Ask The Nurse

Some women experience bladder leakage following a hysterectomy, but it’s not inevitable. The uterus sits over the bladder and provides support for it. Sometimes when the uterus is removed, the bladder becomes more unstable, causing leakage.

An overactive bladder can be caused by many factors, including: too much caffeine, too little fluid intake and loss of estrogen to the bladder lining following menopause. If you regularly drink tea, coffee or sodas, you could help yourself by switching to decaffeinated beverages. Many people reduce their fluid intake because they believe drinking less will make them go less. In fact the opposite is true because low fluid intake results in concentrated urine, which can irritate the bladder lining. It is important to drink as much fluid as you feel like during the day, though you could start to limit your fluids about 3 hours before going to bed.

It sounds like you’ve already had a urodynamic assessment. This is a test to determine if bladder function is present, and was probably used to establish your diagnosis. If this is a neurogenic bladder and you are in overflow incontinence, a means to empty your bladder must be established. I don’t know precisely what is causing the problem, but given your history of nerve damage it’s probably not correctable. Providing you have no underlying handicap relating to your hands or arms, the most likely option would be a self-clean intermittent catheterization. This involves the placement of a catheter into the urethra several times daily. Other less desirable options include a suprapubic cystotomy or an indwelling catheterization.

It’s not unusual for women to complain of urine loss just prior to or during their periods. This is related to fluid retention and the increased pressure caused by menstrual flow. Try using a purpose-made bladder weakness product at these times

Most women regain their bladder control fairly quickly following bladder surgery. I’m not sure what your doctor meant by a hernia on the bladder, so you may need to ask him to clarify. When the bladder is falling it comes down into the vagina because of weakness in the pelvic floor and the vaginal wall. This could be described as a type of hernia and may be what he meant.