Your bladder isn’t directly involved with the reproductive process, but pregnancy may have many effects on your bladder.
Needing to urinate more frequently is both an early sign of pregnancy and a typical symptom in the third trimester, as your expanding uterus puts pressure on your bladder and makes it unable to hold as much as it used to.
Another possible effect of pregnancy on your bladder is a condition called urinary stasis. This refers to an inability to urinate as usual.
Urinary stasis can be uncomfortable and frustrating. It can also lead to complications like urinary tract infections (UTIs), a fairly common — but potentially serious — concern during pregnancy.
Here’s what you need to know about urinary stasis during pregnancy.
Urinary stasis, or urinary retention, is defined literally as the stopping of urine. But it doesn’t always mean you can’t urinate at all.
According to the
- have trouble initiating the flow of urine
- urinate in only small, frequent amounts
- have an inability to fully empty your bladder
- have frequent urges to urinate
- leak urine or have a slow flow of urine
- experience lower abdominal pain or swelling
Aside from being uncomfortable, urinary stasis can cause other concerns during pregnancy. These concerns may be serious.
Urinary tract infection (UTI)
The most common complication of urinary stasis during pregnancy is UTI. If you are pregnant, you are already more susceptible to UTIs for several reasons, including:
- hormonal changes
- anatomical differences
- pressure on the bladder because of your expanding uterus
When urine remains in the bladder for long periods of time, bacteria can grow and lead to an infection in the urinary tract, according to
Kidney infection and bladder damage
When UTIs are treated promptly, people usually recover without any difficulty.
Untreated UTIs can spread to the kidneys, causing an infection called pyelonephritis. This is a serious issue requiring immediate treatment.
Long-term urinary retention can also weaken the bladder and cause incontinence, according to
Miscarriage
Miscarriage due to urinary stasis is very rare, occurring in
Some types of urinary stasis occur early in pregnancy, in the first and second trimester, and are more severe than other types. If this happens, it is called acute urinary retention (AUR). It may happen because of certain uterine differences.
AUR can happen suddenly and cause intense symptoms. AUR during pregnancy is considered a medical emergency. According to
If left untreated, AUR can pose a threat to both baby and parent, a 2022 case report suggests.
The symptoms of urinary stasis during pregnancy are the same as they are outside of pregnancy and include:
- changes to the frequency and flow of urination
- sudden urges to urinate
- inability to void, begin voiding, or void completely
- lower abdominal pain or swelling
Urinary stasis might occur during pregnancy for several reasons. In general, some type of physical compression or blockage due to the growing uterus is usually to blame.
Other possible causes for urinary stasis during pregnancy include:
Constipation
Constipation may happen more frequently through all 9 months of pregnancy. Because constipation can irritate and press on the bladder wall and ureters, it can also lead to urinary stasis.
Bladder or ureter obstruction
Urinary stasis is common in older men, especially those with an enlarged prostate, because the prostate puts added pressure on the urethra and stops the typical flow of urine.
Pregnancy can cause a similar issue, as the uterus not only compresses the urethra but often crowds other organs.
Weak bladder muscles
According to
Uterine anomalies
As we mentioned, structural differences in the uterus can lead to urinary stasis or incontinence. This is especially true for a tilted or retroverted uterus.
This condition usually resolves itself around the end of the first trimester. If it doesn’t, the uterus can become trapped inside the pelvis, causing serious complications, according to 2019 research.
If you have symptoms of urinary retention or stasis during pregnancy, it’s important to let your healthcare professional know right away. They can diagnose it in many ways, including:
- physical exam
- blood work
- urinalysis
- imaging tests, such as ultrasounds and CT scans
- post-void measurements (to see how well your urine is flowing and how much urine is left in your bladder after voiding)
- urodynamic tests to assess how well your bladder stores and empties urine, per
the NIDDK
Your doctor will need to determine the cause of your urinary stasis to choose the best treatment option for you. Treatment options for urinary stasis in pregnancy include:
Catheter
You will likely need to have a catheter inserted to drain the urine inside your bladder. The catheter can help relieve your pain and reduce the stress on your bladder, urinary tract, and kidneys.
Some people with urinary stasis may need to have a catheter that stays in place for a while. This type of catheter is called an indwelling catheter.
Others may have catheters that they insert and remove themselves to help empty their bladder. Your healthcare professional will teach you how to use this type of catheter.
Medication
If your urinary stenosis is caused by a medication you are taking, your doctor may lower the dosage or have you stop taking it altogether. Since even some over-the-counter medications can cause urinary stasis, it’s important to discuss all medications you take with your healthcare professional, especially during pregnancy.
You may be prescribed antibiotics if you have a urinary tract infection.
Vaginal pessary
A vaginal pessary is a device, usually ring-shaped, that is inserted into the vagina. It helps lift and support structures that may be compressing the bladder and limiting urine flow.
Physical therapy
Medical interventions
Although rarely performed, if your urinary retention is caused by a tilted uterus, your doctor may be able to manually or surgically reposition the uterus so that it fits appropriately within your pelvis and reduces pressure on your bladder, according to a 2021 review of scientific literature.
The risk factors for urinary stasis during pregnancy aren’t well researched, though we do know that having a retroverted uterus is a primary risk factor, as are pelvic adhesions, uterine wall defects, and endometriosis.
A
- advanced maternal age
- previous preterm delivery
- gestational diabetes
- prior abortion
- existing UTIs
If you have AUR, it’s considered a medical emergency — immediate intervention is required. With prompt treatment and no further complications, you can have a healthy pregnancy.
Chronic urinary retention is less severe but typically requires management of symptoms throughout pregnancy.
You may be a candidate for physical therapy, bladder training, or in some cases, pregnancy-safe medication to maintain a healthy flow of urine.
Without proper management, you could be more prone to recurrent infections during your pregnancy, which can lead to kidney and bladder damage as well as premature delivery.
Does getting a UTI during pregnancy mean I have urinary stasis?
No, not necessarily. Unless you’re also having difficulty urinating or fully emptying your bladder, you probably don’t have urinary stasis. UTIs are extremely common during pregnancy because of hormonal and anatomical changes, so most people with UTIs during pregnancy are not also experiencing urinary stasis.
Will I need surgery if I have urinary stasis during pregnancy?
It’s possible, but it won’t be the first treatment approach. If you have a more permanent blockage in your urethra, like a blood clot or bladder stone, it may need to be surgically removed. Likewise, if you have a retroverted uterus that can’t be manually corrected, you may need surgery to reposition it.
Will my urinary stasis go away after I deliver?
If your urinary stasis is chronic and caused by the hormonal and anatomical changes of pregnancy, there’s a good chance it will resolve itself after you give birth. That said, postpartum urinary stasis is a common condition as well, especially for people who give birth vaginally.
Many people experience urination problems during pregnancy, whether it’s increased frequency or recurring UTIs. But urinary stasis, or severe impairment in your ability to urinate, can be caused by typical pregnancy-related changes or a serious anatomical difference.
Either way, it requires treatment. So if you’re having trouble urinating or experiencing lower abdominal pain during pregnancy, you should let your doctor or healthcare professional know right away.
