The management of urogynaecological problems in pregnancy and the postpartum period

Abstract

Key content Stress urinary incontinence is common in pregnancy and its severity can be reduced with pelvic floor muscle training. Overactive bladder syndrome prevalence increases with gestation and treatment can be conservative or medical. Pelvic organ prolapse is multifactorial. Pelvic floor exercises and pessaries are important treatments and previous surgical management can affect the mode of delivery. Recurrent urinary tract infections can be treated with antibiotic prophylaxis or with non‐antibiotic prophylaxis such as methanamine hippurate, D‐Mannose and hygiene behaviour. Urinary retention can occur at any point during pregnancy, causing bladder distension, voiding dysfunction and subsequent lifelong catheterisation. Learning objectives To be aware of the pathophysiology and management of different types of urinary tract dysfunction in pregnancy and the postpartum period. To understand the potential causes and management of pelvic organ prolapse in pregnancy and the postpartum period. To understand the different potential management options in recurrent lower urinary tract infections.