Incontinence - what can I do to improve things?

[MSA60]

I had a difficult birth with DS1 that included forceps and an awful lot of rummaging around (retained placenta that wouldn't budge.) As a result I was horribly incontinent after, urge and stress, in fact any kind you like. I had a transvaginal sling a few years later which really helped, and has been problem free. Its now 15 years on and I am in my 50s and I am suffering again. I can't have a full bladder since I will just wet myself when I stand up so constantly monitor and visit the loo too often tbh. I can no longer tell if Im really needing a wee or not. Also, I can't empty properly, and again as soon as I stand up streams more run out of me. Im pretty sure I leak small amounts all day every day too. Given I have had a sling Im not sure if there is anymore that can be done? Does anyone have any advice? After a soul destroying divorce last year I'd really like to get back out there, but this issue is really holding me back

Gosh, that doesn't sound very pleasant for you.

I presume you've tried pelvic floor exercises? They may help with the stress incontinence. You shouldn't routinely do them whilst having a wee as that can lead to you not emptying your bladder fully, but it's fine to occasionally test them whilst you're having a wee to se if you are exercising the correct muscles. You need to do quick squeeze and release ones and slower squeeze, hold and release ones.

Without being judgemental, if you are overweight/obese then losing some weight could help reduce the pressure on your pelvic floor and help with your continence issues.

You could try routinely double-voiding. Have a wee. Wait a short period of time whilst sitting on the loo and then try and empty your bladder again.

Ask your GP for a referral to the continence service (they'll have better ideas than me!) and to gynae or urology. They will hopefully be able to investigate further and offer appropriate medical or surgical treatment. I'm not too sure of the options, but there might be treatments such as botox or bulking agent injections (offered under LA or GA/spinal) or medications if they think it could be an overactive bladder contributing.

Good luck!

@MagnoliaXYZ Belated thanks for your reply...I have indeed tried much of what you suggest, but thanks for taking the time offer some ideas. I think you're right, I probably do need to go back to the gp and take it from there, and fingers crossed I get some suggestions about what I can try next/whether they can refer me again. In the meantime, I guess I'll just have to buy some shares in Tena!!

Definitely return to your GP for more assistance and a referral on. You deserve proper medical support.

How's your core strength overall? I found Kegels didn't help in isolation, but saw improvement when doing pelvic floor exercises as part of a core strengthening exercise routine. It was really low impact (I have a prolapse).

I have issues with an overactive bladder..feeling l need to go when there is no reason to. Made my life hell as l was obsessed with knowing where the nearest loo was and it stopped me going on long treks etc.
Saw a specialist in that area at the Maternity hospital and she gave me two options
1 medication
2 Botox injected in
Went with meds for the moment but if it persisted would have gone back to try botox
I know your issue is different but see a specialist and see what they suggest. It seems to be a very common problem and they may have some new procedures to offer.

You do need to see a specialist to see if you need an anterior repair for a prolapsed womb. I too had a difficult forceps delivery and ended up having the above done ( years ago when I was only 25 years old). It improved things no end but as the years went on I started to leak and developed an obsession with visiting the toilet. My pelvic floor is shot. I try. to do the exercises but I just can’t lift my pelvic floor. I attended a clinic who offered me medication which I have avoided as I am already taking medication for other things (I am 79). The only thing that has helped me is leaning forward after urinating and usually after a short while more comes out and often a surprising amount. The clinic also advised on going too often to the toilet. They suggested that I wait a little longer each time to stretch the bladder. I find I am usually okay until I see the toilet or run water and then I am in trouble. However, on the way to the toilet I often soak myself. However, as said I am an old woman. My daughter is in her early fifties and has had a successful prolapse op so I would definitely push for a consultation and get a considered opinion. I know what it is like to have this control your life.