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What Causes Urinary Incontinence After Hip Replacement?

Posted on Fri, 7 Nov 2014

Question: About 12 months after a hip replacement I havebegan losing urine without much control. Having had to wear nappies for over 10 years due to a prostate problem that has now been rectified, I am wishing to know have I developed a desire to wear nappies? It was on the advice of my urologist that I wore them while I was waitingf for a TURP operation.

Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Brief Answer:
queries explained

Detailed Answer:
Hello and Welcome

I appreciate your concern.

Sir, as physicians we care deeply for the preference of our patients and the choices that they feel most comfortable with.

But I would advise you to not be completely dependent on the nappies though you may very well continue to use them. By not being completely dependent , I mean you should continue a plan of regaining some bladder control. If you completely let go then the principle of use it or loose it applies quite well in this case, the feedback mechanism would cause your pelvic floor muscles to grow weaker and the nerves associated to become even less responsive

keep a 48-hour voiding diary — a record of your fluid intake, the times you urinate, and any leaking episodes. bladder control training would be required. This includes learning to urinate on a schedule (timed voiding), pelvic muscle exercises (Kegels), and sometimes biofeedback. limit fluids to no more than 6–8 glasses per day from all sources while you’re learning to control your bladder.

Pelvic floor muscles are the muscles you use to hold back urination and thus are important to urinary continence. Contracting them also signals the detrusor muscle to relax, which allows the bladder to better hold the urine. You can strengthen and condition these muscles with pelvic floor exercises, also known as Kegels.

Let me know if you have any query

wishing you best of health

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (4 hours later)

I am wondering if I may have already lost it since, sometimes, I realise I am urinating when I feel the pee running down my legs, and at night without realising till I wake up in a wet nappy. I am aware of some muscle and nerve damage from the hip replacemant, as it was at a very advanced state of wear, complete bone on bone, when diagnosed.

Answered by Dr. Dr. Muhammad Sareer Khalil (3 hours later)

Brief Answer:
explained

Detailed Answer:
hi

Nerve damage and loss of muscle viability cant be only assessed subjectively. You would require Cystometric studies of your bladder to confirm the degree of loss of bladder control. You may discuss this option with your urologist.

May the odds be in your favor.

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (20 hours later)

Tests have shown some muscle damage due to the atrophy of pelvic floor muscles from the worn out hip, and require surgery to repair properly. As I do not wish any more surgery, I have begun strengthening exercises which, I am told, will aleviate, but not cure, the loss of urine, so I will just wear nappies to bed and when I am away from home for any length of time. Although this is not the ideal scenario, because of longtime nappy wearing,I think I will be able to live with it..

Answered by Dr. Dr. Muhammad Sareer Khalil (3 hours later)

Brief Answer:
explained

Detailed Answer:
hello

sir, its all about your comfort level. if you feel this method suits you or in fact helps you. then by all means continue it.

though surgical options are available as you dont want to go with them , kegel exercises are the only choice left for regaining some control so please do them regularly.

may the odds be in your favor.

thanks

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar