Postpartum incontinence

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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 you need to see a urogynecologist. Your OB can refer you. I see Dr Shobieri in Falls Church. I am literally having issues 10 years after my first kid now.

Is he going to do surgery for you? He’s not my favorite urogyn, and I’ve seen a lot of them.

Different poster — do you mind elaborating? I have an appointment coming up with him.

I just would not see him. He’s a solo provider and I found him quite negative. He diagnosed me with avulsion and basically made me feel like I couldn’t have another baby because it was going to get so much worse and I couldn’t do any movement or exercise that I wanted to do. I fell into a deep depression after seeing him. Took me 2 years to get over it and I decided to risk it and get pregnant again. That baby was born via C section, my prolapse is exactly the same, and I am so happy I didn’t listen to his advice. There were other issues with the visit that I don’t care to elaborate on. Suffice to say, I would go elsewhere. WHC and JHU have group practices and GW had their own female urogyn who is supposed to be good.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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 you need to see a urogynecologist. Your OB can refer you. I see Dr Shobieri in Falls Church. I am literally having issues 10 years after my first kid now.

Is he going to do surgery for you? He’s not my favorite urogyn, and I’ve seen a lot of them.

Different poster — do you mind elaborating? I have an appointment coming up with him.

I just would not see him. He’s a solo provider and I found him quite negative. He diagnosed me with avulsion and basically made me feel like I couldn’t have another baby because it was going to get so much worse and I couldn’t do any movement or exercise that I wanted to do. I fell into a deep depression after seeing him. Took me 2 years to get over it and I decided to risk it and get pregnant again. That baby was born via C section, my prolapse is exactly the same, and I am so happy I didn’t listen to his advice. There were other issues with the visit that I don’t care to elaborate on. Suffice to say, I would go elsewhere. WHC and JHU have group practices and GW had their own female urogyn who is supposed to be good.

Thank you; I appreciate that — as I’m already in a pretty deep depression about all of this and already decided I don’t want any more kids because I can’t take further damage. If you feel comfortable saying, did he use imaging to diagnose you, and did he suggest the possibility of avulsion repair? I am also seeing someone at WHC but saw that he does advanced imaging and has done avulsion repair in limited circumstances— that seemed to be in stark contrast to the other practices around here. I was highly active before delivery so will do whatever it takes to get back to that but can’t stomach being told there’s no way to get me back there.

I am so glad you were able to have another baby like you wanted without it worsening!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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 you need to see a urogynecologist. Your OB can refer you. I see Dr Shobieri in Falls Church. I am literally having issues 10 years after my first kid now.

Is he going to do surgery for you? He’s not my favorite urogyn, and I’ve seen a lot of them.

Different poster — do you mind elaborating? I have an appointment coming up with him.

I just would not see him. He’s a solo provider and I found him quite negative. He diagnosed me with avulsion and basically made me feel like I couldn’t have another baby because it was going to get so much worse and I couldn’t do any movement or exercise that I wanted to do. I fell into a deep depression after seeing him. Took me 2 years to get over it and I decided to risk it and get pregnant again. That baby was born via C section, my prolapse is exactly the same, and I am so happy I didn’t listen to his advice. There were other issues with the visit that I don’t care to elaborate on. Suffice to say, I would go elsewhere. WHC and JHU have group practices and GW had their own female urogyn who is supposed to be good.

Thank you; I appreciate that — as I’m already in a pretty deep depression about all of this and already decided I don’t want any more kids because I can’t take further damage. If you feel comfortable saying, did he use imaging to diagnose you, and did he suggest the possibility of avulsion repair? I am also seeing someone at WHC but saw that he does advanced imaging and has done avulsion repair in limited circumstances— that seemed to be in stark contrast to the other practices around here. I was highly active before delivery so will do whatever it takes to get back to that but can’t stomach being told there’s no way to get me back there.

I am so glad you were able to have another baby like you wanted without it worsening!

Ok so if you are feeling that way I don’t think any urogynecologist is a good idea because I have seen most in the area (5 total) and I found them all pretty negative. Like, they are surgeons they are going to tell you you need surgery to fix whatever is wrong. They are also going to likely be very conservative with their recommendations on your activity and movement because their field has not advanced to reflect a lot of the contemporary knowledge base in the field of pelvic floor physical therapy. And there’s also not a lot of good info out there and there continue to be old outdated “rules” (eg don’t lift more than 10 pounds ever) that they continue to perpetuate without ANY evidence to support the recommendation.

I hope you are seeing a good pelvic floor PT who is inspiring and hopeful. And who is helping you to address and tackle your symptoms. Not all of them are good, unfortunately. If they say to just do kegels I hope you will run away.

So here’s the thing about having an avulsion. It is actually pretty common but it’s basically quite unrecognized by OBs and it can’t be repaired surgically yet. It’s considered experimental at this point to do so. And The LA muscle is really teeny tiny. And often the muscle is so compromised (eg it’s in shreds) that there’s nothing left to even attempt to sew back together. And even if they could, there’s no guarantee of that improving your symptoms, which is the main thing most patients care about.

If the doctor you saw at WHC’s last name starts with S I hope you will run, he was another one of the doctors I could not stand.

I was totally obsessed with getting my injury properly diagnosed so I could “fix” it (former D1 athlete here so I get it) and get back to my active life before. And you can get it done different places, but Handa at JHU is the person to see if you really want the best in the business. She doesn’t do them routinely but will if you want it. And if I ever get repairs I will probably go to Hopkins. But the problem with surgery is that it’s not a guarantee of fixing your symptoms. If you have prolapse, which I’m assuming you do, surgery may put the organs back but it might not eliminate the dragging feeling or other bothersome symptoms, for instance. Dr. S also does imaging but his takes forever (over an hour) with old outdated machines and is quite invasive (eg transvaginal wand etc) versus how Dr. Handa’s group does it (modern ultrasound machine, nothing inside you and done in about 10 min).

If you’re not yet a member of POP Up please join and do the programs, there’s a lot of info and a great community and many stories of hope of women who have returned to very active lifestyles and reduced their symptoms while avoiding surgery. Also follow @wildmatresence on Instagram.

https://pop-s-school.thinkific.com/

[Anonymous]

Oh and don’t let this ruin your family plans if you want more kids. It took me years to be ready to do it again but it was 100 percent the best decision. Most of the damage to your body is sustained during the first delivery anyway, according to the research, so you may as well have the amount of kids you want. That was my thinking anyway - if I couldn’t get my body back to what it was before and get back to running the way I wanted to at least I could have the family I wanted. And I’ve been able to find other exercise snd movement practices that I find fulfilling.

[Anonymous]

Anonymous wrote: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!

Really!? Tell me more! I was supposed to get it done Friday but I chickened out bc I felt like it wouldn’t actually work after trying pelvic floor pt and pessarys.

I really miss high intensity work outs 😭

[Anonymous]

Anonymous wrote:Oh and don’t let this ruin your family plans if you want more kids. It took me years to be ready to do it again but it was 100 percent the best decision. Most of the damage to your body is sustained during the first delivery anyway, according to the research, so you may as well have the amount of kids you want. That was my thinking anyway - if I couldn’t get my body back to what it was before and get back to running the way I wanted to at least I could have the family I wanted. And I’ve been able to find other exercise snd movement practices that I find fulfilling.

+100000

I swore off more children because of the depression I was in after realizing I’d never run the same way again. But the damage was done and my children were everything. I found other outlets

[Anonymous]

Anonymous wrote:

Anonymous wrote: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!

Really!? Tell me more! I was supposed to get it done Friday but I chickened out bc I felt like it wouldn’t actually work after trying pelvic floor pt and pessarys.

I really miss high intensity work outs 😭

What would you like to know?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: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!

Really!? Tell me more! I was supposed to get it done Friday but I chickened out bc I felt like it wouldn’t actually work after trying pelvic floor pt and pessarys.

I really miss high intensity work outs 😭

What would you like to know?

Was it painful and what was the recovery like?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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 you need to see a urogynecologist. Your OB can refer you. I see Dr Shobieri in Falls Church. I am literally having issues 10 years after my first kid now.

Is he going to do surgery for you? He’s not my favorite urogyn, and I’ve seen a lot of them.

Different poster — do you mind elaborating? I have an appointment coming up with him.

I just would not see him. He’s a solo provider and I found him quite negative. He diagnosed me with avulsion and basically made me feel like I couldn’t have another baby because it was going to get so much worse and I couldn’t do any movement or exercise that I wanted to do. I fell into a deep depression after seeing him. Took me 2 years to get over it and I decided to risk it and get pregnant again. That baby was born via C section, my prolapse is exactly the same, and I am so happy I didn’t listen to his advice. There were other issues with the visit that I don’t care to elaborate on. Suffice to say, I would go elsewhere. WHC and JHU have group practices and GW had their own female urogyn who is supposed to be good.

Thank you; I appreciate that — as I’m already in a pretty deep depression about all of this and already decided I don’t want any more kids because I can’t take further damage. If you feel comfortable saying, did he use imaging to diagnose you, and did he suggest the possibility of avulsion repair? I am also seeing someone at WHC but saw that he does advanced imaging and has done avulsion repair in limited circumstances— that seemed to be in stark contrast to the other practices around here. I was highly active before delivery so will do whatever it takes to get back to that but can’t stomach being told there’s no way to get me back there.

I am so glad you were able to have another baby like you wanted without it worsening!

Ok so if you are feeling that way I don’t think any urogynecologist is a good idea because I have seen most in the area (5 total) and I found them all pretty negative. Like, they are surgeons they are going to tell you you need surgery to fix whatever is wrong. They are also going to likely be very conservative with their recommendations on your activity and movement because their field has not advanced to reflect a lot of the contemporary knowledge base in the field of pelvic floor physical therapy. And there’s also not a lot of good info out there and there continue to be old outdated “rules” (eg don’t lift more than 10 pounds ever) that they continue to perpetuate without ANY evidence to support the recommendation.

I hope you are seeing a good pelvic floor PT who is inspiring and hopeful. And who is helping you to address and tackle your symptoms. Not all of them are good, unfortunately. If they say to just do kegels I hope you will run away.

So here’s the thing about having an avulsion. It is actually pretty common but it’s basically quite unrecognized by OBs and it can’t be repaired surgically yet. It’s considered experimental at this point to do so. And The LA muscle is really teeny tiny. And often the muscle is so compromised (eg it’s in shreds) that there’s nothing left to even attempt to sew back together. And even if they could, there’s no guarantee of that improving your symptoms, which is the main thing most patients care about.

If the doctor you saw at WHC’s last name starts with S I hope you will run, he was another one of the doctors I could not stand.

I was totally obsessed with getting my injury properly diagnosed so I could “fix” it (former D1 athlete here so I get it) and get back to my active life before. And you can get it done different places, but Handa at JHU is the person to see if you really want the best in the business. She doesn’t do them routinely but will if you want it. And if I ever get repairs I will probably go to Hopkins. But the problem with surgery is that it’s not a guarantee of fixing your symptoms. If you have prolapse, which I’m assuming you do, surgery may put the organs back but it might not eliminate the dragging feeling or other bothersome symptoms, for instance. Dr. S also does imaging but his takes forever (over an hour) with old outdated machines and is quite invasive (eg transvaginal wand etc) versus how Dr. Handa’s group does it (modern ultrasound machine, nothing inside you and done in about 10 min).

If you’re not yet a member of POP Up please join and do the programs, there’s a lot of info and a great community and many stories of hope of women who have returned to very active lifestyles and reduced their symptoms while avoiding surgery. Also follow @wildmatresence on Instagram.

https://pop-s-school.thinkific.com/

Thanks; I appreciate this detailed response. I won’t lie, it scares me (D1 athletics is no joke and you are obviously no stranger to a hard training/rehab schedule), but I value the honesty. Not seeing Dr. S, am scheduled with another provider and then Dr. C in solo practice out in VA, who had been recommended on here. Still not sure what’s going on (conflicting assessments from PTs) but it sounds like it’s going to be a long and winding journey. I’ll look into Dr. Handa — much appreciated!!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: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!

Really!? Tell me more! I was supposed to get it done Friday but I chickened out bc I felt like it wouldn’t actually work after trying pelvic floor pt and pessarys.

I really miss high intensity work outs 😭

What would you like to know?

Was it painful and what was the recovery like?

I was sedated for the procedure so I don’t remember any of it. Had it done at Holy Cross in same day surgery. For about 24 hrs after the procedure it burned when I peed and there was a little blood, but that’s it. Otherwise no pain whatsoever. The results were immediate. I was back to (mostly) normal activity the next day - just skipped my workout. Super easy.

[Anonymous]

OP back here. Thank you all so much for sharing. I have a PT appointment but unfortunately they had to book it a couple months out (not in the DMV). Meanwhile, it helps to know I am not alone. For me, it took some courage to finally talk to someone about this. I hope that this thread will help others seek help too.