Urinary incontinence - who to speak to

[Tootingbec]

Hello. 52 and perimenopausal and for the past year have noticed I am struggling to basically not constantly wee myself when walking about 🫤

Sometimes it is so bad I actually significantly wet myself even while wearing a pad. I have had some stress incontinence for about 10 years but only when sneezing etc on a full-ish bladder. Now I can go for a wee and then immediately go for a walk and can feel urine slowly leaking out of me as I walk. I’ve gone from wearing a panty liner to full on thick pads in the last year because of this. The severe experiences are infrequent but I wonder if they are related to my oestrogen levels at a different time of the month?

I had a check up with a women’s physio about 12 months ago who checked out my pelvic floor from a mechanical point of view (IYSWIM!) and no problems with that and I am ok-ish at keeping up my pelvic floor exercises.

It’s starting to really get me down and make me anxious about being out and not being able to find a loo so that I can keep my bladder as empty as possible.

I’m on estrogel and have a mirena coil. But who do I speak to about this? GP? Go straight to a Gynaecologist? Urologist? Menopause expert?

Help!

GP and then they refer you

Definitely related to hormones, I've had sneezing etc incontinence since first was pulled out of me with forceps and third degree tear, but I've noticed now in the week before my period it's basically uncontrolled when I walk anywhere. I'm only 44. So depressing.

Look on your GP website. Where I live you can refer yourself to the bowel and bladder nurses. Also , see your GP. Mine was very understanding and told me if the tablets she was suggesting didn't work, I should try other solutions and not just put up with it.

Local oestrogen like vagifem pellets often resolve this problem. You do a loading dose of 1 every night for 2 weeks then 1 3 times a week

Estriol cream might help.

I also have some incontinence when I walk but only later in the day.
I have a stage 2 cystocele and a uterocele and just had a rectocele repair.

My private gynae won't do a cystocele repair until it gets worse.

You should probably go and check you don't have prolapses. If you would rather go private, try to find a uro-gynae, they do know more than just gynaes.

Oh I did see one uro gynae privately who said he could give me a 'bulking injection' in my urethra which might help before surgery. Didn't go down that route and I'm sure it has a technical name!