Stating that there are some changes in the urinary system inevitably due to hormonal changes in the pregnant person’s body, Prof. Dr. Tufan Tarcan, “At the beginning of these, there is an increase in the glomerular filtration rate (increase in the urine production capacity of the kidneys) and a change in the smooth muscles that make up the urinary system due to hormonal changes.” said.
Emphasizing that as the fetus grows, the pressure in the pelvis of the fetus affects the physiology of the bladder and ureters. Dr. Tufan Tarcan said, “We see that some urological diseases have increased due to these during pregnancy. One of them is urinary tract infection. In addition, because the kidney or kidneys blocked by the fetus cannot transmit the urine to the bladder, swelling in the kidneys called hydronephrosis
may occur. In addition, there may be problems with urination. Both the increased amount of urine and the decrease in the space to expand the bladder can play a role in the frequency of urination. Urine becomes more frequent because there is less room for the bladder to expand. As the fetus grows, it pushes the bladder forward. Thus, the space between the bladder narrows.” made a statement.
Women who had urinary tract infections in their childhood experience more frequent urinary tract infections during pregnancy. Dr. Tufan Tarcan, “Urinary tract infection can cause more important problems if it is not treated during pregnancy. Urinary tract infection monitoring during pregnancy is very valuable.” said. Stating that urological complaints are more common during pregnancy in women who had urinary tract infections in childhood and recurring, Prof. Dr. Tufan Tarcan, “If a pregnant woman has a history of urinary tract infection, she should pay special attention to urinary tract infection that increases during pregnancy.” he said.
Stating that swelling in the kidneys mostly occurs due to the pressure of the fetus on the ureter, Prof. Dr. Tufan Tarcan continued: “The problem of urinary incontinence mostly disappears ex officio at the end of pregnancy. Sometimes, obstruction of the front of the kidney can cause pain in the kidney or advanced hydronephrosis in the kidney, that is, kidney enlargement. Sometimes it can even combine with urinary tract infection and cause kidney inflammation. In such tables, we insert a type of catheter called a ureteral stent into the urinary system endoscopically so that the urine produced by the kidney
can be easily expelled. This stent is approximately 26 to 30 cm long with one end in the kidney and one end in the bladder. a material made of silicone in size. It is not visible outside the body. We remove this stent after the pregnancy is over. Thus, this ureteral catheter enables the kidney to transmit the urine produced by the kidney to the bladder more easily or without problems during pregnancy. The enlargement of this kidney is more on the right side. This is a situation related to the position of the child. It can also be seen on the left side, although it is rare.”
Stating that a more valuable problem in pregnancy is stone disease, Prof. Dr. Tufan Tarcan said: “We are very careful in using diagnostic tools and tests in such a situation. Because, as is known, radiological techniques are used in the diagnosis of stone disease. Computed tomography is a very valuable weapon in the diagnosis of stones, but we do not want to use it so that the child is not affected by radiation during pregnancy. Because of this, we are progressing as much as possible with radiological systems such as ultrasonography that do not harm the pregnant and baby without radiation. When the diagnosis of stone is made, we try to be conservative in the treatment of stones, unless it is absolutely necessary, for example, if it does not cause a severe problem in the kidney. If the stone obstructs the kidney or causes significant stone pain in the patient, of course, something needs to be done to this stone. By-passing the stone with the ureteral catheter advanced from the edge of the stone, leaving the stone in the body, and thus both relieving the pain and protecting the kidney is a faithful way until the pregnancy ends. In very selected cases, stone surgery can be performed in the treatment.”
Mentioning that the frequency of urination increases during pregnancy and that loosening can be seen on the pelvic floor due to the pressure of the child, Prof. Dr. Tufan Tarcan said, “We see pelvic organ prolapse and tension-type urinary incontinence more frequently during and after pregnancy. In order to avoid these, our first advice to our patients is not to gain too much weight. Because the more weight
he gains, the more intra-abdominal pressure increases. This has a damaging effect on the pelvic floor. Therefore, attention should be paid to weight during pregnancy in order to avoid complications of urinary incontinence and pelvic organ prolapse as much as possible.” said. Stating that they definitely recommend Kegel exercises to women who they think are prone to urinary incontinence during pregnancy, Prof. Dr. Tufan Tarcan, “These are exercises that work the pelvic floor. Thus, we aim to increase the pelvic floor strength. Some of the urinary incontinence seen during pregnancy is temporary and may disappear after the pregnancy has disappeared. However, some of them can be permanent.” made a statement.
We recommend bladder pads to pregnant women
Underlining that hygienic pads specially designed for the bladder are very valuable in case of discontinuous urinary incontinence during pregnancy, Prof. Dr. Tufan Tarcan concluded his words as follows: “We use bladder pads especially in patients with minimal urinary incontinence. We cannot use the drugs we use in the treatment of overactive bladder during pregnancy. When these drugs are stopped during pregnancy, we can sometimes see a more active bladder
. Sometimes, the hormonal situation that changes during pregnancy can suppress a very active bladder itself. In tension-type urinary incontinence, there is no random surgical treatment during pregnancy. Instead, we care about Kegel workouts again. We recommend hygienic bladder pads again as a precaution against this type of urinary incontinence. As stated above, if the patient did not have such urinary incontinence before, it may disappear after pregnancy itself.
