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Cancer: Bladder Message Board
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Old 09-21-2008, 06:50 PM   #1
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Epidural without Cathader- Could this have caused bladder damage?

My wife gave birth last Tuesday at a hospital in NYC. She was givin a low dose epidural (walking epidural) that allowed her to walk about and still have some sensation. She was able to urinate a bit throughout the labor (very slow trickle) and thought that it was sufficient to empty her bladder. She had an IV as well, went though about two bags before her delivery 12 hours later, and also was taking in some fluids orally. However by the time she was ready to push, the OB noticed that her bladder was very full (protruding a lot- a big bump on her stomach). She immediately gave her a catader, and was astonised by the volume that came out: 1.5 liters. She was extremely angry with the nurse staff for overlooking this- and made sure to report it.

My question: could she have sustained any damage to her bladder? She appears to have regained most of the mucle tone now (5 days later), but I'm concerned that the 1.5 liters could have damaged the muscle lining. She's only 100 lbs normally, and before her pregnancy could never really hold much urine (thought she had a small bladder). 1.5 liters is a tremendous amount I think, and would like to know if there could be any potential compliations. Becuase of the epidural, she lost most of her sensation, and if the spincter muscle (or whatever holds the bladder shut) was frozen shut, could the normal over-pressure dumping that typically occurs been over-ridden?

Thanks so much!

 
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Old 09-21-2008, 09:22 PM   #2
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Re: Epidural without Cathader- Could this have caused bladder damage?

First, let me say congratulations on your new baby!
Is this her first child? I ask because after the birth of my boy last year, I didn't expect to have such weak bladder control and leakage afterwards. I had an epidural as well (however, I had the catheter inserted right away), and I was told afterwards that you need to again build up your muscle that is weakened by the catheter itself. You are also more susceptible to getting a bladder infection after giving birth, if you have one inserted.
I'm not sure if this was really your question, but I just wanted to offer my experience, because it sounds like she's having some similar troubles! Tell her to do her kegals exercises, and that should help to strengthen that muscle again (although it may never be the same! I'm now realizing that mine is not as strong, now that I'm pregnant again with baby #2). If your really concerned about it though, I would definitely call her doctor, just to be sure it's normal. I would think it's more due to the catheter itself, rather than her holding in all that urine (by the way, 1.5 litres seems like a very large amount to me, as well).

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Old 09-22-2008, 08:05 AM   #3
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Re: Epidural without Cathader- Could this have caused bladder damage?

The bladder is a very strong elastic muscle and can hold upto 1.5 liters at a time for some people. Normally you will feel the urge to urinate when it is 200ml to 500ml full. I am in my third trimester and I can hold for 4 hours unless the baby kicks me in my bladder and I say it is more than 300ml. Im also drinking a lot of water during the day so I go every 1-2 hours.

In our birthing class, we were told to pee every hour with or without an IV fluids during the first stage of labor. A catheter is only inserted if the woman is unable to get out of bed due to numbing effect of epidurals but it is not a routine procedure because of infection control policies of the hospitals.

1.5 liter for your wife is a lot but she was also numb with anesthesia so her bladder sort of went to sleep. Like the previous poster said, your wife will regain bladder control overtime and can speed up by using kegel exercises. Empty her bladder regularly to prevent residual urine and infection and drink lots of fluids.

The only way to tell she is having poor muscle tone is by going to the urologist and do a bladder scan which is non invasive. They can measure how much urine her bladder is holding (residual) after she urinates and they can tell if her bladder is weak. I will only do this if she continues to have bladder problem. Congrats on the new baby!

Last edited by hotmama08; 09-22-2008 at 08:06 AM.

 
Old 09-22-2008, 09:38 AM   #4
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Re: Epidural without Cathader- Could this have caused bladder damage?

I'm going to agree with the ladies on this one. I had an epidural pain blocker with my son and didn't have a catheter. I am about 105 lbs normally and pushed out an 8-and-a-half pound baby at 42 weeks gestation. I wet my pants for about 3 months after the birth. Sneezing, coughing or waiting too long to go will all cause this postpartum.

Think about it like this: Picture pushing a bowling ball through a garden hose. That hose is going to take a while to go back to it's normal elasticity on a good day. It probably won't ever go all the way back to normal.

So I'd say, based on my experience, it's not so much the bladder, but the birth canal that takes a beating.

 
Old 09-22-2008, 10:00 AM   #5
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Re: Epidural without Cathader- Could this have caused bladder damage?

Just a side note: I had my baby naturally without any drugs or interventions and I also had some of the same trouble. You really have to build some muscle tone back up and give it time to heal. I read extensively about drugs, so I suggest you look up the package insert information that would come packaged with the epidural medicine (you can find this type of information online). The insert reveals that the epidural can effect muscle tone and they are unsure of how long that can last.

Last edited by AlexaIn2006; 09-23-2008 at 09:22 AM.

 
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