Stress Incontinence

[NanaNina]

Hi - can anyone talk to me about this embarrassing problem. I am 69 and have had it for years but it's getting much worse. I saw a "Continence" nurse on the NHS and she has referred me to a physiotherapist with special knowledge of this problem, but she's off sick and likely to be for a long time, and there is no-one else. I started off with the GP but she just said I had a "teeny weeny prolapse" and to do pelvic floor exercises. I have been using a small machine for my pelvic floor for months on end, with no improvement.

Any help/advice would be really appreciated.

THE BEST pelvic floor exercise bar none is to - when sitting on the toilet - try to stop weeing half way through for a couple of seconds.
You should be able to get to the stage of start .... stop .... start ... stop ... start ... stop
but it will take a fair few weeks.
On the other hand you'll KNOW you are working the right muscles!

Another really good thing for pelvic floor is either yoga or pilates ... both of which do lots to strengthen up all of the lower abdominal muscles.

Thanks TinP but the continence nurse specifically told me not to try to stop the urine flow as they no longer gave this advice. I do know I'm working the right muscles because I use a Sensatone machine and it is designed for pelvic floor muscles. Sorry don't want to sound dismissive. Good idea about yoga and pilates though, and have heard this before. Trouble is I would be too scared to go to a class and exercise because the incontinence is so bad I would surely have it while exercising. I get it even when I'm just walking about sometimes. I have decided to go back to the GP and tell her how much worse it is and maybe get more help than I did last time.

get back to the doctor and get a referral to the hospital. There is loads that can be done to sort this x

Interesting that the nurse said not to use it
because my yoga teacher who teaches antenatal and post natal and works with the NHS specifically mentions it as the best bar none

and I agree with MadLizzy : go see a different GP and demand support.

Re the stopping peeing mid-flow: I'd heard/read/been told (can't remember which now) that while it's a good exercise to do once or twice to check/teach you that you are indeed using the right muscles, it wasn't a good exercise to do routinely as it was bad for the kidneys. Not sure why - think it was something to do with it stopping you emptying your bladder fully.

Should have added that I was referred to the gynae physios by my GP after some problems after having ds (more to do with holding a tampon in - my Pilates was helping to mask the fact that there had been damage). The physio didn't tell me to stop the urine flow. Instead I had to do exercises (TMI alert) with a wee device which had a stick on it. If I did the exercise right, the stick moved one way. If I did it wrong, it moved the other way. A sort of direct bio mechanical feedback.

You are certainly not alone. The recent NICE Guidelines for the treatment of stress incontinence estimate that up to 2/3 of women are suffering BUT ONLY 2% are 'known' to the health service.

Doctors also know that over 80% of cases of stress incontinence can be cured if you exercise correctly and restore your pelvic floor muscle tone but you wouldn't know it from the advice you get.

When Arnold Kegel gave us his Kegel (pelvic floor) exercises he said it was necessary to squeeze 300x a day AND AGAINST A RESISTANCE. Squeezing thin air, as physios recommend, will never get you anywhere. But you’ll be lucky to find a GP who will refer you to a physio anyway.

In a recent survey 62% of GP practices just gave out an exercise sheet to women complaining of embarrassing leaks despite the fact that there are no clinical trials or NICE recommendations that show that handing out a leaflet is an effective treatment.

We have a situation where over half of new mothers still have the problem and there are an estimated 7 million women with stress incontinence. GPs hand out leaflets. The two facts are not unrelated!

This is only one clinically proven pelvic toning device available on prescription. In clinical trials the PelvicToner (£30) proved to be as effective as a 3 month course of supervised treatment with a physiotherapist. Most users noticed a significant improvement or cure in just a couple of weeks. The exercises take just a few minutes each day.

If you want the real lowdown on the farce of treating stress incontinence read The Kegel Legacy. It's only £1.99 on Amazon

Good luck

Thanks for the info brendaf - my GP is usually very good but she was a bit dismissive of my stress incontinence though at the time it wasn't too bad and I showed her my Sensatone machine and she just said it looked ok. However I am in real trouble with it now and it's SO embarrassing. I leaked onto my DIL's car seat the other day.

I am not getting very far with the local NHS Continence service, which seems to consist of 1 nurse, 1 physio and 1 receptionist! The nurse was pretty hopeless and referred me to the physio and I am still waiting for an appt as she has been off sick for ages and there is only one of her!

I did read on MN once that if the ligaments had worn, then no amount of pelvic floor exercises would make any difference, but not sure about that. I've been on the private hospital sites and they mention various operations that can be done, but they would cost thousands of course. I feel a bit concerned because with the strain on the NHS at the moment and this govt slashing budgets of public services to sell them off to "any willing provider" I think my problem is medically very insignificant.

Thanks for the info brendaf - my GP is usually very good but she was a bit dismissive of my stress incontinence though at the time it wasn't too bad and I showed her my Sensatone machine and she just said it looked ok. However I am in real trouble with it now and it's SO embarrassing. I leaked onto my DIL's car seat the other day.

I am not getting very far with the local NHS Continence service, which seems to consist of 1 nurse, 1 physio and 1 receptionist! The nurse was pretty hopeless and referred me to the physio and I am still waiting for an appt as she has been off sick for ages and there is only one of her!

I did read on MN once that if the ligaments had worn, then no amount of pelvic floor exercises would make any difference, but not sure about that. I've been on the private hospital sites and they mention various operations that can be done, but they would cost thousands of course. I feel a bit concerned because with the strain on the NHS at the moment and this govt slashing budgets of public services to sell them off to "any willing provider" I think my problem is medically very insignificant.

I think I can feel a prolapse but have been putting off seeing the doctor. I was just told initially to do Kegels too. I'm scared is beyond that but I hate operations too.

Hello

This website is quite good.

www.bladderandbowelfoundation.org/bladder/bladder-treatments.asp

If you go down the page and click on the drop down boxes you can see the range of treatments available.

I had a TVT on the NHS about five years ago. It's not perfect but it's better. I had to go through incontinence clinic and physiotherapy first, before they would consider surgery. It took about a year before they would consider surgery for me.

In the meantime, whilst you're waiting for your physio appointment, the Tena pads are good and may save you from embarrassing incidents.

Have just read that you're scared of operations. If the TVT is a suitable treatment for you, it's non invasive and carried out under local anaesthetic.

Sorry I posted twice. Thank you bolderdash for the info and the link. I will certainly have a good look. It's Northernshore who is afraid of operations not me! I would welcome any kind of improvement to be honest. Interesting that you had a TVT on the NHS but that was 5 years ago and I think things have changed a lot since then, but hopefully ops might still be available on the basis of clinical need obviously.

Oh and Tena pads (or similar) I am wearing 2 large ones when I know I am going to have to walk (even a short distance) or pick up my grandchildren etc., and even then I am often soaked within a few hours. I have a terrible itchy vagina which I'm sure is because of the pads. The GP gave me cortisone cream which helps a bit.

The Continence service just phoned with an apt with the physio next Tuesday so that's a step in the right direction.

Northernshore if you feel you have a prolapse you really will need to see a GP about that.

Sorry Nina - was posting in a hurry. Hopefully the physio will be of help.

Right I'll make an appointment -you've spured me on. I can feel something there underneath. Its not come out but its there. I leak but its more a dribble than whole pads full.panty liners are ok. Im also very over weight but had a very difficult forcep birth with additional procedures so I think it went down hill then!

Right I'll make an appointment -you've spured me on. I can feel something there underneath. Its not come out but its there. I leak but its more a dribble than whole pads full.panty liners are ok. Im also very over weight but had a very difficult forcep birth with additional procedures so I think it went down hill then!

Went to the appointment. Do have some prolapse. Given a pelvic floor toner and told to list weight (I am very big post child). Scared silly of an kp but as the doctor said too young for it to b be a problem.

well done on going - and at least you are on their radar now to get it under control