Urinary Incontinence overview at iVillage Pregnancy & Parenting

My urinary incontinence began near the end of my first pregnancy. My obstetrician said it was normal and suggested Kegel exercises, but they didn't work. After a year, a urologist diagnosed a "neurogenic bladder" and started me on Ditropan, but after almost a year, the problem seems worse! The pharmacy assures me that there are no known effects on the fetus with this medication, but I am still wary. I am pregnant again and wondering if I should put off treatment until after the pregnancy.


Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Congratulations on your pregnancy. I am sure you are excited and yet wondering if this condition will worsen and what you can do about it.

Ditropan (oxybutynin) is an antispasmodic/smooth muscle relaxant, which should eliminate or slow the spasms and contractions of the bladder that cause you to lose urine or feel the urge to urinate frequently. It is classified by the FDA as a Category B drug, which means while its safety has not been absolutely established for use in pregnancy, no adverse effects have been reported with its use. Of course, no controlled studies are ever done on pregnant women, so its safety will never actually be proven beyond a doubt.

There was an article published in "Nurse Practitioner" (March, 1997) called "Urodynamic Tests: Client Preparation, Assessment and Follow-up," which discusses all the testing and indications for the various tests. I doubt any provider would recommend a full work-up during pregnancy as the testing always involves interventions such as catheters and medications.

It would be wise to ask an obstetrician if anything can be done surgically after you give birth, while you are still in the hospital. Sometimes insurance companies are more enthusiastic if you are already admitted.

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