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frequent urination post hysterectomy
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frequent urination post hysterectomy

I am a 50 year old woman. I had a hysterectomy one year and nine months ago and I have had urinary problems developing progressively since then. I have to get up during the night, usually three times, sometimes only twice and I feel the need to urinate very frequently during the day, even though there isn't much to pass. I don't have a urinary tract infection as this has been checked.
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408163_tn?1242953101
Hi there,
Did you have your oaries removed? I have been reading lots and lots on menopause symptoms including urinary frequency and leaking. It seems that when estrogen has decreased or stopped, these urinary symptoms are very common. I too had urinary symptoms, was tested for 3 UTI's that I didn't have, and was placed on a higher dose of estrogen. I use the vivelle dot patch, oral estrogen and vaginal estrogen. This seems to have helped the urinary problems amongst other things. Are you on hormone replacement?
There is a great book I am reading called "Screaming to be heard" by Elizabeth Vliet MD and it really goes into detail on how hormones affect every organ system.
Are you on Hormone replacement? I hope this helps, and I hope you get some answers.
Keep us posted, and get the book. Its nice being your own advocate...
Laney
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Avatar_n_tn
Hi, thanks for your feedback, much appreciated.  I've been away and also still trying to figure out how this system works.
No, I didn't have my ovaries removed, so I believe my menopause should proceed pretty much naturally.  You've given me a really important lead though, thank you.  I'm going to discuss the estrogen thing with my doctors.  
Thank you also for the info re the book.  You're right, its really important to be informed!
Best to you.
Malgosia

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106886_tn?1281295172
Laney is absolutely right (my personal opinion). It is all related to Menopause. Please don't think that I have no faith in doctors, but if your doctor says there is no connection, go and see someone else ... do the research... it is unfortunate but there is so much confusion about all this that you do, as Laney suggested, have to be your own advocate.

Before I had my hysterectomy in 2000, I was sent to a Urologist because of the symptoms you mentioned (I had ovaries removed in 2000). The doctor could not find any problems and sent me on my way (still miserable). Then right before my surgery in 2000, my Oncologist sent me to another Urologist thinking there must be a problem because, again, I had the symptoms you mentioned. I was 47 at this time. It was not until after my surgery (Not saying the surgery corrected it, in fact, it had the potential to make things worse) I got relief because by then I was on a steady stream of Estradiol (by way of the Vivelle patch.. a bioidentical hormone... estradiol is reputed by many to be the premier estrogen and personally I won't use anything else for estrogen replacement). I also use testosterone, which will also keep that area supple. But with declining Ovarian hormones, and in your case, who knows if the blood supply to the ovaries has deminished, thus bringing menopause on sooner than if you'd not had the Uterus removed (this is often a concern)... anyway, with this decline, you will lose the all important effects of Estradiol in this area, thus causing atrophy which in turn causes the uereter to, shall we say, get out of alignment!  

I have had times since the surgery, especially times when I have messed around with my hormones when I have been in trouble again in this area. I saw an OB/GYN Urologist in the area and after a dreadful first appointment I did not go back. I have correced the problem, though, by going back to my Trusty Vivelle and at a decent dose. I also stopped using Progesterone and since then things have been even better. I still use testosterone. I find it totally unacceptable that in order to finish urinating, I have to literally stand up and put my head to the floor just to get everything to drain. Crazy. As far as Intimacy, too, my husband said just recently he has noticed a huge difference. We went through a number of years, actually, where we were not able to have sex because of the dryness (and other things, too, but in retrospect for both of us, things have gotten better ... much better, since I have been following the latest hormone regimen.


I NEED Estradiol and an Optimal dose of it... around 90 to 100 ng/ml blood values... in order to maintain function in the bladder area among other things, too... feet problems were huge this summer when my Progesterone was high and Estradiol was low. I had problems walking and I have always been active. Leg cramps and fuzzy thinking also topped the list.

It should not have to be this hard!

I totally second the Vote on Dr. Vliet. I found her work last Spring and honestly, that woman has given me my life back. My doctor is a huge Progesterone believer, but for us menopausal women (especially those with no ovaries) it seems to not be the miracle hormone we all once thought. Not sure what my hormone doctor will say about all this. Have been unable to get in to see him, but my regular OB/Gyn knows that I have lately felt better than ever... so he will support me if my hormone doctor does not. There is still so much to learn about Estradiol and its effects on the female body. Some of thinking on this whole area has changed and I am concerned that my hormone doctor has not been as free-thinking as I'd hoped.

Order Vliet's work through Amazon... I just got my own copy after borrowing from a friend. Her website is interesting, too, and supports her work to this day (since Screaming....... was revised).

Take care,

Mary
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488689_tn?1337996758
I had a laparoscopy done on Oct.6 this year and both my ovaries and tubes were removed. Within a week of the surgery, I started having urinary frequency and painful urination. I had tests done for a UTI and they all came back negative. I have also had a series of urodymamic testing done and everything is normal except there is severe urethral inflammation. I'm now seeing a urogynecologist who is attributing my symptoms to estrogen loss, and how it thins out the tissues of the vagina and urethra. I am using Vagifem estrogen to try to help with the painful voiding symtoms (symptoms) and also using a oxytrol patch to help with the frequency. Even if you still have your ovaries, the estrogen loss from menopause can cause your frequency issues. I think you should see a urogyencologist who can run tests to see if you are voiding normally and to see if your bladder is normal too. Then you can get some medications that will give you relief from the urinary frequency and if you need some hormone replacement they will determine if it's right for you. I can't take oral HRT because of a history of blood clots in my leg when I was on birth control pills years ago, but using a vaginal estrogen cream or tablet works directly on the tissues of the vaginal and urethra and bladder, all which are made up of the same kind of tissues. Estrogen helps to restore moisture to these tissues and also helps to reverse the thinning. It doesn't get into your system the way an oral estrogen does if you can't use them for medical reasons. It is a very minor amount that gets into the rest of the body. I wish I could use a patch or an oral medication to help with the constant hot flashes I've been having but I can't take the chance. Keep a record of how much fluid your drinking and how many times a day and night your voiding so the doctor will have an idea if you may also have an overactive bladder. Urinary problems after gyn surgeries as I've now found out is very common. It's too bad the surgeons don't tell us about these issues before but they seem to just avoid mentioning it to us. You can get relief so try to get yourself to a urogynecologist or even a urologist for a start.
I know how miserable it is to keep having to run to the ladies room all the time, and the sleep interruptions are the worst of all. I'm hoping I start to see some improvement myself soon.
Valerie
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I just want to encourage you to do some more research into the different types of estrogens available. More and more physicians who know anything at all about HRT or BHRT (Bioidentical HRT) do not recommend the type of estrogen that is in Birth Control pills for menopausal use. The difference between a bioidentical estrogen patch such as Climara or Vivelle (one made from soy and one from yams but bioidentical in the body to what we once made naturally) is so huge that they should not even be in the same classification.

Granted, I know you certainly may choose to avoid the estradiol patches altogether, but I just wanted to say that I support being armed with as much information as possible so if/when more menopausal symptoms crop up, you will be aware that there are possibly more options available to you than you once thought.

Great description, by the way, on how estrogen effects the bladder area.

After researching this stuff for over 8 years now, I have to say that Dr. Vliet's work makes the most sense to me, although Schwartz and Northrup also address the leg clot issue with relationship to the various types of estrogens available.

OK... hope you don't mind me popping in with this encouragement. I have just had such a roller coaster ride with bone loss/bladder issues/lack of  concentration/depression/slipped disc on the lumbar region/debibilitating leg cramps/feet issues that have prevented me from even walking like a normal person/high cholesterol for the first time in my life ... when estradiol was too low (again, I am only talking about bioidentical estradiol... no other estrogen) etc. that I at the very least, want women to be armed with information. No one should have to live like this... and, then to have the doctors all miss out on the reason we are falling apart... DUH... Ovarian hormones are missing and that is HUGE.

Our bodies make Estrone from fat cells. This is a harsher type of estrogen and is made once we are in menopause, surgical or otherwise. It is why there is that new-found fat in the middle of the body, it is easy for the body to utilize when it is in our "middles" but the estrogen is not the type we want, according to the research I have been doing, and it is not enough to sustain the functions (over 400) for which Estradiol is king.... our bodies crave estrogen. But, I don't want the Estrone. That is what has been linked to breast cancer and other problems. It is one reason I supplement with my estradiol patch.

I am not a doctor. But, I have suffered enough to know what works for me and what does not, with the least amount of harm. There has been so much confusion out there and I, too, have been confused on all this. I needed answers this summer... quality of life was horrid. I found some answers and just wanted to share. Pick up Vliet's work if you can. See what you think.

Mary
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Thank you both for your contributions. So much to think about.
We've had a great deal of negative publicity locally about natural hormones and possible problems they cause.  I refuse to take any medications unless absolutely necessary.

Because my periods were so difficult, before the hysterectomy, over a number of years I tried progesterone tablets, a progesterone IUD and then an ablation which required me to take hormones prior to the operation. Those hormones led to massive bleeding (5 x worse than my worst periods) and finally they put me on testosterone which had terrible side effects (took 15 months to get over).  The ablation didn't work (I bled constantly) and in desperation I had the hysterectomy.  Now I'm no longer suffering for two weeks of the month and my iron levels are normal, but this urinary thing has started.  

I'm not keen on taking any hormones at all, but I will certainly start investigating this as thoroughly as possible.  I will find Dr Vilet's web site and her book.  We have women's clinics here and I think I'm going to go there rather than back to my (male) doctor who has told me several times to go home and do pelvic floor exercises!

Thank you both for your informative posts.  I really appreciate them.

Malgosia
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