Anyone had surgery for Stress Incontinence

[golfgirl79]

Hello
I'm 30 years old and just had my second child 5 months ago. A traumatic forceps birth, it has left me with severe stress incontinence... its so bad I am having accidents every time I stand up, walk, basically anytime except when I am sitting down still.

I am hoping to hear from anybody who has had surgery for incontinence. The doctors want me to wait another 7 months before I consider it. I really feel if it was going to get better, it would have by now... I have been seeing a physio and also using eletrical stimulation with no results... I am tired of my life being 'on hold' while I deal with this...

My uro-gynae says he has no doubt I will definitely need surgery, but to wait 12 months til after the birth to give my body a chance to fully recover... I just feel if I am going to have the surgery what is the point in waiting.

He is suggesting tvt, although I have read some horrible things about it. Keen to hear some success stories...!!

Also since I'm only 30, I am worried in a few years time my symptoms will come back (as the surgery doesn't last forever) and then I will have no further avenues, since surgery is sort of the last stop.

I'd love to hear from anyone who can give me any advice or offer personal experience.

This is the worst thing I have had to deal with and having this for the next 50 odd years scares the hell out of me.

Thanks in advance,
Golfgirl79

Going to Bump this one.

I'd also love to hear of others' experiences of TVT, especially if there is anyone around who had it a few years ago? interested to hear how effective it is a few years later? and wondering if there is any discomfort or awareness of the tape inside you?

I had TVT about 6 months ago. My incontinence wasn't quite as bad as yours sounds Golfgirl, but I couldn't walk without leaking, let alone run/jump/laugh/sneeeze. It was forceps that did me too!

The op itself was fine, quick and no real pain after, tho was pretty groggy for a week or so, so maybe the anaesthetic didn't agree with me? You do need to expect to feel quite weak for a month or so after tho, which surprised me, and you musnt lift in that time.

It has worked on the whole. I can walk, run etc now no problem and throwing the incontinence pads away has been great! You really cannot feel anything is there at all, so don't worry about the tape being obvious or uncomfortable.

The only thing I would say is that it has become rather slow to wee now, and I have to concentrate a bit to make sure I empty my bladder. I have been known to get up too soon in which case I will leak , so not as easy/natural as it was before children. So I guess Im not completely back to normal as such, but its way way much better than before the op.

I hope that helps. It is worth getting it done IMO since incontinence is really quite unpleasant to deal with for a long time.I would wait just a bit as the docs suggest tho - it does get a bit better as the pregnancy hormones leave your body and that can take up to a year I think? I guess they need to know how bad things are once the post pregnancy stuff has settled down.

Post again if you have more questions and i'll try and answer!

OopsDoneItAgain that's interesting about finding it slower to wee now. On days when I know I'm going to be particularly active I use a vaginal stress inco devise that supports the neck of the bladder thru the vaginal wall and when I pee it does take a lot longer to completely empty bladder. I was wondering if that's what it would be like permenantly if I had the op and it seems like it could be from what you say.

This wouldn't put me off having the op though.

What still concerns me is the idea of a "foreign body" meshed into my tissue.
Cat64 are you able to share any more detail about what went wrong and why with the third person you know who had problems?

I had TVT about 3 years ago .
Needed it because of birth traumas ,but I suffered a long time ( years )before I it done .
I had to have a hysterectomy first - prolapse - and then wait another 6 months which was awful as incontenence was even worse .
Had TVT as day surgery - couldn't wee after op and sent home with catheter and bag .That bit not much fun because I'd been drinking loads after op ( as per staff's advice ) and the bag was a small one that I had to keep getting up in night to empty .
Had to go back after couple of days and then I could wee and all fine .
Otherwise all ok ,I agree about concentrating when you wee and it being a bit slow ,tho now I think about it ,it's not so slow now as it was at first .
Agree about 85% better ,simply could not live with the level of incontenience I had .
Can't think of anything else of relevance ,except watch out for pain killer induced constipation after op .

thank you so much for writing..... it is definitely helping me decide the tvt is for me.... like you mamaMtundu i am a bit hesitant about the foreign object being in my body, and have read the same horrible U.S. based website you probably have... after i read that i thought "no way!!'... but i was advised not to read things on the internet (lol and here i am reading this and making up my mind!!)...

the main reason they want me to wait, is a 'just in case' measure, as in just in case my body improves and the incontinence gets better to a level i can manage... at the moment it is simply unlivable (is that a word?)... today i have had only 1 drink... i have gone from drinking 1-2 litres of water a day when i was continent, to barely drinking now, as it literally means i will be wetting myself...

my uro-gyane said i would definitely need an operation, but because i am so young (30) he recommended waiting... can i ask how old you guys are? i am also scared that in a few years time my symptoms will reappear... but i am thinking i will just have to cross that bridge when it comes, and hope that there is new treatment by then... i have read up on really promising things using stem cells, injected at the bladder neck, which then creates new cells and repairs damage and reduces incontinence significantly... sounds amazing and i only hope something like this becomes available in the next 10 years or so.

i think i will compromise and ask for the op in say november this year... it means it will have been 10-11 months since the birth, and i feel i will have given my body plenty of time to fix things, with all the intense physio etc i am doing... it would be nice to have this problem sorted before christmas and the summer season (i am in australia)...

sorry for the essay, this is just a huge thing for me right now and as i have said before, i really don't have anyone else to talk to, its a hard thing to be going thru, nobody wants to constantly hear about these issues, plus nobody understands it properly unless they have been there... so its hard.

thanks again....

cat64 sorry another question, how long ago did you have the op? sorry if you have already said and i have missed it...

i can only imagine how wonderful it is to do all those things without leaking, i am dreaming about it actually... i just pray that its successful for me, as i am not sure what the answer is otherwise.

violetqueen you said you had the op 3 years ago, is it still as successful as it was initially, or have you found your symtoms slowly worsening? when you say about 85% successful, do you mean you only leak say on occassion, like with a sneeze etc, where as before it was alot more? sorry just trying to understand it all... this is helping me enormously so thank you so much.

cat64 yes, incontinence is not best topic to chat about on the school pickup!

golfgirl I really would consider waiting at least a year for the Op if that's what your gynae is recommending. Sounds like they are talking sense to me. If your youngest is still only 5 months, then in my experience your body still has some more healing to do. Also if you are still breastfeeding, things can also improve a bit when that stops too. Additionally with 2 little ones, you won't be getting much sleep at the moment either ...and my god, sleep makes such a difference to the speed at which your body repairs.
You'll notice too, once your periods come back that the stress inco is worse before and during your periods ... hormones really do affect it.
Have they referred you to a physio as well? Can be useful as they can check you are doing the PF excercises correctly and measure how strongly. Being able to return after a month and have an actual improvement measured can be quite motivating, cos doing them is dull, dull. dull. But it all helps.

I completely understand how upset you are feeling at the moment. It's horrible. At first I was distraught as I thought I would never be able to go for a run again or play badminton. But then the daily stuff really got to me too... before sneezing or coughing having to stop and sort of cross my legs and clench!! Leaks if you suddenly jerked to reach for an errant toddler, leaks if you let your bladder get too full. Not being able to walk too quickly if bladder full.
Always needing to plan that there was a loo nearby if visiting a park.

It won't all clear it's self up by waiting until youngest is at least a year, but with PF exercises and time it will be a bit better. here's some other stuff to try too..

Don't stop drinking your fluids.

Cutting back/or completely cutting caffiene helps a bit.

Cut out any diet drinks as the artificial sweetners are supposed to be bad

Also, constantly going to the loo all the time just to get the littlest bit of urine out can irritate your bladder. I was advised not to go every 5 mins like I was at first. It's hard, cos you feel happier if you think bladder not so full, but you just end up getting a sort of 'Urge' incotinence too if you're not careful. Don't go there!!

Also, do ask your gynae or physio about Contrelle Activgard. Might not be suitable for you as I don't know wether you've had prolapses or what state all your lady bits are in, but they've been a life saver for me ...I am almost back to normal while I wear one. It's not a permanant solution and NICE (National Institute for Clinical Excellence) recommend that devices like this are just used occasionally,when you know you are going to be doing physical exercise.

I must admit I end up using one quite often, eg. jogging, when going to soft play with kids or if I want to be active with kids at park or even on a night out (don't want to leak or wear a pad if you've got skinny jeans on!) or long journey even. Not only does it seem to stop leaks for me, but I can also last longer between toilet visits.

kids need bath, do ask if you got more questions, will pop back later

lovely, the DH is doing the bath/bed thing tonight it turns out. So I have returned, glass of wine in hand. Yes, alcohol not great for stress incontinence either, but hey! it is friday evening after all. Not sure what time it is in Oz at moment?

Just re-read your first post without rushing and things do sound bad for you at the moment and somewhat worse than mine initially was. That's good that you are seeing physio. do keep on with it. It can still be very disheartening if the pyhsio doesn't give amazing results(mine didn't), but every little bit of toning helps. It didn't fix my inco, but I did console myself that the fitter you are down there the quicker you'll recover from your op if/when you have it. A few months into the physio, she also gently broke it to me that even with the op I should keep on with the exercises for life .... I didn't want to hear that really!

I have a DS(5) and DS(3). I did all the urodynamic tests etc when youngest DS was about 10 months and then was booked in to have the TVT op when he was about 15 months.

I backed out a month or so before hand for a number of reasons.

1. I hadn't realised until this point that the recovery time was going to be at least 4 weeks. NO LIFTING for at least 4 weeks. this was just impossible with a toddler who was potty training and a 15 month old who was very clingy and still wanted to be carried most places.
2. horror stories on the net and also been put on a "general list" for the surgery. This apparently meant that whoever was free would do my surgery. I was freaked out that at this late stage i still had not met the surgeon and had no name even, so how could I check how experienced they were in this procedure even?
3. I really was so knackered after that first year with toddler and baby that I just couldn't make a truly informed decision. My brain was like porridge. I decided to re-visit the whole thing at a later date.

so here I am!!

Sorry golfgirl that you are having a rotten time. I am in a similar position, though I only have one DS. Would you mind if I hijack for a second to quiz Mama? I have been offered the op too, though I think I might try the pessaries first as I would like another DC in the future. Mama you mentioned running. Are you able to run now? Did you have a prolapse? Sorry, I am desperately trying to find information on this. I have had my six months physio, which improved my pelvic floor strength but sadly not my prolapse symptoms. I have just had my urodynamic tests-bladder capacity was good but my bladder was far to mobile and they found a small tear which they are unable to repair. They said that I had a 'stretchy vagina' . Sorry again for the hijack but I know nobody in RL who has been in this position.

golfgirl do you have the Kari Bo-corewellness (sp?) DVD. It's free to order online (sponsored by TENA!). I find it quite good as it works on your core and pelvic floor. It was recommended by my physio. And I second the recommendation for the activguard, they make me feel just a little bit safer!

I had the TVT op about 18 months ago for severe stress incontinence following the birth of DD2. I would say it is a pretty minor procedure - I had no complications, recovery was fast, not too much pain etc. BUT it didn't work for me.

I had to have a colposuspension which is much more major surgery and something I really would think twice about doing and plan the timing of really carefully. This did work though I now have problems with urge incontinence and overactive bladder though no one is clear whether they are related to the surgery.

You should definitely wait a year for the TVT op - it is quite a delicate arrangement and they need to get the sling in the right place to provide support to the urethra but not stop you being able to empty your bladder. So your body should have healed and returned to 'normal' before doing the op otherwise further changes in muscle tone etc could have a negative effect.

Good luck - and in summary - definitely try the TVT - if it works for you then it is in most cases a pretty simple fix for a really dreadful problem.

I was 36 when I had the TVT by the way

hi golfgirl - sorry you're having a tough time .
It doesn't do a lot for one's self esteem does it ?
I'm fine three years on ,I don't think it's "wearing off ".
I do still leak a little bit ,if my bladders very full and sometimes when it's not very full but I also need to empty my bowels !
Agree you must keep up fluid intake - I used Tena pads to help cope with my leaking .
You do get used to them... ( need very close fitting knickers tho ,to ensure pad is snug against body .)
It's really not a big op ,you'll be amazed .
And it will sort the problem out for you .
Honestly you'll feel quite normal afterwards ,you won't feel as tho you've got anything inside you or that weeing is anything other than the tiniest bit different .

I had TVT about 6-7 yrs ago after 6 yrs of UI

I only feel it if I dance really hard or that one (very bad idea) go on the trampoline

I had (still have) a partial prolapse

I was 36 (& dd was 6)when I had it & terribly scared as I am massively allergic to rubber/plastic/metal but I haven't had any problems

I haven't read any horror stories - but I under estimated how long the recovery would be

Katymac did you have a prolapse repair alongside your TVT?

No - it wasn't 'bad' enough

ok. the bl**dy football has driven me back. somehow I thought we'd get away with just england matches, but no it's france Uraguay tonight.

bellamysbride I'm going to fire a question right back at you ... pessaries? I haven't heard of these ..what treatment is this?

In answer to your question, yes, I am able to run without leaking if I use an Activgard. I have stress incontinence with no other bladder problems. After my second DS I had a mild cystocele prolapse. This improved with time and PF exercises and no other intervention was deemed necessary. (with regards the prolapse).
If I do lots of heavy lifting(e.g. lugging youngest DS(3) up the stairs for naps when he begs to be carried) or no PF exercises for a few weeks it does start to 'drag' down again.

KatyMac I came across some of your posts a couple years back when I was first offered TVT I think.
That is really encouraging to hear that TVT is still doing it's job and has not caused probs. You are the "longest since op" person I have come across. ROFL at you attempting to trampoline . What were you thinking. Mind you, I was a girl who had to be a bit careful around trampolines even before kids!!

yipee ...i just heard the final whistle... I'm off back to the living room.

Well it looked like fun & I never really did before

Pessary for the prolapse. Apparently a good option for women who are still considering childbearing. They get replaced 6 monthly and can be worn during pregnancy and post partum. However sometimes a prolapse can cause a kink in the urethra which helps incontinence, so you can find that the pessary makes your incontinence worse because it removes the kink. Also some sexual positions are uncomfortable for your partner, the gynae didn't specify which .

Trampolines are things I look longingly at. I couldn't go on as a child either. Makes me think some women have a predetermined factor for incontinence.

Mama does/or did the cystocele get worse with running? Did your prolapse not get worse/return after birth of DS(3)?

bellamysbride I'm guessing my cystocele prolapse was considered too mild for Pessary? I'm now off to read more about pessaries.

Mind you the first dr I saw, seemed awfully young and maybe on rotation and new to gynae as she hadn't even heard of filler injections to support bladder neck when I enquired about diff treatment options. When I returned to gyna a month or so later after the uurodynamic people had done tests and recommended tvt, the dr I saw then at clinic couldn't even answer my questions about surgery risks without going and getting a leaflet to refer to. As I said previous post, I was a bit of a tired, porridge brained mess ...so just sort of panicked and gave up rather than try to work the system to get to talk to someone who could give me the answers I needed.

I guess that any high impact sport is going to strain your pelvic floor and I know some on here have been advised not to do it ..full-stop. But the Physio I saw felt it was a realistic goal and she was this superfit 50+ women with years of experience in this field of physio, so I felt inspired to do my PF's and try return to running. Unfortunately I haven't been able to run for more than 20 mins a couple of times a week at moment due to an unrelated hip instability problem. (well ... related in that childbirth exacerbated an exisiting hip weakness due to overpronating when running with turned in knees and flat feet) So maybe if I ever get back to higher levels than this, then it may impact badly on prolapse?
I expect there are differing opinions about what you should and shouldn't attempt and of course it must vary on case to case basis. I'm sure that overall running is prob not the best choice of sport after kids, but then like any lifestyle choice you have to weigh up what the personal health/happiness benfits v risks are for you. i love running and am still really sad that I can't return to previous levels.

didn't get prolapse after first DS, just stress inc. the prolapse came along and joined the party after the second DS

oops didn't quite answer question I think?, ... so , no the cyctocele doesn't seem to get worse with running (I do gentle jogging rather than fast runs ...only do 10 min miles ...v. slow), but I'm not doing that much, so hard to say.
Lots of heavy lifting really does affect it though! e.g. carrying buckets of water at allotment is now on my list of tasks I cannot do. carrying heavy toddler is bad.

Thanks Mama. As you may have guessed I'm feeling a bit desperate about the not running thing right now! I also know what you mean about the confused messages/lack of information from the docs. The first one I saw said I should get the TVT/repair now and deliver via c section for future deliveries. The second said definitely NOT a c section as my pelvic floor is already compromised without compromising my core too-Arrrrgggh! I think you speak words of wisdom about waiting, absorbing it all and making an informed choice later down the line. The problem is you just want it fixed so you can return to 'normal'. I am just coming to terms with the idea that to a certain extent it will never return to its pre baby state!

Sorry golfgirl-hijack over!

I had TVT 2 years ago and have no problems with stress incontinece now, but it did make my urge incontience worse. I was told this could happen but I'm glad I got it done. You need to take it very easy after getting it done.