One In Three Women Who Ever Had A Baby Wet Themselves in Cantonese

Why do you leak urine after having a baby?

When the baby moves down through the birth canal, it stretches the nerves and muscles that keep the bladder shut. These are called the pelvic floor muscles, and they can sometimes be left weak, and not able to keep the bladder from leak ing. Leaking happens mostly when you cough, sneeze, lift or do exercise. It is rare for the bladder to be hurt during birth, but the muscles and nerves often are, and you need to do pelvic floor muscle training to help the muscles get strong again.

為什麼生孩子後會漏尿？

當胎兒通過產道下移時，會拉扯保持膀胱關閉的神經及肌肉。這些肌肉叫作骨盆底肌群，它們有時會變弱，並因此無法防止膀胱的尿液漏出。當你咳嗽，打噴嚏，提物或做運動時最可能出現漏尿。生孩子時損傷膀胱很罕見，但肌肉及神經常常會受損傷，因此你需要做骨盆底肌肉鍛練，幫助這些肌肉重新變得強健。

Will this leaking go away by itself?

If you have any leaking, it will not go away if you just ignore it. Leaking is likely to stop if you train your pelvic floor muscles, to help get their strength back. If you don’t get pelvic floor muscle strength back after each baby you have, you may start wetting yourself, as the pelvic floor muscles get weaker with age.

漏尿會自己消失嗎？

如果你有漏尿而不去管它，它是不會自動消失的。如果你鍛練骨盆底肌肉來幫助它們恢復力量，漏尿就有可能停止。如果你在每次生完孩子之後不幫助骨盆底肌肉恢復力量，就可能會開始尿濕褲子，因為隨著年齡增長，骨盆底肌肉會變得更弱。

How does my bladder work?

The bladder is a hollow muscle pump. It fills slowly from the kidneys, and can hold at least one and a half to two cups of urine (300 to 400mls). The bladder outlet tube is kept closed by the pelvic floor muscles. When the bladder is full and you decide to pass urine, the pelvic floor muscles relax when you sit on the toilet, and the bladder squeezes the urine out. Then the same “fill and empty” cycle begins again.

我的膀胱如何運作？

膀胱是一個中空的肌肉泵，慢慢會被從腎臟排出的液體充滿，裡面至少容納1.5至2杯尿液（300至400毫升）。骨盆底肌肉將膀胱的排泄管閉合。當膀胱充盈需要排尿時，你坐在馬桶上骨盆底肌肉就會放鬆，然後膀胱將尿液擠出。這樣的“充盈 - 排空”周而復始。

What do my pelvic floor muscles do?

See the picture of the pelvic floor. The pelvic floor muscles do a number of things, they:

• help to close off the bladder, the vagina (front passage) and the rectum back passage); and
• help to hold the bladder, the uterus (womb) and bowel in their proper place.

我的骨盆底肌肉有甚麼作用？

參閱骨盆底圖片。骨盆底肌肉有多種作用，它們：

• 幫助關閉膀胱，陰道（陰道口）和直腸（肛門）；及
• 幫助將膀胱，子宮及直腸維持在正常位置。

What happens if my pelvic floor muscles are weak after having my baby?

• You might leak urine when you cough, sneeze, lift, laugh or do exercise.
• You might not be able to control passing wind.
• You might feel an urgent need to empty your bladder or your bowel.
• You might not have good support for your bladder, your uterus or your bowel. Without good support one or more of your pelvic organs might sag down into your vagina. This is called pelvic organ prolapse. Prolapse is very common and happens to about one in ten women in Australia.

如果我的骨盆底肌肉在生孩子之後變弱會有甚麼後果？

• 當你咳嗽，打噴嚏，提舉物件，大笑或做運動時可能會漏尿。
• 你可能無法控制排氣。
• 你或許會感到急需排小便或大便。
• 你的膀胱，子宮或直腸可能得不到到良好的支撐。沒有良好的支撐，一個或多個盆腔器官可能會下垂到陰道內。這就叫作盆腔器官下垂。盆腔器官下垂非常普遍並發生在大概十分一的澳洲女性身上。

What can I do to stop these things from happening?

• Train your pelvic floor muscles (we tell you how later).
• Keep good bladder and bowel habits: 
  - eat fruit and vegetables; 
  - drink 1.5 - 2 litres of fluid per day; 
  - do not go to the toilet ‘just in case’ as this might cut down how much your bladder can hold; and
• Protect your pelvic floor muscles when opening your bowels. A good way to sit on the toilet is to put your forearms onto your thighs and, with your feet close to the toilet, raise your heels. Relax your pelvic floor muscles and gently push.
• Keep your weight within the right range for your height and age.

我可以做些甚麼來防止這些問題出現？

• 鍛練你的骨盆底肌肉（稍後我們將告訴你如何鍛練）。
• 保持良好的大小便習慣： 
  - 吃水果蔬菜； 
  - 每天飲用1.5—2升液體。 
  - 不要為了“以防萬一”而去廁所，因為這樣做可能會減少膀胱的儲尿量；以及
• 排大便時要保護好你的骨盆底肌肉。坐馬桶的一種好方法是將前臂放在大腿上，雙腳靠近馬桶，提起後腳跟。放鬆骨盆底肌肉然後輕輕向下用力。
• 保持你的體重處於符合你的身高及年齡的範圍內。

How can I care for my weak pelvic floor muscles?

The birth of a baby might have stretched your pelvic floor muscles. Any ‘pushing down’ actions in the first weeks after the baby’s birth might stretch the pelvic floor muscles again. You can help to protect your pelvic floor muscles by not pushing down on your pelvic floor. Here are a few ideas to help you.

• Try to squeeze, lift and hold your pelvic floor muscles before you sneeze, cough, blow your nose or lift.
• Cross your legs and squeeze them tightly together before each cough or sneeze.
• Share the lifting of heavy loads.
• Don’t strain when using your bowels.
• Do not do bouncing exercises.
• It’s alright to get up once a night to pass urine—don’t go to the toilet just because you had to get up to baby.
• Strengthen your pelvic floor muscles through training.

我怎樣才能護理好衰弱的骨盆底肌肉？

分娩可能扯傷了你的骨盆底肌肉。嬰兒出生後最初幾周，任何“向下推”的動作或會再次拉扯骨盆底肌肉。你可以透過不向下推骨盆底來保護你的骨盆底肌肉。這裡有一些建議會對你有幫助。

• 在打噴嚏，咳嗽，擤鼻涕或提舉物件之前儘量收緊，提起骨盆底肌肉並保持下去。
• 每次咳嗽或打噴嚏之前交叉雙腿，並用力將其收緊在一起。
• 與別人一起提舉重物。
• 大便時不要太用力。
• 不要做跳躍運動。
• 每晚起床一次去小便沒問題—但不要因為反正要起床照顧嬰兒而去廁所。
• 透過鍛練增強骨盆底肌肉。

Where are my pelvic floor muscles?

The first thing to do is to find out which muscles you need to train.

1. Sit or lie down with the muscles of your thighs, buttocks and stomach relaxed.
2. Squeeze the ring of muscle around the back passage as if you are trying to stop passing wind. Now relax this muscle. Squeeze and let go a couple of times until you are sure you have found the right muscles. Try not to squeeze your buttocks together.
3. When sitting on the toilet to empty your bladder, try to stop the stream of urine, and then start it again. Only do this to learn which muscles are the right ones to use—and only once a week. Your bladder may not empty the way it should if you stop and start your stream more often than that.

If you don’t feel a distinct “squeeze and lift” of your pelvic floor muscles, or if you can’t stop your stream of urine as talked about in Point 3, ask for help from your doctor, physiotherapist, or continence nurse advisor. They will help you to get your pelvic floor muscles working right. Even women with very weak pelvic floor muscles can gain from pelvic floor muscle training.

我的骨盆底肌肉在哪裡？

首先要找出你需要鍛練哪些肌肉。

1. 坐下或躺下，放鬆大腿，臀部及腹部。
2. 收緊肛門周圍的環形肌肉，就像你正盡力忍着不排氣一樣。然後放鬆這塊肌肉。收緊及放鬆數次，直到確定你已經找到正確的肌肉為止。儘量不要同時收緊臀部。
3. 收緊肛門周圍的環形肌肉，就像你正盡力忍着不排氣一樣。然後放鬆這塊肌肉。收緊及放鬆數次，直到確定你已經找到正確的肌肉為止。儘量不要同時收緊臀部。

如果你沒有明顯感覺到骨盆底肌肉“收緊及提起”，或者如果你不能像第3點提到的那樣停止排尿，就要向你的醫生，理療師或排便科護士顧問尋求幫助。他們會幫你令骨盆底肌肉正常運作。骨盆底肌肉非常弱的女性將得益於骨盆底肌肉鍛練。

How do I do pelvic floor muscle training?

Now that you can feel the muscles working—

1. Squeeze and draw in the muscles around your back passage, your birth canal and your front passage all at the same time. Lift them UP inside. You should have a sense of “lift” each time you squeeze your pelvic floor muscles. Try to hold them strong and tight as you count to 8. Now, let them go and relax. You should have a distinct feeling of “letting go”.
2. Repeat (squeeze and lift) and let go. It is best to rest for about 8 seconds in between each lift up of the muscles. If you can’t hold for 8, just hold for as long as you can.
3. Repeat this “squeeze and lift” as many times as you can, up to a limit of 8 to 12 squeezes. When you first start after having your baby you might like to begin with 3 squeezes only, and work up to more over a few weeks.
4. As you get stronger, try to do three sets of 8 to 12 squeezes each, with a rest in between.
5. Do this whole training plan (three sets of 8 to 12 squeezes) each day while lying down, sitting or standing.

While doing pelvic floor muscle training—

• Do NOT hold your breath;
• Do NOT push down, only squeeze and lift; and
• Do NOT tighten your buttocks or thighs.

我如何做骨盆底肌肉鍛練？

現在你可以感覺到肌肉在運動—

1. 同時收緊並向內收起肛門，產道及陰道口周圍的肌肉。將這些肌肉向內向上提。每次你收緊骨盆底肌肉時應該有“提起”的感覺。儘量一邊用力保持收緊一邊數到8。然後放鬆這些肌肉並讓自己鬆弛下來。你應該有明顯的“放鬆”感覺。
2. 重覆“收緊及提起”然後放鬆。最好在每次提起肌肉之間休息8秒鐘左右。如果你不能堅持收緊數到8，只需量力而為。
3. 儘量多次重覆這種“收緊及提起”鍛練，每組最多收緊8至12次。當你生孩子後開始做鍛練時，可能只想從3次收緊開始做起，並於數周內逐漸增加次數。
4. 隨著你的身體逐漸強壯，儘量每次鍛練做3組8至12次收緊，每組之間要休息。
5. 每天在躺下、坐下或站立時做完整套鍛練計劃（3組8至12次收緊）。

進行骨盆底肌肉鍛練時—

• 不要屏住呼吸；
• 不要向下推，只收緊及提起；以及
• 不要繃緊臀部或大腿。

Do your pelvic floor muscle training well

Fewer good squeezes are better than a lot of half hearted ones! If you are not sure that you are doing the squeezes right ask for help from your doctor, physiotherapist, or continence nurse advisor.

認真做骨盆底肌肉鍛練

認真地做幾次收緊鍛練比馬馬虎虎地做很多次效果好！如果你不確定你的收緊鍛練做得是否正確，就要向你的醫生，理療師，或排便科護士顧問尋求幫助。

Make The Training Part Of Your Daily Life

Once you have learnt how to do pelvic floor muscle squeezes, you should do them often. Every day is best, giving each set of squeezes your full focus. Make a regular time to do your pelvic floor muscle squeezes. This might be when you:

• go to the toilet;
• wash your hands;
• have a drink;
• change the baby;
• feed the baby; or
• have a shower.

It’s a good idea to get into the lifelong habit of doing one set of pelvic floor muscle exercises every time you go to the toilet, after passing urine or opening your bowels.

令鍛練成為你日常生活的一部份

你一旦學會了如何做骨盆底肌肉收緊鍛練，就要經常進行鍛練。最好是每天都全心全意地做每一組鍛練。你應該定時做骨盆底肌肉收緊鍛練。可以於以下時間做：

• 去廁所；
• 洗手；
• 喝水；
• 給嬰兒換尿片；
• 餵嬰兒；或者
• 洗澡。

建議養成每次去廁所大小便後都做一組骨盆底肌肉運動的好習慣，並且終生如此。

What if things don’t improve?

Pelvic floor muscle damage may take up to six months to get better. If things are not getting better after six months, speak to your doctor, physiotherapist or continence nurse advisor.

如果情況沒有改善怎麼辦？

骨盆底肌肉受損可能需要長達6個月才能好轉。如果6個月之後情況還未好轉，就要告訴你的醫生，理療師或排便科護士顧問。

Also ask your doctor for help if you notice any of the following:

• any leaking of urine;
• having to rush to get to the toilet, to pass urine or open your bowels;
• not being able to hold on when you want to;
• not being able to control passing wind;
• burning or stinging inside when you pass urine; or
• having to strain to start the flow of urine.

如果你留意到以下任何情況亦要向你的醫生尋求幫助：

• 漏尿；
• 急需去廁所大小便；
• 雖然想忍住大小便卻無法做到；
• 無法控制排氣；
• 排尿時尿道灼熱或疼痛；
• 必須用力才能開始排出尿液。

Seek help

Qualified nurses are available if you call the National Continence Helpline on 1800 33 00 66* (Monday to Friday, between 8.00am to 8.00pm Australian Eastern Standard Time) for free:

• Information;
• Advice; and
• Leaflets.

If you have difficulty speaking or understanding English you can access the Helpline through the free Telephone Interpreter Service on 13 14 50. The phone will be answered in English, so please name the language you speak and wait on the phone. You will be connected to an interpreter who speaks your language. Tell the interpreter you wish to call the National Continence Helpline on 1800 33 00 66. Wait on the phone to be connected and the interpreter will assist you to speak with a continence nurse advisor. All calls are confidential.

Visit bladderbowel.gov.au or continence.org.au/other-languages

* Calls from mobile telephones are charged at applicable rates.

尋求幫助

如果你致電國家排便節制熱線，有資質的護士會接聽你的電話1800 33 00 66* （週一至週五，澳大利亞東部標準時間8:00am—8:00pm）。

• 信息；
• 建議；及
• 資料單張。

如果你在講英語或者理解上有困難，你可以透過撥打13 14 50獲取免費電話傳譯服務以接通國家排便節制熱線。電話會用英語接通，因此請說明你要講的語言並且不要掛機。你會被連接到一個講你母語的傳譯員。告知傳譯員你想要致電國家排便節制熱線，電話是1800 33 00 66。待電話接通後傳譯員會幫助你與排便節制護理顧問對話，所有的來電均保密。

請登陸：bladderbowel.gov.au或者continence.org.au/other-languages

* 用手機打出會收取相應費用。