[20F] Postpartum with urinary urgency and pelvic pressure

What might be happening

Based on the symptoms you've described, here are some possible explanations:

1. Urinary Tract Infection (UTI):

   • Rationale: UTIs are common postpartum and can cause symptoms like frequent urination, urgency, and pain during urination. However, you mentioned that you were told you do not currently have a UTI.
   • Typical Treatments/Testing: A urine test to check for bacteria, and if confirmed, antibiotics are usually prescribed.

2. Postpartum Urinary Retention:

   • Rationale: This condition can occur after childbirth and may cause difficulty starting urination, a feeling of incomplete emptying, and pelvic pressure.
   • Typical Treatments/Testing: A physical exam and possibly a bladder scan to measure residual urine volume. Treatment may include bladder training exercises or, in some cases, catheterization.

3. Kidney Stones:

   • Rationale: Given your history of a kidney stone, it's possible that another stone could be causing urinary symptoms and pelvic pressure.
   • Typical Treatments/Testing: Imaging tests like an ultrasound or CT scan to detect stones. Treatment may include pain management, increased fluid intake, or procedures to remove the stone.

4. Pelvic Floor Dysfunction:

   • Rationale: Childbirth can weaken the pelvic floor muscles, leading to symptoms like pelvic pressure, difficulty urinating, and a feeling of incomplete emptying.
   • Typical Treatments/Testing: A pelvic exam and possibly referral to a pelvic floor specialist. Treatment may include pelvic floor physical therapy.

What you can do

Frequent and painful urination:

• See a doctor: Given the severity and sudden onset of your symptoms, it's important to see a healthcare provider as soon as possible. They may perform a urine test, physical exam, or imaging to determine the cause.
• Stay hydrated: Drink plenty of water to help flush out your urinary system.
• Avoid irritants: Avoid caffeine, alcohol, and spicy foods, which can irritate the bladder.

Pelvic pressure and difficulty urinating:

• Pelvic floor exercises: Try doing Kegel exercises to strengthen your pelvic floor muscles. These can help improve bladder control.
• Warm baths: Taking a warm bath may help relax your pelvic muscles and relieve pressure.
• Bladder training: Try to urinate at regular intervals, even if you don't feel the urge, to help train your bladder.

General postpartum care:

• Follow-up appointments: Make sure to attend any scheduled follow-up appointments with your healthcare provider to monitor your recovery and address any ongoing issues.
• Rest and recovery: Ensure you are getting enough rest and allowing your body to recover from childbirth.

What you should look out for

Given the complexity of your symptoms and recent postpartum status, it's important to seek medical care promptly. Reasons to seek care even more urgently include:

• Fever or chills: These could indicate an infection.
• Severe pain: Especially in your lower back or sides, which could suggest a kidney stone or other serious issue.
• Blood in urine: This could be a sign of a more serious condition.
• Inability to urinate: If you are unable to urinate at all, seek immediate medical attention.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.