• Restoring Bladder Function after Surgery

    Posted on May 9, 2012 by Dawn in Anatomy, Human Body, Muscle Pain, Questions and Answers.

    Hello everyone – Our family has welcomed a new addition. Last week my oldest daughter had a baby girl. The baby is fabulous, healthy, and cute as hell (of course!). My daughter, however, had various complications, one of which I would like to discuss here. After having an epidural, and extra epidural medication for repair work after delivery, she was unable to urinate.

    This problem first came to my attention about 4 years ago. I had a client whose elderly father had fallen and broken his nose. He needed surgery. After the surgery, he was unable to urinate. The next time I heard of this was from one of my graduates whose husband had had shoulder surgery and was unable to urinate after coming out of the anesthetic. Then it happened to my father after shoulder surgery, my husband after a colonoscopy, and three more clients had relatives with this problem.

    I, of course, was curious about the causes of this. Western medicine does not seem sure what causes this particular phenomenon. It is more common in middle age or elderly men, but it does happen to women as well. They believe it is a side effect of the anesthetic, but why is a question no one can answer.

    The initial client asked me to go to the nursing home and work on her father. He had been unable to urinate for 8 months at that point and could not return to his assisted living with a catheter. I went to the nursing home, worked on him for 10 minutes, and an hour later he urinated. What I found was that his pelvic floor muscles felt as if they had shut themselves off. Muscles turn themselves off in response to trauma or non-use, this isn’t uncommon, but to have an entire group of muscles turn off is somewhat strange.

    Next, I coached the graduate in how to work on her husband and she said she too felt like the pelvic floor muscles had no tone. Being me, I jumped at every opportunity to play with this. Each time the pelvic floor muscles came back fairly quickly, and within an hour the person was able to urinate. However, without help some people can end up using a catheter for an extended period of time. It really is a catch-22 for the medical community. If they do not insert a catheter and drain the bladder, urine will back up into the ureters and kidneys and cause infection. But the catheter itself causes damage to the urethra and can also lead to infection. Plus, the more the catheter is engaged, the more dependent on it the bladder becomes.

    So far I’ve had pretty good luck, but I have not done this enough times to say it works without fail. When my daughter told me the morning after delivery that she was having this problem, I left and went to the hospital immediately. She had told the nurse she did not want a catheter, which was really helpful, but the nurse only agreed to leave it out for a few hours, so time was of the essence.

    I worked on her for five minutes and it did not fix the problem, so I worked on a different area for five minutes and we were closer, finally with the third round and the third area we had success. Most of the moves are very simple and I would like to describe them to you because anyone who can be helped with this problem should be. Some of the moves are too complicated, but most I can describe in writing.

    So, first, walk the pinky edge of your hand from the belly button down to the superior edge of the pubic symphysis, feel the tension or lack of tension in the muscles as you do this. After that hand is placed on the superior edge of the pubic symphysis, slide your other hand under the client’s body and onto the sacrum, placing the pads of your fingers close to the spinous processes of the sacrum.

    Now, move the pubic symphysis slightly inferior and posterior, you don’t need much movement. Next, move the sacrum slightly inferior and anterior. This has you moving the origin and insertion of several of the pelvic floor muscles closer together, and doing a passive contraction. In kinesiology, one of the ways to turn muscles back on is to move the origin and insertion toward one another. Hold this for a minimum of 45 seconds. When you release, go back to the lower belly, just above the pubic symphysis, and check the tension in the tissue. You can repeat this as many times as you feel you need to. Sometimes moving slightly to one side or the other can be helpful, particularly in men. Prostate swelling tends to sit in the left pelvic region, moving slightly left can help alleviate that swelling, which may help with urination. For women, particularly women who have just had a baby, the uterus naturally sits slightly to the right. If it is swollen or unhappy, it may be causing some problems, so moving slightly to the right may be helpful.

    Our next move is to target coccygeus. Place one hand on the lateral side of either hip, thinking about where the iliac spine is, so about halfway between the iliac crest and the ischial tuberosity, directly lateral. Move your hands slightly toward one another and then mildly diagonal toward the inner thighs. Hold this for 45 seconds. Release and check the tension just above the pubic symphysis. And again, this move can be repeated.

    These two moves seem to work best and you may have success after just these two moves. If, however, the client is still unable to urinate the next move we will try has to do with the alignment of the coccyx. If possible, have the client roll to one side. If this is not possible, reach your hand under their body. You want to feel the edges of the superior coccyx in whatever position your client is in. If you feel like the coccyx is shifted to one side, slightly move the coccyx in the direction it is already shifted in. You will do this by placing your fingers on the opposite side of the coccyx and moving it toward the side it is already shifted to. Generally, the side the coccyx is shifted to is posterior, if this is true, accentuate what you are doing by pushing the side you are on anterior. Hold for 45 seconds. Release and re-palpate. You can do this move several times if needed, just remember to follow the pattern of the coccyx.

    Hopefully this is helpful and you will be able to use this information to help someone get off a catheter or out of the hospital. Let us know how you do on facebook or at our contact email contact@efullcircle.com

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