Urinary incontinence, a condition often colloquially referred to as “bladder weakness,” affects approximately 15 million women in Germany. Involuntary urine loss poses not only physical limitations but can also have adverse psychological and social consequences for those affected. It is important to note that not all cases of urinary incontinence are the same, varying from minor leaks that cannot be controlled to complete and involuntary bladder emptying, representing a spectrum of severity.
Various forms of urinary incontinence exist, with stress incontinence, urge incontinence, and mixed incontinence being the most common types [4]
Typical symptoms indicative of urinary incontinence include:
The symptoms of bladder weakness resulting from endometriosis surgery closely resemble those arising from other causes.
In a study involving 108 women who had undergone laparoscopy to treat endometriosis, a retrospective assessment of bladder function was conducted. Various preoperative and postoperative factors were closely observed and compared. This comprehensive analysis included the evaluation of bladder function before and after endometriosis surgery. The findings revealed that approximately 19.6% of the women who had undergone laparoscopy experienced bladder dysfunction after the procedure. In concrete terms, this equates to roughly 21 out of the 108 patients encountering difficulties with urination following the surgery [5].
In a separate study, 52 patients with endometriosis underwent laparoscopic partial colon resection. After approximately 19 months, these patients returned for a follow-up examination to observe urinary symptoms. The outcome showed that 29% of these patients experienced dysuria, characterized by painful and uncomfortable bladder emptying [6].
Another study focused on 47 patients who had rectovaginal deep infiltrating endometriosis, where there is a connection between the rectum and the vagina. Within 5 years of their surgeries, these patients reported bladder weakness to their physicians. The most common complaints included a weak urinary stream and the need for what is known as the Valsalva maneuver during urination.
The Valsalva maneuver might be familiar to many as a technique used, for example, to equalize pressure during activities like flying; it involves sealing the lips and nose and then attempting to exhale forcefully. When urinating, employing this maneuver can produce a similar effect [7].
Cause of Bladder Weakness in General
Bladder weakness, particularly in women, often occurs after pregnancy or during old age. Conversely, in men, stress incontinence is more commonly associated with surgical prostate removal [4].
Causes of Bladder Weakness Following Endometriosis Surgery
The emergence of bladder dysfunction after surgery appears to be somewhat individualized. This means the bladder is sensitive to certain substances or stimuli [5]. As highlighted earlier, colorectal resection for endometriosis treatment can also be a contributing factor to urinary dysfunction [6]. For patients who have undergone surgery for rectovaginal and deep infiltrating endometriosis, there is a risk of bladder paralysis, underlining the importance of long-term monitoring for these individuals [7].
Additionally, temporary bladder weakness or urinary tract discomfort may result from the presence of a bladder catheter after surgery. It is a common practice to insert a bladder catheter during and after surgery, and this catheter can sometimes lead to irritation. While patients may experience pain and occasional involuntary urinary leakage in the short term, these issues typically resolve as the healing process progresses.
Bladder endometriosis is a condition characterized by the presence of tissue with cells similar to those found in the uterine lining, located within or on the bladder, among other possible sites [1]. Around 0.3% to 12% of individuals with endometriosis are affected by urinary tract endometriosis (UTE), meaning that in approximately 2 out of every 100 endometriosis cases, these growths can be identified within the urinary tract.
The symptoms associated with bladder endometriosis, such as lower abdominal pain, frequent urination, and a strong urge to urinate, are highly nonspecific. Consequently, they do not provide clear indicators for an accurate diagnosis. Instead, they often resemble those of a urinary tract infection, leading to the unfortunate administration of antibiotics as treatment [2].
Given the varied symptoms and causes of bladder weakness following surgery, there is no one-size-fits-all treatment. Nevertheless, several options are available.
One possibility is physiotherapy. We previously had the opportunity to interview Annika Cost, a physiotherapist specializing in endometriosis. Annika explained that pelvic floor tension can contribute to bladder floor irritation, potentially leading to premature urges to urinate. In physiotherapy, patients can keep a daily urination diary. Using these records, the situation can be analyzed to identify potential areas for improvement. This may involve addressing adhesions and muscles around the bladder and adopting urge-control strategies.
Furthermore, bladder training and pelvic floor strengthening can offer relief. Bladder training focuses on expanding the bladder’s capacity and improving urine storage.
For those dealing with bladder weakness following endometriosis surgery, several helpful aids can make daily life more manageable.
Dealing with incontinence, especially at a young age, can be uncomfortable and may lead to feelings of shame, fear, and insecurity. Many questions might arise, such as the adequacy of a panty liner, concerns about stains, and how to discuss the issue with a future partner. To combat these feelings, we recommend connecting with and sharing your experiences with others who face similar challenges. The sense of community can be reassuring and alleviate insecurities. If your bladder weakness becomes overwhelming and hinders your ability to find comfort in sharing with others, consider reaching out to a medical professional and/or psychologist for support.
We trust you found valuable information in our blog post about bladder weakness following endometriosis surgery. If you have a personal experience you would like to share or helpful tips for others living with endometriosis; please do not hesitate to leave your comments. Your input can make a difference in supporting those going through similar challenges.
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Psychologist Teresa Götz (Endo-App) interviewed Dr. Cecilia Ng, who is doing research on endometriosis in…
Psychologist Teresa Götz (Endo-App) interviewed Dr. Cecilia Ng, who is doing research on endometriosis in…
Psychologist Teresa Götz (Endo-App) interviewed Dr. Cecilia Ng, who is doing research on endometriosis in…
Psychologist Teresa Götz (Endo-App) interviewed Dr. Cecilia Ng, who is doing research on endometriosis in…
Psychologist Teresa Götz (Endo-App) interviewed Dr. Cecilia Ng, who is doing research on endometriosis in…
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