Stress Incontinence
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Stress Incontinence
May 2012
I am considering having surgery for ongoing stress urinary incontinence (SUI).
I've done my kegels, I ''squeeze then sneeze'' etc. but since having # 2 ( 8
years ago) I have never been able to do any even moderate-impact exercise
without leaking. I wear Poise pads now whenever I run and that works, but is
obviously a huge drag - and I just sit out the improptu running games at the
park. So I'm looking at surgery. BUT there are several approaches used AND
there's now an FDA investigation into some of the mesh used to in these
procedures.
I've had successful hernia repair surgery in the past (so reacted ok to use of a
surgical mesh product), but I'm trying to sort through which procedures the
FDA is investigating, because apparently the high complication rate is only
with some approaches and not others. But even the information forms my MD
(Dr, Margulies, Kaiser) sent me are not totally clear.
Has anyone had surgery for SUI recently? (FDA investigation started last year)
Does anyone know if the problems are with the retropubic approach vs.
transobturator approach vs. single-incision sling?
Any medical professionals who can explain the difference in approaches in lay
language? Do they all go through the vaginal wall (yoikes!)
Would love to hear any and all thoughts/experiences.
thanks so much
longing not to leak
Hi,
I stressed about having the surgery for so long! I am only 46 and really
active.
I had to wear pads for years and practically had a panic
Attack when I ran out. It was awful, couldn't run or do any activity.
I couldn't walk without leakage. Had the surgery at Kaiser Vallejo
And it changed my life. I feel like a new person. I had a couple of days
Recovery and a little tenderness for a couple of weeks. I had two
incisions internal and two
Tiny ones on pubic area. Worst part was Kaiser's bikini
Wax and no sex for 6 weeks. You will feel like a new person.
Happy gal
You are right to do your homework! I have 20 years
experience doing these surgeries. The good news - the
surgeries do work well for stres incontinence.
The surgeries that I have experience with are:
TVT (transvaginal tape), TVOT (Transvaginal Obturator
Tape) and the Burch procedure (which hardly anyone does
anymore, but still worked well, back in the day).
The TVT and TVOT use mesh, but a small piece just near the
bladder neck. My understanding about all the mesh
lawsuits is that they are mostly related to the ''mesh
kits'' used for repair of cystocele (when the bladder
bulges into the vagina) - sort of like a new ''hammock'' for
the bladder. That is a separate procedure from the
incontinence surgery.
A lot of women that have stress incontinence also have
prolapse symptoms, so make sure your doctor knows how to
fix those too, if you should need them. The success rate
for these surgeries is about 85%, which is pretty darn
good. Other non-surgical options are biofeedback and use
of a pessary (a diaphragm like device that you wear in
your vagina to hold up the bladder neck). Biofeedback, in
the right hands, has a 70% success rate.
Good luck with your decision. Any surgery is a big
decision, but women rarely regret having this surgery.
a BPN Ob/Gyn
Hi-
I had repair work done in January by Dr. Margulies. Mine surgery was pretty
extensive (hysterectomy, etc...), but included a mid urethral sling. I too was
overwhelmed by all the info, choices, etc. I did a TON of research and made the
decision to go with the sling as the amount of mesh used is really small. It
seems like most of the mesh issues are from using it for suspension of vagina.
There is a lot of info on the Hystersisters website.
Long story, short: I am so glad I had the surgery and my urinary issues that I
had from having 3 kids in 4 years, have basically subsided. I no longer pee
when I sneeze, laugh, or turn the faucet on to do dishes. I am not running to
the bathroom every half hour and I don't worry about HAVING to be on aisle
seat for movies, concerts, etc as not annoy others.
You really need to have support post surgery, so plan that in.
Finally, I really trusted Dr. Margulies and felt she really is an expert in her
field.
You are welcome to get in touch with me if you want to.
Best of luck!
K.
I have the same problem as you since my second child. I might have to
contemplate surgery in the future (I think the problem will likely get worse
after menopause), but in the meantime, I've found a satisfactory solution:
using a menstrual cup when I exercise. These are sold online or at the
Berkeley Bowl West as the Keeper (latex) or the Mooncup (silicone). It
goes in your vagina and over your cervix by suction and provides a gentle
pressure on the urethra which prevents bladder leakage. I run 18-25
miles/week and have done two half marathons without leaking. If I don't
wear it, I totally look like I peed in my pants (which in essence I did). You
might want to try it and delay surgery.
The downside is that its use may provoke bladder infections. I used to use
it during my periods as an eco alternative to disposable products, but
noticed I would get more frequent bladder infections, so now I only use it
for my workouts, but still get a bladder infection a few times a year.
stress-incontinent athlete mom
I had a TVT (Tension-Free Vaginal Tape) procedure with Dr.
Margulies in 2009. To give you some scale of my problem, I
couldn't run without completely filling a large pad, and
decided I couldn't take it any more when I couldn't jump on
a trampoline with my daughter during her gymnastics class. I
too, tried Kegels 'till I was blue in the face, but my
urethra was prolapsed so all that was wasted energy.
Some small downsides of my surjury. I couldn't pee
immediately after the surgery and had to go home with a
catheter (which I understand happens in some small
percentage of cases) but after 24 hours I was back to peeing
normally. Recovery was a drag (no lifting for 6 weeks) but
after that everything was great (and you will be familiar
with these restrictions from your hernia repair). But after
that, I was 90% better, which has made a huge difference to
me. I am running competitively, and every once in a while
for mysterious reasons I have some leaking but nothing like
it was.
I found Dr. Margulies to be very approachable, and if you
have questions, I think you should talk to her about your
concerns -- she's an urologist, and this is her area of
specialization. I found her to be frank, intelligent, and
caring. The surgical team at Kaiser Richmond (where I had my
surgery) was fantastic.
Feel free to contact me with any questions -- I think
urinary incontinence in women is pretty common, and I'm
surprised it doesn't come up more frequently.
M.
Checkout the Pelvic Floor Goddess Leslie Howard she is at
Lesliehowardyoga.com I was having problems and I took her
daylong workshop she gave at 7th Heaven Yoga in the East
Bay (she teaches throughout the Bay Area and travels the
States and the World) and I have relief! She has simple
exercises and she knows so much about the Pelvic Floor to
inform us about our own bodies & how they work. Take time
to investigate it is worth it. She also gives you the
straight shoot on the operation which every women
contemplating it should know. Be Well!
I.
Feb 2012
After giving birth vaginally to two large babies, I have
female stress incontinence, so I can't run, jump, cough,
sneeze or dance without wetting my pants. I've seen a uro-gyno
at UCSF and am signed up for some physical therapy and the
doctor encouraged me to do 3 sets of 15 kegels everyday -
which I do, but the kegels don't seem to make a difference.
The doctor said that because I am young I am a good candidate
for surgery. Does anyone have any successful experience with
physical therapy for female incontinence? Does anyone have any
experience with the "sling" surgery for stress incontinence?
Did it work? Thanks.
Anon
I had the same problem, although mine didn't fully manifest until my 50s. I tried
kegels and PT with absolutely zero results, so I opted for the sling surgery. Not
only did it totally work, but it was an easy surgery with a very quick recovery. I
recommend it- the relief is fantastic.
C.
I saw your posting and have not had any experience myself with incontinence,
but as a yoga instructor and Restorative Exercise Specialist, it is important to
look at your whole body to address this issue. It is likely due to weak pelvic floor
muscles that may have been an underlying problem before you were pregnant
and become much more evident after giving birth. Kegels are important, but it
is essential to also look at whether the pelvic floor muscles are weak or are they
tense/overly contracted. Otherwise doing the Kegels just puts more stress on an
already over-stressed muscle and will then cause what is happening. I can go
into much more detail and discuss and show you some exercises so that you can
address your incontinence issue which may be affected by much more than your
pelvic floor muscles.
T.
Hi!
I've been through two successful rounds of physical therapy
(I delivered 2 kids in a short span of time as well). I
thought physical therapy sounded crazy, but I did not want
to have surgery even if I was a ''young, ideal candidate,'' if
it could be fixed without, nor did I want to wears pads the
rest of my life. I did the first round not long after my 2nd
child was born, I did the second round after I had a bout
with a nasty stomach bug that left my pelvic floor weak
(Give the kegels a chance while you wait to get into
physical therapy (it takes time). The physical therapist
will expand from basic kegels, and ask if they use
biofeedback. If you are considering having any more
children, wait on the surgery, as you will likely have to
have the repair again. And keep up with your kegels after
physical therapy ends! Goodluck!
happy to have fixed the problem without surgery
Feb 2011
I am seriously considering having the TVT (transvaginal taping)
procedure done as I am at the end of my rope with my stress
incontinence- can't play games with my kids or join in a game of
soccer or kickball without a good chance of wetting my pants these
days and kegels haven't helped at all. Has anyone had experience with
this procedure and, if so, what doctor? My OBGYN has recommended
another doctor in her practice but I am wondering if I should consider
a second opinion with a urologist? I am also wondering about the
recovery- how long until I will be back to feeling normal?? Any advice
is helpful...thanks!
anon
For 6 years I had stress incontinence resulting from
pregnancy and/or birth. I tried physical therapy (kegels and
other core exercises), and finally gave up and got a
''periurethral sling.'' I don't know why I waited so long, as
I'm completely cured! I don't know what a TVT procedure is -
it was never mentioned to me - but you might want to look
into the sling too. It was surgery, I was totally under, but
it felt very minor and was a simple recovery. (My physical
therapist recommended it to me. She was Stephanie
Prendergrast - pelvicpainrehab.com). My surgeon was out of
CPMC in SF: Heidi Wittenberg, Pacific Gynecology and
Obstetrics Med Grp. 415-923-3123. Good luck.
Gimmie a jumprope!
I've had the procedure done and highly recommend it-
everything about it, including the recovery (I was not
bedridden and was only moderately uncomfortable), was quick
and easy. I was just miserable with leaking before and now
am DRY, even when I sneeze!
I had it done at Kaiser Richmond by a wonderful urological
gynecologist, Dr. Rebecca Margulies, and I think that
someone in that speciality is the best choice.
C.
Before you go the surgical route, please consider
www.wholewoman.com
I also suffer from stress incontinence and was discussing it
with a friend just before I had my third child 2 weeks ago. I
had a prolapse with my second birth and my friend had one with
her third. She told me about whole woman and said she went
through the exercises and can now jog daily with no leakage.
I play a lot of soccer and once I recover from this birth,
will look into this natural remedy first.
Just a thought....surgery had been on my mind, too. Good
luck!
anon
I have had the tvt. Life changing really! It doesn't
have many down sides, but I am probably in that 10% that has
had a couple problems. Regardless, it was completely worth it.
I'm pretty new to the parents network so I'm not sure if my
email address shows up, if so please, feel free to contact
me directly and we can talk in more detail.
R
March 2009
Hi, I'm wondering about -- this is kind of delicate -- but
whether many women who've delivered vaginally in their late
30s/early 40s have developed sporadic incontinence problems in
the years after birth? Friends of mine who have had 2 and 3
vaginal deliveries at around my age have cautioned me about
this. I'm considering a vbac versus planned c-section for my 2nd
baby (1st was an unplanned c-section) and wonder if this whole
incontinence thing is a common problem with older moms who
deliver vaginally?
Active mom
I was thirty-nine when my son was born after induced labor, and I
had significant incontinence for months afterwards -- I couldn't
walk down the street without wetting myself. I suspect that this
might have also been due to the fact that I had an epidural and
perhaps pushed harder and sooner than I should have. But I don't
know that with certainty. I was a jogger and could no longer jog
for, say, six or seven months. I did kegels and wore pads.
After a while I could jog again (partially because I decided that
I would just deal with the incontinence), but always with a pad.
In fact, I wore pads every day just to go out for quite a few
years. Now I experience only occasional problems (I have to wear
a pad for a long hike or a jog), but the problem is nowhere near
what it once was. So two things: if you have an induced vaginal
birth, you could indeed have problems with incontinence, but the
problem definitely diminishes with time. I would consult a
doctor about the risks and tribulations of Caesareans versus the
problem of incontinence. You may find that you would rather do
the vaginal birth anyway.
mostly dry now
Oh yes, you bet. One vaginal birth at 37 (from one pregnancy total),
and I've totally
lost my iron bladder. Before my son, I could go 8 hours without a
restroom; since my
son, the max is probably 3 hours, and one ill-placed sneeze can result
in a change of
clothing.
As an added issue, my body doesn't give me all that much warning about
the need to
defecate. I find myself just needing to go NOW. This is one thing they
don't tell you
that much about, but apparently it's not uncommon.
anonymous
This problem is all too common after vaginal delivery. You can
try doing lots and lots of Kegels. You can get a medication
from your doctor to ''dry you out,'' but it gave me really dry
mouth. Or, I wear a liner pad when I run, to avoid accidents. I
have found I can't jump anymore either, like skipping rope,
without leakage. Fact of life. Apparently there is also
surgery, but I don't see the leakage as that big an
inconvenience. Most women are already used to using liners
anyway.
A Little Leaky
I had two natural, vaginal births at ages 38 and 40 and yes, a
year after the second birth, I do experience some incontinence
when I exercise. It's annoying, and I'd be eager to hear if
others have ideas for what to do about it. That said, in regards
to your situation-- I feel very fortunate that I was able to have
unmedicated births and certainly do not wish I'd had c-sections,
despite this lingering effect.
anon
Pilates can really help you with that. I used to have the same
problems till I started to work out and do Pilates.
Pilates strengthens the core muscles including the pelvic
floor. I can highly recommend Synergy Fitness Pilates studio at
the bottom of Solano avenue in Albany.
Also, I'm a personal trainer and can show you exercises that
will help you strengthen your pelvic floor and core muscles.
It's really not hard to do, just takes being consistant.
Good luck
June
For what it's worth, I had a successful VBAC at 40 and my kid is
5 months old now and I have had no problems with incontinence. I
was worried about this too as I've heard it can be a problem, but
I can't think of anyone I know who it has actually happened to.
So I personally wouldn't let that be a factor in deciding whether
or not to go with a VBAC.
Good luck!
The research evidence seems to point not to vaginal birth but
genetic make-up as the primary cause of stress in continence:
http://www.gentlebirth.org/archives/postpart.html#Urinary
The benefits of a VBAC really do outweigh the repeated cesarean
unless there's a specific medical reason for it.
ICAN has information on VBAC that may be of help to you:
http://www.ican-online.org/
Incontinence from natural birth is normal and natural but you can
prevent or at least
reduce that by doing Kegels exercises.
I am more so than before children (born at 35 and 40 naturally).
I did my kegels regularly after both and probably should continue
to do so even now! I think we all get a bit incontinent w/age
either way and don't see why those muscles can't be toned/trained
like the rest of our body's muscles. Good luck with whatever you
decide.
*anon.*
Your friends are good to caution you about incontinence after
giving birth. But I'm not sure how much of the problem stems
from the actual delivery method, and how much stems from just
carrying the baby for 9 mos. Or other factors: I had a very
long prodromal labor, which some say is why I experienced
severe urinary incontinence for about 7 - 10 mo.s after giving
birth (vaginally), which eventually tapered off to ''mild and
sporadic'' and stayed there. Forever. :-(
You should talk with your OBGYN (and maybe even see if you can
consult a urologist), and ask them for the straight dope! Maybe
you can do something to prevent it, maybe you can't. I wish the
topic had come up, ever, in the 9 months of pre-natal OB
visits, or 8 weeks of childbirth classes! I felt so humiliated
and frustrated - until the day I saw a TV commercial
for ''Depends.'' (Swear to god!) And guess who was in it: not an
old lady or old man. It showed a 30's-ish woman running around
on the beach, playing with her toddler! That was an ''Aha!''
moment.
And either way, start practicing your kegels! ;-)
anon
Boy can I relate to this concern! I only have one child, and I
have a really annoying problem of leaking when I sneeze if my
bladder is not completely empty. I had a 3rd degree tear during
the birth, so maybe that has something to do with it, or maybe
nothing. All I know is that if I don't empty my bladder very
frequently, I will inevitably sneeze and leak. Not a lot, but
enough that I have to change my underwear, which is a real pain
if I'm home and obviously is not possible if I'm out. I probably
go to the bathroom easily 10X a day just to avoid this! I've
also started wearing pantiliners more frequently, like if I'm
planning to be out for a while and maybe not near a restroom (I
tend to avoid yucky public restrooms). I try to contract my
pelvic floor muscles when I feel a sneeze coming on, but it's
usually impossible. Sometimes it happens if I laugh too hard,
but at least that's something I can control. I'm sure kegels
would help, but I just have never been good about doing them.
I'd try the kegels, and also be open to the idea of keeping your
bladder empty at all times.
sneezy
I had two natural births around that age, but have always done
Kegels, so have never had any problems with incontinence. From
what I have heard, the real key is to do Kegels -- the type of
birth doesn't make a difference.
doing my Kegels now!
Incontinence from natural birth- if you have any rip in the vagina
because of the birth-
is to be expected. It can be fixed by surgery- painful to even think
about where they
put the anaesthetic needles. However, if you have a birth at a hospital,
the certified
nurse midwife (in my case) fixed it right away, about three minutes
after the baby is
born, rather than having to have a separate surgery. I strongly endorse
the latter
approach, rather than having to schedule a separate, later surgery to
fix the vaginal
tear.
Been There, done that.
I had a friend who experienced exactly this. I recall her
mentioning that she would leak urine when she laughed hard after
the birth of her daughter. Several years after the birth of her
child, she had this problem surgically corrected and now she is
fine. Talk to your ob about this.
Best to you
Oh yeah, it's real. And age has nothing to do with it. I've had
incontinence related to
my first natural childbirth ever since, and I was 23 (now 36). Kegels
only do so much.
I had my last child right before my 42nd birthday. I did
experience some urinary incontinence after the delivery. They
also don't tell you about the poopy incontinence, but that
happens too. This probably lasted a couple of weeks.
I really can't discern any difference in my functions now 2.5
years later.
Good Luck
I had both of my normal sized babies the old fashioned way. (I did have
an epidural). I was 38 and 40. NEVER had a problem with incontinence.
I am fit, I excerise. I did some kegels but not a lot. It was never an
issue.
anon
Yes, it is possible to suffer from incontinence from a natural birth. I
had my first child at 28 and my second at 30, both vaginally. I
suffered problems for a year after the birth of my second, before my
ob/gyn finally listened to me and worked to resolve the problem. It
took 2 months of physical therapy (sounded odd to me too), but I was
able to avoid surgery by simply following the program and strengthening
the kegels (like any muscle these need to be worked too, and can loosen
as we age, regardles of pregnancy/birth status, so do your kegels!).
My ob/gyn said it was unsual for someone my age to develop these
problems, but it does happen. She also told me, despite what so much of
the info out there says, it's not always the delivery part that causes
it, but rather the pregnancy (or
pregnancies) themselves. In my case, she believed it was caused by
having two pregnancies so close together (2 years), and the excess
weight I was carrying after the first and into the second, since it took
only about 6 pushes to get number one out and 2 pushes (preemie) to get
number two out. So, if it does occur, it can be fixed, but chances are
slim it will.
Time magazine recently had an article about the risk of multiple
C-sections, even as few as 1. I would risk the incontinence (since it
is such a low risk) over another major surgery (the C-section), as long
as your ob/gyn is supportive of a VBAC. I was up and moving within a
half an hour after the delivery of my second child...can't beat that!
You will have to decide what is right for you, but you heal so much
better and faster from a vaginal delivery, and it's such a small risk to
take. Good luck! Do your kegels! Hope you have a smooth delivery!
been there, but it's fixed
Hello, I gave birth to my daughter at age 40. I delivered naturally, and
have stress incontinence. It's not bad, only when I'm running (and since
running was hard on my knees, I've just given it up and found other
forms of exercise that work for me).
I took an incontinence class through Kaiser and learned that its the
pressure of the baby during pregnancy, not delivery, that contributes to
incontinence (I started having problems being able to hold my bladder
during pregnancy, so this makes sense). I also learned that close to 1/3
of women develop incontinence at some point, due to gravity taking it's
course (muscles sagging, etc.) over time. It IS a delicate subject, and
I wish more women would acknowledge that it's a common problem.
I'd urge you NOT to get a C section, or at least to talk to your doctor
and not just your friends who are in fact theorizing about the likely
cause of their problems.
don't make me laugh
Are you talking about Pee? Nah, don't worry about it. If you do pelvic
squeezes after birth it will be fine. I had my kid late, late 30's and
am fine. When I cough really, really hard (like occasionally with my
recent bout of Bronchitis) I might leak a tiny abount of pee, but then
again in my young 20's I would leak pee if I threw up.
If you are talking about Poo, after the first 3 months, no discomfort
and completely normal.
BTW way I had a drug free, episiodomy-free vaginal birth.
I P Freely - not!
I saw the previous responses and wanted to add something. Yes, this can
happen, and
Kegels aren't always enough to fix the problem. What I learned from my
doctor is that
it tends to be genetic. In other words, if your mom had/has incontinence
issues, you
are likely to have them, too.
Ask your mom
August 2006
I am having a really embarrassing problem and am hoping that
someone can suggest a solution. Like many women, I experienced
incontinence after giving birth to my child. With regular
kegeling, I no longer wet my pants when I sneeze or really need
to go but can't quite get my belt undone quickly enough.
However, when I run or jump rope, it's a different story. I wet
my pants regularly. I always empty my bladder before a run or
work out. But, because I drink water throughout the day, a tiny
amount of water can enter my empty bladder while I am running.
It's not very much so I don't have the sensation of needing to
pee. But the pee comes right out, everytime my foot hits the
ground. I've noticed it's worse when I am in the 2nd half of my
cycle. I've only had one child, albeit a big one, that I pushed
for more than 3 hours to get out.
Anyone out there have the same issue and found a solution? I
can't imagine running in an adult diaper, so please don't
suggest one. Ditto for refraining from running or jumping rope.
Open to anything else. Isn't motherhood so glamorous?!
Thanks in advance!
kid potty trained; mom not?
Don't worry. You have a common, but easily remedied problem.
Check out http://www.restrooms.org/kegel.html or do a search on Kegel
exercises. The exercises strengthen the muscles around the bladder and
the vagina. They are easy to do. No one will know you are doing them.
You will be able to rectify the problem AND at the same time, you may
find there is a beneficial effect on your sex life.
Good luck
JOANN
I had stress incontinence since having my second child. Kegels didn't do
it for me, but I wasn't religious about doing them.
My OBGYN, Dr Wharton, suggested an Athena Pelvic Muscle Trainer. It was
expensive: $360 and still trying to get insurance to pay for it. BUT it
worked miracles. After a month of using it, I no longer leak. Don't know
if it will work for running or jump rope, but it's worth checking out.
Website is http://www.athenaft.com/aft/pmt/ Good luck No More Leaking
You didn't say how long it has been since you gave birth. My son is
nine now. Right after he was born, I couldn't walk down the street
without a pad, and I cried in frustration when I tried to go back to
aerobics class or run. Finally I decided to put on pads and exercise
through it. Nine years later after kegeling (sporadically at best :)
and exercising and just slowly recovering some of my muscle tone, I can
walk down the street and sneeze and even run (if my bladder is not
full).
Still, I run long-distance and if I can't empty my bladder after about
eight miles, I will wet my pants. My solution (don't get grossed out,
everyone) -- I wet them. So what. I'm sweaty and yucky anyway after a
run. I go straight home, take a shower, change, and wash my clothes.
I've decided that it's more important to me to stay in shape than to
worry about a little pee. My mother was mortified when I tried to bring
up this topic with her. She had four children and had terrible
incontinence and felt unable to exercise for years. But it was mostly a
sense of shame that kept her from talking about it and from exercising.
I think that we should chuck the attitude that we have to stay bone-dry
when exercising. If you are going to jump rope you will sweat and maybe
pee a little. Go for it, I say!
not willing to be ashamed
Unfortunately I am experiencing the same problem. It doesn't really
happen when I run but when I jump rope it does, a big problem in a group
exercise class. I have resorted to wearing a maxi pad because
fortunately it is a small amount so I don't quite need an ''adult
diaper''. I tried using larger pantyliners but during exercise they
sometimes shift out of the needed area so the pads work. Hopefully
someone else knows how to eliminate this problem! I have heard of some
sort of surgery but not to do it until you are done having kids. Good
luck!
Glad I'm not the only one
I had the same problem and decided to get a ''sling'' under my bladder,
which was surgically placed (through the vagina). I
had the surgery in my early 40s and am SO glad I didn't wait.
I didn't want to have leaking problems for years just to decide 20 years
later to do something about it. It's been 5 years now and I haven't had
any leaking at all. Probably not what you wanted to hear (surgery), but
it was a great solution for me Been there, too
My gyno recommended using lite tampons when jumping or running.
I sympathize with you!
anon
dear leaky,
After 2 kids I too was at the point where even walking ''hard''
might cause a leak. Ditto sometimes with leaky bum - despite a zillion
kegels done pretty rigorously. I went to see a specialist in the
''whole picture'' - a urogynecologist, who will really evaluate the
whole pelvic floor.
I had the bladder/urethra alignment problem, a prolapsing uterus (which
I knew was happening from my annual exames) and less than 65% of the
''ring muscle'' left that handles the squeeze/stay closed function of
the anus. That 3.5 hours of active pushing with my first kid 10 years
earlier... yes, it really does do permanent damage down there, or can.
Had surgery (hysterectomy, bladder sling, anal muscle repair) 2 years
ago; worked great. If kegels alone help you, GREAT. If not, get
evaluated! I worked with Dr. Eugene Kaplan in WC
925.979.9969 and recommend VERY HIGHLY.
good luck
- Leaky No More
Keep up the kegels, wear mini pads every day and don't worry about it if
it's not too bad. If I don't wear pads, just about the time that I think
I'm not leaking anymore, I end up having to change my pants or shorts.
Mini pads are easy, and they can hold a little leak, and are easily
changed. Your OB can also prescribe something for it if it's really bad
Ask your gynecologist for a referral to a physical therapist for
incontinence issues. There are different kinds of incontinence and they
require different strategies. The therapist can also show you how to
get the most bang for your buck from the Kegels.
Anon
March 2005
A little problem which is creating more and more frustrations: I
am losing urine more and more frequently when I run (a real
embarassement!), when I jump (playing basketball with my kids),
and let's not talk about trampoline!
I can still stop the flow of urine when I go to the bathroom and
can always contain the need to go to the bathroom. A friend of
mine had such a problem and had surgery, with mixed results. Any
ideas? experiences? Advices? Thanks
embarassed mom
This isn't a solution, just a tip for the present.
I had the same problem (in my case I eventually tracked it down to a
side effect of a medication I was taking), and I bought those expensive
pads for incontinence at the drugstore to avoid the mess and
embarrassment. Then I had a better idea- cheap and easy. I went to a
diaper service and bought some old diapers and cut them up into pad size
pieces which worked very well.
good luck with solving the problem!
anon
It sounds like what you have is Stress Incontinence (the other main type
is called Urge Incontinence, and that's when you suddenly have to go and
feel like you can't hold it). I had the same, horribly so, after
delivery (7 months ago) and what did the trick for me was physical
therapy. Kaiser Richmond has a Biofeedback Pelvic Floor Physical Therapy
program and if you do the exercises carefully, it is great! They use a
program called Beyond Kegels, and if you have Kaiser but through another
facility, you can ask your OB/GYN for a referral to the Richmond
program; they don't yet have it at all facilities. If you don't have
Kaiser, well, at least now you know what your problem's called and what
to start looking for to fix it! Good luck; it's embarrassing, I know,
but it can definitely get better.
August 2004
I have just given birth to my first baby (11 days ago) and, to
my surprise I am having to deal with much more than sleepless
nights.
At the hospital, I've noticed that I couldn't hold the urine and
talked to my OB who told me that he would address the issue in
my 6-week post partum visit. I don't want to wait that long to
get some info on this. Sometimes I can wait to release the urine
sometimes, I can feel it dripping down on my way to the
restroom. Once the urine is release I cannot interrupt the flow
at all. I thought I would be getting a bit better with time, but
I haven't noticed any improvement. Any info that eases my fears
of wearing diapers for the rest of my life would be a Godsend.
On top of that, I've noticed that I was getting increasingly sad
since I got back home. Much more than I was comfortable with. I
would cry for no reason, and all the known symptoms of
depression. I was also feeling some 'weirdness' physically and
since I have a history of depression in my family, I decided to
look for help. I am now taking Zolof and I am a bit better (I
wouldn't be able to sit down and write this post two days ago,
believe me!). If you have any info on post partum depression and
any info that can help at this point, I would be most grateful.
Thanks to all,
Not so excited new mom.
I was like you - very concerned about incontinence after my 10-
month old was born. It was v. bad at first: I wasn't able to
stop the urine stream. Jumping, lifting, laughing, sneezing,
coughing, etc. all made me pee myself. My laundry hamper
smelled of pee. I changed clothes 4 times a day, etc. It was
scary and well, icky. I asked my Dr. about it and he shrugged
it off, saying it will improve with time. This made me angry
because I felt like he was making light of the situation. Now
for the good news - it did improve and today is ALMOST gone.
Sorry I can't say it's gone completely but when I drink alcohol
it returns. Also, when I have a cold it worsens. Not sure what
these two things do to my bladder. Anyway, in normal life I don't
think about it at all and I'm not bothered by it, but
sometimes it does sneak back. One thing that I can say is that
it did imrpove, as the Dr. predicted, but it happened slowly.
Keep trying to stop that urine stream - I think it helped the
muscles down there.
Andrea
Greetings,
Congratulations on the birth of your baby. I know that it is
an incredible time of transition and often full of unexpected
and stressful surprises.
My name is Lee Safran and I'm a marriage and family therapist
with an office in Albany. I specialize in pregnancy,
postpartum and parenting concerns and I am offering a group for
postpartum stress (depression and anxiety) in Berkeley at
Waddle and Swaddle.
I'm sorry to hear about your incontinence and the sadness that
your are noticing. I can share that for most women the
incontinence DOES get better, slowly, even though that seems
hard to imagine. You may also be aware that the majority of
women experience'''the blues'' after having a baby and it usually
passes by 2-3 weeks postpartum. This includes tearfulness,
irritability, anxiety and poor sleep. Also, up to 20% of women
have some type of post partum emotional distress beyond ''the
blues.'' So, you may well be feeling better soon (and I urge
you to get rest and support from others to help this along) or
you may be someone who has more to contend with.
Here are some resources: You can contact Postpartum Support
International at www.postpartum.net and Depression after
Delivery at www.depressionafterdelivery.com. They are both
excellent organizations. You can look at an on-line
assessment at http://www.pndsa.co.za/ms-fc.htm. Also, I would
be happy to send you an educational brochure about postpartum
emotional stress and/or to speak with you further, if you would
like.
Take good care,
Lee
ELEVEN DAYS? Darling, of course you're going to feel crazy 11
days after the birth of your first child. You've just gone
through a profound life change AND had the physical equivalent
of a truck running over you. It's TOTALLY NORMAL! Everyone goes
through some variation on this. I cried for three weeks after
the birth of my first daughter. And really over nothing. It was
just so intense and my newfound motherlove terrifed me.
Talk to your pediatrician. Get yourself to a new mom's group
immediately - your hopsital will have one already going.
Nothing helps the post-partum blues like sitting with a bunch
of other moms, lactating and crying over the joy and craziness
of it all, together. Talk to your mom, or sister, or friend
who's had a baby before you. Or just go hang out in the park
until another new mom sits down next to you and asks you how
your labor was. Don't isolate yourself! Buy some books on the
topic. Most of all, don't over-analyze how you feel. Go with
it. Don't worry that you can't get dressed before 5 pm. and
don't seem to have a brain cell anymore. Just float. Stare at
your baby all day. Get to know him or her. I promise you that
by three months you'll feel 200 percent more on top of things.
I promise.
Mom of Two who remembers
I'm sorry to hear that you're having such a difficult time, I was also
very emotional in the weeks following my daughter's birth, and had
many of the same concerns, but after time, my hormones leveled out a
bit, and I found myself enjoying motherhood a great deal.
I would suggest,
1) finding a mother's group, it's amazing how much the extra support
can be helpful, and to know that other mom's are going through the same thing.
2) inquire the possiblity of hiring a postpartum doula. They have a
lot of experience with newborns, and newborn moms, and really know about the
physical and
emotional changes. I would call Waddle and Swaddle on Shattuck, or
look on www.dona.org for any doula reccommendations.
3) breast feed as much as possible, and sleep whenever your baby
sleeps. Let the house work go, and foucs on sleep!! It's amazing how much sleep
will
change your out-look on life!!
4) it never hurts to talk to a therapist. there are so many changes
that you are going through, physical, emotional, spiritual, hormal, not to mention
the obvious lifestyle change. I questioned my ability as a parent, as a person
and
so on. My therapist was a great relief to me, as well as a cognitive ''check in''
on how I was really handeling things.
5) make sure you are eating really well. all the physical and homonal
changes create a much greater need for nourishment - if you can, ask friends,
neighbors and parents or realitives to help with meals.
6) get support wherever you can, don't be ashamed to ask for help - we
are all in this together as parents, we all have the same goals to raise healthy,
happy children, and enjoy ourselves as much as possible in the process. We NEED
each
other, and we, as families, deserve support and love!!
Good luck to you
jent
Urinary stress incontinence happens to almost everyone after a
vaginal delivery. Because the pelvic floor muscles are lax
(stretched out) and sometimes traumatized after delivery, they
just don't contract very efficiently. But there is no reason to
wait for your six week follow up. In fact, ''Kegels'', or voluntary
contractions of pelvic floor muscles should be started as soon as
possible after delivery.
Weakened pelvic floor muscles can also contribute to uterine or
bladder prolapse, a more serious condition where the organs drop
down and sag into the vaginal wall.
When performing pelvic floor contractions you want to be able to
close both the anal and vaginal sphincters and also lift the
entire area up into your abdominal cavity just a little bit.
First squeeze the anal sphincter closed as tightly as possible,
then close the vaginal sphincter.
To help yourself find these muscles use mental imagery and words
that you would use to yourself if you needed to use the bathroom
and none was available.
Then imagine that you can pull your pubic bone and your tail bone
closer together. This will contract and lift your entire pelvic
floor upward. As an alternative, some women like to imagine an
elevator rising up from the pelvic floor to help lift the area.
Hold the contraction as tightly as you can for five or six seconds.
Completely relax your muscular effort and allow your muscles to
soften.
Don't be concerned if you feel your deep abdominals
co-contracting with your pelvic floor muscles. In fact, the deep
abdominals, pelvic floor and deep spinal muscles are designed to
work together to provide internal support and stability for your
torso.
A single “Kegel” should take only 10 seconds or so. Repeat the
sequence 10 times to complete one set. These muscle fatigue
easily, so you’re going for volume here. Repeat the entire
sequence of 10 repetitions 5 or 6 times throughout every day.
Pelvic floor contractions are particularly helpful to do after
every bowel movement.
After childbirth, you are finished reconditioning your pelvic
floor muscles when you can clamp off a full stream of urine
without any leakage.
If you have trouble finding your pelvic floor muscles, you can
learn how to contract them by trying to stop a full stream of
urine while using the bathroom. However, do not practice “Kegels”
while urinating. This can interfere with complete emptying of the
bladder which increases the likelihood of urinary tract infections.
As to your emotional state, if your feelings of depression are
continual and deepening, please call your doctor right away and
get a referral to see an expert and treatment for postpartum
depression. Most of us experience some amount of the ''baby blues''
after childbirth, but these feeling are transitory and not
overwhelming in nature.
Best of luck and congratulations on the birth of your baby.
Helene Byrne author, ''Exercise After Pregnancy: How to Look and Feel
Your Best''
Hang in there!! The first few weeks are really hard, and it takes
a LONG while for your body to recover from giving birth. I have a
4-month old baby, and had quite a hard time for the first three
months, when it suddenly got a lot better. I cried every evening
for the first few weeks... It's not unusual.
The urine problem is also not unusual (I know, why don't they
tell you about that in childbirth preparation classes?). My
advice is to do your Kegels. I had a similar problem holding
urine and doing Kegels helped (make sure you do them right, and
do them several times a day). They're frustrating at first,
because it seems that you just can't squeeze those muscles at
all, but after 2-3 weeks I started noticing a difference, and now
I can hold my urine just fine.
You should know, however, that it can take months (even a year)
for all the muscles, nerves and ligaments to heal completely, so
you may not be 100% back to normal for a while.
As for the depression, sounds like you're doing the right thing
(taking an anti-depressant). Other things that may help: join a
new moms group (Alta Bates has one, for instance), ask friends to
visit, and make sure you have some help at home. For me, going
back to work at 3 months was the best help. I finally felt like a
human being again.
Things do get better. Good luck,
anon
Dear ''Not so excited new mom'':
I am sorry to hear about your postpartum difficulties and I want
to address the postpartum depression aspect of your letter. My
name is Dr. Mirjana Kelava and I am a licensed psychologist with
a private practice in Berkeley. One of the areas that I focus on
in my practice is postpartum mood disorders/adjustment. I also
present information on postpartum mood disorders and adjustment
to some of the childbirth prep classes at Alta Bates Medical
Center (run by Jennifer Marks).
I would like to give you some information on postpartum
adjustment and mood disorders. It is estimated that between 50%
to 80% of new mothers experience what is know as the ''baby
blues.'' Symptoms of the ''baby blues'' may include periods of
sadness/moodiness/irritability, tearfulness and feeling
overwhelmed and stressed. Symptoms may come on within a few days
to a week postpartum and last anywhere from a few hours to about
two weeks. The ''baby blues'' are thought to be the result of: 1)
rapidly changing hormone levels, 2) the physical demands of
childbirth, 2) and sleep deprivation. While many women may
experience the ''baby blues,'' the symptoms usually resolve a few
weeks after the baby's birth and the ''baby blues'' is not
considered a true psychological disorder. However, 15% to 20% of
postpartum women do experience a postpartum mood disorder. You
mentioned that you gave birth to your first baby just 1! 1 days
ago, so you may have been experiencing the ''baby blues.''
However, the fact that you have a family history of depression
does increase your chances of experiencing a postpartum
depression. The symptoms of postpartum depression affect your
daily functioning and may include: feelings of
sadness/anxity/irritability/guilt/hopelessness, of frequent
crying, sleep and appetite disturbances, of loss of interest in
activities that were previously enjoyable, and of lack of
feelings for the baby or discomfort around the baby. In
addition, new mothers may also experience a postpartum Panic
Disorder, Obsessive-Compulsive Disorder, PTSD, or postpartum
psychosis. Postpartum depression is treatable and you should not
have to suffer.
I understand that you have started on Zoloft and I am glad to
hear that you are experiencing some relief. You may also find
psychotherapy to be helpful. Please feel free to contact me with
any questions that you may have. In the meantime, it is
important to take care of yourself! You may want to ask your
physician to check your thyroid levels, as thyroid dysfunction
may also occur in postpartum women and these women may
experience symptoms of depression and anxiety. Make sure that
you are eating well and get as much sleep as you can (sleep
deprivation has been linked to depression). Ask for and accept
support - with childcare (try to have someone watch the baby
while you make some time for yourself....take a walk, go outside
by yourself) and with household chores. Be gentle and take care
of yourself and lower your expectations (it is difficult to be a
perfectionist when you have a newborn!) Some helpful and
informative websites include: www.postpartum.net,
www.depressionafterdelivery.com and www.womensmentalhealth.org.
Good luck to you and please feel free to call me with any
questions.
Mirjana Kelava, Ph.D.
Hi. I can't comment on the post partum depression, but had a
similar experience with incontinence after my second child was
born. Initially, I basically couldn't hold my urine. I was
also worried it was not going to get better. I went out and
bought incontinence pads (serenity or whatever) and did LOTS of
kegel exercises. And the incontinence gradually got better.
At the beginning, I couldn't really feel my muscles even moving
with the kegels, but I just stuck with it and gradually the
muscles returned to normal. I don't remember how long it took,
but I think over 3-4 months it gradually improved (from
complete incontinence to just leaking with
laughing/coughing/jumping to no problem now).
Good luck and hang in there.
anonymous
Hi, I didn't see your original post, but my only child is now 5
and I am still dealing with ''stress'' incontinance. I've just
dealt with it for years because my gyno would just tell me to
try a vigorous regimen of kegel exercises, and each year I saw
her again, I couldn't honestly say I tried them long enough to
conclude that the kegels just didn't work. Just this spring I
asked my Gyno to check again, and got a thorough pelvic exam. I
am now slated for a minor surgery for cystocele...which in
laymen's terms is a surgical insert of a sling for my bladder to
hold it in place, and a consequence of vaginal delivery of a
child.
So, enjoy your baby, try kegels, and if it persists, keep at
your OB/Gyn because there are alternatives to soggy undies!
JBS
June 2004
Two years after the birth of my second child, I still have to
cross my legs when I feel a big sneeze coming on, and can no
longer run without feeling that I am going to pee in my pants.
No, I am not a fanatical kegel-er. Do they work?! Are they the
only solution? Is there hope for me, or must I start looking for
pull-ups in a size 30 to 40 yrs (no Disney Princesses, please)?
anon
As a perinatal exercise specialist I can tell you that YES!,
Kegel exercises do work, no matter how far postpartum you are.
Pelvic floor muscles are small and thin, so when performing
Kegels, you need to go for volume. Plan on doing 8 to 10
repititions in one set, and performing 5 or 6 sets every day. It
may sound like a lot, but one Kegel only takes about 10 seconds,
and they can be done anywhere without anyone knowing that you are
doing them.
I recommend that you do a urine test to evaluate how strong your
muscles are now, so that after a few weeks, you can see your
progress. Urine test: Use the bathroom with a very full bladder,
and start peeing. After three or four seconds try to clamp off
the flow. Estimate what percentage you can stop. That will be
your benchmark. Be aware that you should not practice Kegels
while urinitating as this can interfere with complete emptying of
the bladder which can contribute to urinary track infections.
If you have trouble locating your pelvic floor muscles, or
getting a good enough contraction, feel free to contact me,
www.exerciseafterpregnancy.com, and I can teach you how to do
them in more depth. And please note that squeezing the thighs
together is not advised, (they are leg muscles, not pelvic floor
muscles) when performing Kegels.
Helene Byrne author, ''Exercise After Pregnancy: How to Look and Feel Your Best''
Do your boring, insanely annoying kegel exercises. They do help.
You'll probably still pee from time to time. I pee every time I
jump, but less so when I keep up on the exercises, and can
sneeze freely when I keep up with them. Otherwise, just wear
mini pads every day, which is almost more of a pain.
anon
I feel for you. Right after my son was born I could scarcely walk
down the street without peeing in my pants. This went on for a
couple of months, and then things slowly started to get better --
but I would still pee if I laughed, sneezed, coughed, went to my
aerobics class, ran up the stairs, etc. etc. I did do kegel
exercises, but the problem persisted, albeit in a milder form. My
son is now seven years old, and there are still some things (like
play soccer with him, chase him around the playground, jump rope,
and yes, sneeze) that I can't do without leaking a small amount of
urine. But things are much, much better, so part of the answer
may be time. Here's what else I did to help myself:
1) exercise. I started working out nearly every day when my son
turned five. I train on cardio machines and weight machines and
go running once or twice a week. I also ride my bike. I believe
that this more than anything else got my muscles toned, including
those interior ones!
2) pads. I wear incontinence pads (the ''Poise'' regular or generic
equivalent) nearly all the time. Usually it's just a precaution,
but it makes me feel secure to know that the pad is in place just
in case. When I exercise the pads are a must.
3) giving up. That is, for a long time I felt ashamed and
downhearted about the fact that I was leaking urine and I didn't
want to get out and jog or dance. Now I just tell myself to let
go. I will wet my pants if I run or dance, so I put on a pad. If
a little urine leaks out on my running clothes, them's the breaks.
I'll change pads in the middle of a dancing evening if things get
too humid. I think that I actually made things better by deciding
that it was OK to wet myself a bit. When I first started having
this problem, I confided in my mother and she was horrified. She
told me that she had always had this problem but was unable to
discuss it with anyone, including her friends. She was too
embarrassed to buy pads at the store, but used menstrual pads
instead! Now, really, I ask you girlfriends -- is this or is this
not something that happens to us in the normal course of events,
about which we should try our best not to be ashamed? Sure, no
one wants to smell bad or have sopping clothes, but we should be
able to take care of this problem matter-of-factly.
Original poster, I liked your sense of humor. It should carry you
far. And things will get better.
not ashamed anymore
I suffered with this problem for 12 years after our second child, and I can't
believe I put up with it all that time. I kegeled up the wazoo to no avail. Even
with pads, I had to stop jogging, and the problem worsened over the years
until I had to stop walking for exercise (I'm not kidding). I finally had bladder
sling surgery which is a fairly simple procedure, and have been totally cured for
6 years, a new person. Sort of - now I'm too old to jog! What a shame to
suffer. You should certainly try kegels, and there is a biofeedback version
which is supposed to be more effective than going it alone. But if these
approaches don't work, surgery will, and I promise you it's not a big deal. You
need to find someone with specialized training though, may be a urologist or a
gynecologist. I'd recommend my surgeon, but he is no longer in Berkeley.
Good luck.
surgical success
Kegels definately work. I did them my whole pregnancy and 6
months later I'm fine. Sex is great. I never peed on myself or
even a trickle. I was determined to do Kegels in my pregnancy
because I was afraid it would make sex hurt. Kegel, kegel,
kegel. They aren't that bad. I would make a game out of it,
seeing how long I could hold it for. Try it.
Good luck!
zenasia
Hi - I was fine until my third child, but now - whenever I see
a particular friend, whose birthday it is today, I laugh so
much that I pee - when this first happened I was astonished.
Now I do Kegels and hope - and go to the toilet before I see
Jonny.
Just to say you're not alone! I'm hoping as time goes on it
will improve - but somehow I don't mind too much, because it
only happens when I laugh...a lot...
anon
February 2004
I'm experiencing stress incontinence after giving birth to my
child 6 months ago. It's extremely frustrating that I'm not able
to exercise, or even to be out walking for long without having
to use the restroom. Kegels have not seemed to work much. Does
anyone have any advice on what else may help? Any
recommendations for a Specialist/Urologist? Thank you in advance
for any advice!
Stress incontinence is definitely no fun. I had it pretty bad for quite a while
after the
birth of my baby- my first. I'd heard about it happening but wasn't prepared for how
bad it was the first few weeks postpartum. I'd head for the bathroom and I'd be
peeing even before I sat on the toilet. My midwife promised it would get better and
it did. I did lots of postnatal yoga with kegels (I think sex helps too!) but I
think part
of the problem was that I was just sort of numb down there for a while and couldn't
even feel the kegels. But I kept at it and it kept getting better. I have no problems
now.
There's a lot of info about incontinence on the women's health web site,
www.drdonnica.com -- articles about various forms of incontinence and
treatment recommendations. Just go to the site and enter a search for stress
incontinence.
Good luck!
anon
I could not help but reply. I had the same problem after the
birth of my son and found it quite distressing, especially
because I could not exercise. I discussed it with my Ob/Gyn.
She suggested I use a diaphram when I exercise. It works
great. It has not solved all of the problem, but it allowed me
to resume exercise. Talk to your doctor. It is very common.
Good Luck.
anon
April 2003
I have stress incontinence after having two kids. My OB/GYN examined
me and said that I don't have it ''that bad'' and kegel exercises should
work. What experiences have people had? Do they work? How long and
how often did you do them? Has anyone had surgery to fix the problem?
I've had similar problem...and finally got serious about doing
the Kegels...after about a month of doing Kegels several times
a day, I found that my incontinence troubles had diminished
significantly. I still don't do any trampolining though!
Anon
I am a perinatal exercise specialist and can tell you more than
you probably wish to hear re:Kegel exercises. I'd be happy to
spend a few minutes on the phone with you to get you started in
the right direction.
Helene Byrne
I have terrible stress incontinence since giving birth.
My mom also had it most of her life until she got surgery,
she never found kegels did much. I unfotunately inherited
her anatomy and her opinion about kegels. What I have tried:
1-it helps a ton to wear Poise or other incontinence pads
(look like sanitary napkins but hold more)
2- A pessary, ring-shaped device that goes in the vagina
and holds things up. Prescribed by my OBGYN. THis didn't help me
much.
3- My MD prescribed Ditropan, which I understand is for frequency
but sometimes helps with incontinence. It helped at first and
then stopped helping with leakage, but allows me to sleep through
the night without getting up to pee. So I still take it for that
(it decreased my problems with insomnia)
4- I will look into surgery at some point (my mom was very happy
with hers).
5-And, gee, I feel like I should re-try serious kegels after
reading the other posts!
Anon
I suffer from the same problem - after my first and only child!
I saw a urologist who told me to give it time, because the
ligaments and nerves take a long time to heal. He was right - it
took more than a year to feel like I was more well than unwell,
if that makes sense. I feel about 85% - 90% healed. But at
17mo.s out, that last 10% is still no fun.
My OB's office recommended a Physical Therapist who specializes
in pelvic floor rehabilitation. Her name is Em Squires, and she
works near Lake Merrit in Oakland. (510-206-5790) She's the only
one in the Easy Bay who does this work, so your insurance should
cover her. I went to see her recently, so I can't yet quantify
the results. But her approach is to examine the tissues,
muscles, etc. in the pelvic floor to determine more specifically
where the weaknesses are. She then teaches you exercizes that
target those areas. They are ''Kegels,'' (along with exercizes
that strengthen the abdominal and lower back areas) but she
teaches you that a Kegel is more than just clenching, and helps
you to do them in a way that makes them more effective.
I just want to mention here that I was shocked to find out how
common this problem is, and how little it was ever mentioned or
talked about when I was pregnant. Not in the OB's office, not in
my childbirth prep. classes, not by my doula. I've since learned
that it is quite possible that my prolonged labor contributed to
the condition, if it wasn't the sole cause. I've also noticed
many more TV commercials for urinary incontinence ''personal
protection'' products (like ''Serenity pads'') that feature younger
women playing with their small children. Are they talking to us,
or what?!
An upside? Now my post-menopausal mother and I have
something in common! Best of luck to you... I'm right there with
you!
Anon
Kegel excercises do work. You have to keep them up, and you have
to do them frequently. Beats medication, though, and certainly
beats wearing a diaper. Plus, you are protecting yourself from
more serious medical problems. There are devices designed to
make your Kegel exercises more effective -- I bought one, called
the Kegelcisor -- but just doing them the regular way is
probably good enough, and anyway I've found the Kegelcisor hard
to use.
anon
April 2003
I have reached the limit of tolerance with my leaky bladder! I
have had four big babies (now aging between 15 and 3). NO MORE
PLANNED. I've been leaking since after #3 was born 11 years
ago. My GYN had me consult with Physiotherapy Associates who
gave me exercises to help strengthen the muscles. I noticed a
very small improvement. I now use giant pads for exercise and
I even have leaking problems all day long. My Gyn is not a fan
of surgery, but I wanted to ask other mothers. Anyone out
there had a procedure done that has helped reduce or eliminate
the problem? I am 43 years old and I can only see this getting
worse. I'm paranoid about the smell too. Kegels is not the
answer anymore. Help?
mom with a leaky bladder
I have not had surgery, but I can recommend trying (or at
least asking about) a pessary. It is a ring that is inserted
into the vagina exactly like a diaphragm; it has an enlarged
area that puts pressure on the urethra to prevent leakage. It
has been enornously effective, though not 100%. I still wear
a pad sometimes, just in case, but I rarely need it.
anon
I work at an outpatient surgery center -- and there are
gynecology surgeons who treat women for this problem all the
time (the official term is ''urinary stress incontinence). It is
a common problem out there, particularly for women who have had
multiple births. It is called ''Anterior and Posterior Repair''
or ''Bladder Lift'' -- I highly suggest calling a gynecologist who
is comfortable doing this surgery. It is an outpatient surgery,
and you wil go home with a foley catheter (which depending on
the surgeon, is removed anywhere from 3-7 days post-surgery).
Not all gynecologists are focused on surgery, go to one who is.
Hope this helps.
Anonymous
For professional reasons, i.e, not as a patient, I've been talking
to Leslee Subak, M.D. at UCSF. Tnis is one of her research
specialties. I highly recommend you get her advice. There is no
real regulation of surgical repair for urinary incontinence,
with the result that women regularly serve as guinea pigs for
experimental surgical approaches with varying results. I think
you can trust Leslee to give you state-of-the-art advice and to
feel real compassion and understanding.
Anon
I can recommend an excellent surgical gynecologist who is also
very interested and skilled in bladder/urinary aspects of gyn,
ie urogynecology. In addition, he has a very lovely bedside
manner. He could talk to you about all the surgical options,
including anterior-posterior repair, and a new procedure called
the tension free vaginal tape, which has had high success
rates. First, he would see if you were a surgical candidate at
all, then he would determine which surgery was best for you
given your symptoms. You should at least set up a consultation
with him. His name is Dr. Ed Blumenstock, and his office is in
Oakland (and sometime Lafayette) 510-893-3193. He does
surgeries out of Summit and Alta Bates Hospitals.
-Goodluck, another gyn
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