strict on that, and to save my 'lifting allowance' for carrying DD), and really watching how I was using my body; always 'engaging' core and pelvic floor when doing anything that may exert force on the pelvic floor, including just walking pushing the buggy. Lots of kegels. NO straining on the loo allowed, so lots of water and daily prunes, and going to the loo at regular intervals pre-emptively so no pressure builds up in either bladder or rectum.
Go easy on sex that might pull on the urethra, but I found (non-penetrative, both solo and with DP) sex to be one of the first and best indicators that nerve endings were healing and muscle fibres re-knitting together. But scary at first.
And celebrating the tiny steps in the right direction, praising myself and my battle-scarred pelvis for all its hard work. I think it is easy, when potentially traumatised and isolated and silenced by social convention, to feel massively let down by our bodies, and a bit frightened, grossed out and ashamed of our ailing parts and functions. This is going to out me as the frightful hippie I am, but really, make friends with your pelvis, your core, your vulva, your bladder, your vagina, your bottom again, hold them, talk to them, commiserate with them, praise them, look at them (can be worrying to get a mirror out after a traumatic birth with potential birth injury) with love, appreciation and acknowledgement of what they've been through.
All in all, 6 months perhaps?

@YouWereGr8InLittleMenstruators
Thank you so much...I already feel so much better knowing that this will be all behind me...thanks for all the tips too...

So sorry that you’re going through this. It’s terrifying isn’t it. I have very similar. I’m 5 weeks pp. Forceps and episiotomy. Since birth I’ve not regained any sensation in my bladder so I have no idea when I need a wee. No urges or feeling.. nothing. I just leak/wet myself every time I move/stand/walk/cough, you name it, I’ll leak. Sometimes just a dribble, sometimes a full blown wee, and I can’t stop it. No idea if or when it will get better. At the moment I’m terrified I’ll be like this forever and like you say, it’s making it super difficult to bond with my beautiful first child. I should be cherishing this time but in reality, it’s the worst most traumatising experience I’ve ever been through.

I left hospital after my first with a catheter in place my bladder was so badly affected. I'd had a six hour second stage with a stuck baby and midwife error, then emergency high rotational forceps in theatre.

Loss of control and no sensation.

Took tena and physio and time. Catheter was out after 5 weeks. Then lots of accidents and managing both urge and stress incontinence for some months.

It's improved with women's health physio, nhs and private i saw later on.

Now 12 years on I wear tena thins for back up. I have to watch what I drink so as not to irritate the bladder and make it tetchy (it doesn't like fizzy or citrus much). I try and keep weight in the healthy range to stop too much pressure on the pelvic floor.

My core is permanently damaged so I was explicitly told to stop any impact exercise. No running or weights. Just walking, cycling, swimming. I'm at risk of a prolapse as my core is so weak. You might not be hopefully.

I do a mix of adjusted yoga and Pilates moves but avoid why that place a lot of pressure on the core. I've a kegel8 machine I use to help tone the muscles, not glamorous but helps a lot.

Hormone changes affect it so I am currently peri menopausal and am getting the GP to sort HRT as falling oestrogen will further weaken the core and the bladder muscles.

But I'm grateful it isn't painful to live with like some birth injuries.

I did chose an elective section for my second and last child who I had 19 months after my first. I wanted it all done and then to focus on recovering as much as I could.

Pregnancy hormones would weaken it all and the weight of pregnancy would worsen it, but I took some control with the elcs as I didn't want to risk double incontinence.

I've adjusted and while it is annoying to be always aware of where the toilet is, and there have been numerous close shaves and some accidents, I've put energy into doing what helps and knowing it's a lot more common then you'd think.

Hope that's not too much info. There is a ton of help out there and keep pushing for it. My key input was a few years ago from the women's health physio who properly assessed my pelvic floor and told me to stop the impact exercise.

I thought I'd been building strength with weights. I was trying to tighten my core and be safe doing them. But I was bearing down on it and holding my breath. I just don't have good muscle tone there now. Knowledge is so helpful with this.

So sorry it's tough. It will improve a lot. Just be prepared it might shift over time with hormones and keep an eye on it and be proactive.

@CharleyC0956...I know it is traumatising ..I am 5 weeks pp but still no improvement...I have no clue what is wrong with me...NHS is doing nothing..I have no clue what to do...I have booked a private appointment with a urologist in the hope to find some answers...please do let me know if anything improves with your condition.

@coathangerdays
Hi,
Thank you for the detailed information...I am sorry you went through so much...I wish I knew the damages beforehand...sadly none tells us..and prepares are for this..even the midwifes...could I please ask after how long you got the sensation to wee came back? And also how long did it take to control the all the time leakage?

I could have written this. It's horrifying.
I can't remember exactly when the sensation came back for me but I think it was around 4 months pp.
I got my first physio appointment at around 12 weeks pp. I had dutifully been doing my pelvic floor exercises but when the physio checked, I wasn't doing them properly due to the loss of sensation down there.
I had about 9 months of appointments and saw some improvement but I never got to the point of being leak free. I couldn't run / jump / sneeze without leaking.
I was told the NHS wouldn't do anything until I'd finished having babies. I wanted another so I just put up with it.
I'm now a year pp with number 2 and 4 years after the first labour that caused my problems.
I was immediately referred for physio and this time has help with core strength and exercises. Again, I have seen an improvement but I still leak when doing anything high impact - particularly if my bladder isn't full.
I am still breastfeeding and my physio told me that this may be affecting my recovery as you still have the relaxin hormone. I have been continuously breastfeeding since I had my first and so my physio said I could well see a significant improvement once I stop (she wasn't suggesting I give up breastfeeding - just laying out the facts). I was told a consultant wouldn't do anything until I have finished breastfeeding so I am waiting it out.
In the meantime, my physio prescribed a contiform pessary which has been an absolute game changer for me. It is a silicon rubber ring that you insert and it does the job of your pelvic floor and stops leaks. It is amazing. I can run, jump etc and I don't leak. You can't feel it when inserted (a bit like a tampon) and you can leave it in all day or just use it for when you know you need the extra help.
It's been amazing. I'm going to rely on this until I finish breastfeeding and then see if I see further improvement. If I still need help, I'll then be asking for a referral.
I know this will probably horrify you that at 4 years I'm not recovered, but I'm managing it. It's ok.
Good luck OP. I remember those early months when you fear you will never be normal again. You are not alone.

Sorry - typos there. I have problems if bladder is full.

P.s. I make a point of talking about this. It is shit that no-one is open about the damage labour can cause.

Sensation gradually came back, I think it's hard to say how many months as I had internal stitches and bruising and external tears too - so a lot of damage to heal up that affected the whole area's nerves. It improved initially in weeks though.

I don't have full sensation again. I struggle with pelvic floor exercises as I can't feel the muscles properly. Like exercising ghost muscles I sometimes say.

The excellent women's physio showed me how to work around that in some ways, to put my hand just above my hip bone and feel the tilt of the pelvic floor etc. To make sure I am breathing out loudly before I tighten the pelvic floor so I am using the right muscles only and not abdominal muscles.

I'd advise getting a proper assessment and exercise advice from one when you're no longer breastfeeding, as the above poster says, once the hormones have settled.

I've also talked about it a lot. The nurses on duty the night I got up after my traumatic forceps emergency birth were not supportive. They treated me as an inconvenience as I flooded when I stood up. They said it wasn't normal. They made me feel very broken.

There is hope. It improves. And you can find ways to work around the weaknesses.

Keep pushing for proper treatment when you're out of the initial phase and can see what's remaining. Watch for hormone impacts on it all.

So sorry it's affected you too, find someone you can be open with about it all too if possible.

As an example of how it isn't just about pelvic floor exercises. My full physio assessment a few years ago showed one side of my pelvic floor has a 2/5 strength. The other has minus 2 out of 5. It is permanently tight and wound up so can't tighten and loosen as it should.

Ask about risks of further damage too. I am aware I'm at risk of prolapse because of this too. So that makes me cautious about doing things with the kids at times that would be fun but add to that risk - eg assault courses you jump and pull up on.

Im looking at it from a long term perspective and minimising my damage where I can.

There is a wall of silence on all this at times, hence the over sharing here in the hope it helps you and others reading to not jump unknowingly into worse issues.

@Lishhhh
Has your urge to wee come back yet? That’s the bit that terrifies me. I feel like if I felt the urge then atleast I’d know when to take myself off to the toilet which would surely help with the leaking.
I’ve seen obstetrician, urologist, urogynaecologist, physio and anaesthetist (to rule out complications with the epidural) and they’re all mystified. Nobody can give me answers or reassure me. The obstetrician literally said “we don’t know what to do with you” which made me feel great

@coathangerdays @BlackKittyKat

Have / would you ever consider surgery?

I don't want surgery. I'm concerned about taking something I am managing with inconvenience into a permanent chronic pain issue from surgery complications or scars.

I was very wary of the mesh op before the horrors of that became public. I am quite scarred internally and have had flashes of nerve pain from a smear that lasted 24 hours once. (The nurse used a medium speculum instead of the small I requested, she had run out of small).

I would look at all options if it worsened. But I'd do a lot more to my diet and weight and physio first.

I know it works well for some people.

Similar to coathangerdays, I'm wary about surgery due to the issues around mesh. I would certainly seek a referral and would consider surgical options but I would research very carefully first.
I know that mesh surgery was put on hold due to the complications women were having - I'm not sure if that is the case.
There's a lot that can be done prior to surgery and I would certainly want to exhaust all non-surgical options first.
I have to say that the contiform is working wonders and I may well just continue using that, if required.

Happened to me too. It's horrible. Took me about 6 weeks to regain sensation. I just had to go sit on the toilet every hour or so to see if anything would come out.

Forceps are horrible things. I've had 2 forceps deliveries and both times were awful 💐

@BlackKittyKat

Do you wear the pessary everyday? Have you had any issues with it?

@toastjam did you have leaking too?