Postpartum incontinence

[Anonymous]

I am 1 year+ postpartum and am still having major incontinence issues. It is just horrible and psychologically horrible too. If you had this problem and improved the situation, can you shared what helped? Of course I am also consulting my doctor, but it would really help to hear some experiences and suggestions. I want to finally seek treatment or physical therapy or whatever would help.

[Anonymous]

Run to pelvic floor physical therapy. Your OB can write you a script for it. Sorry you’ve been suffering so long.

[Anonymous]

I did “pelvic floor therapy“ but didn’t spend money on it – just looked it up. It took a couple years. Not sure if the exercises or time is what fixed it.

[Anonymous]

Are you perimenopausal? Some estrogen might help

[Anonymous]

Anonymous wrote:I did “pelvic floor therapy“ but didn’t spend money on it – just looked it up. It took a couple years. Not sure if the exercises or time is what fixed it.

It’s not PT unless you are seeing a clinically trained and certified pelvic floor physical therapist. Try someone trained by Hermann and Wallace Institute, they have a directory

[Anonymous]

Op, pelvic floor physical therapy can help but it isn’t always a cure. A Post partum body will be forever postpartum it’s not gonna be the same as before. I have stress incontinence and a very mild prolapse. None of it was bad enough to warrant surgery per two Urogyns. I saw some improvement with two rounds with certified physical therapist specializing in pelvic floor disorders at VHC. They were very good and it’s an excellent program. However I still need to wear a liner every day just in case I have an unexpected cough or sneeze and I do not run/jump if I can help it. I just want to put that out there because sometimes I feel like pelvic floor physical therapy is presented as a cure all for this issue and it will certainly help but it is not always a cure-all for all women

[Anonymous]

Anonymous wrote:Op, pelvic floor physical therapy can help but it isn’t always a cure. A Post partum body will be forever postpartum it’s not gonna be the same as before. I have stress incontinence and a very mild prolapse. None of it was bad enough to warrant surgery per two Urogyns. I saw some improvement with two rounds with certified physical therapist specializing in pelvic floor disorders at VHC. They were very good and it’s an excellent program. However I still need to wear a liner every day just in case I have an unexpected cough or sneeze and I do not run/jump if I can help it. I just want to put that out there because sometimes I feel like pelvic floor physical therapy is presented as a cure all for this issue and it will certainly help but it is not always a cure-all for all women

To clarify two four-month rounds- going once a week for four months two separate times (after each childbirth)

[Anonymous]

I just had a procedure done - a urethreal bulking agent (called Bulkamid) is injected into the walls of the urethra to - you guessed it - bulk it up. Absolutely changed my life. I am 99% cured - I maybe get a drop or two during a vigorous workout, but that’s it. Amazing!

[Anonymous]

Anonymous wrote:I did “pelvic floor therapy“ but didn’t spend money on it – just looked it up. It took a couple years. Not sure if the exercises or time is what fixed it.

Pelvic floor therapy is more than exercises. Mine did manual manipulation. It was the only thing that helped; urine and fecal incontinence.

[Anonymous]

OP you can also go see a urogynecologist. You may benefit from a stress incontinence pessary. And there are surgical options like a sling if pelvic PT and a pessary don’t help and you exhaust other options. A urogyn would fit you for this and educate you about options. Obviously they are predisposed to surgery but they can give you a good sense of how serious your incontinence is relatively speaking and what options are for managing it from conservative to surgical.

[Anonymous]

Pilates. And physio as above.

[Anonymous]

I didn't have this issue specifically (mine was hypertonic pelvic floor) but if you decide to see a pelvic floor PT, I recommend Jenna Bythrow in Falls Church. She is at Advantage Physical Therapy. I've had a great experience with her.

[Anonymous]

Anonymous wrote:OP you can also go see a urogynecologist. You may benefit from a stress incontinence pessary. And there are surgical options like a sling if pelvic PT and a pessary don’t help and you exhaust other options. A urogyn would fit you for this and educate you about options. Obviously they are predisposed to surgery but they can give you a good sense of how serious your incontinence is relatively speaking and what options are for managing it from conservative to surgical.

+1

urogynecologist. After 1 year they can evaluate if you are a candidate for surgery (e.g.., "sling" for incontinence), they wait for a few months after postpartum for body to recover by itself before considering surgery. Other less invasive therapies could work too as mentioned by PP in the thread, including the bulking agent, PT, pessaries, etc.

In NOVA, I recommend mid-atlantic urogynecolologist practice. They can determine if PT, pessary or surgery is the recommended treatment.

[Anonymous]

Anonymous wrote:Op, pelvic floor physical therapy can help but it isn’t always a cure. A Post partum body will be forever postpartum it’s not gonna be the same as before. I have stress incontinence and a very mild prolapse. None of it was bad enough to warrant surgery per two Urogyns. I saw some improvement with two rounds with certified physical therapist specializing in pelvic floor disorders at VHC. They were very good and it’s an excellent program. However I still need to wear a liner every day just in case I have an unexpected cough or sneeze and I do not run/jump if I can help it. I just want to put that out there because sometimes I feel like pelvic floor physical therapy is presented as a cure all for this issue and it will certainly help but it is not always a cure-all for all women

Agree with this…but my question continues to be, why don’t ob gyns warn about all of the permanent negative body changes beforehand? I knew all about post partum hair loss, stretch marks, etc, but never knew about prolapse or dreamed I’d have bathroom issues like an 80 year old man in my 30s. Had I known, I would have made a different choice about delivery method and may have decided not to have kids. I doubt many women are in my boat on the second point, but running was my life before my kid and I wanted it to be a large part after. I also didn’t want all of my toileting organs gathered together in my vagina, which seems like a reasonable ask.

To the OP — I’m sorry; this sucks. I wish there were better answers.

[Anonymous]

I follow a woman on instagram - she's legit trained in this stuff and after her twins made this her life work - @getmomstrong.

She teaches everything on how to manage intra-abdominal pressure and really advocates pelvic floor physical therapy as well as learning how to work out in a way that is safe for your pelvic floor.

Go to PFPT and check her out.