Appointment with uro-gyn for stress incontinence

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Tomorrow… through DP’s private insurance

im 50yo and i cannot sneeze without leaking, even walking fast makes me leak. I wear “dailies” pads everyday just in case.
Very weak pevic floor, littlesensation when haing sex

have tried women physio but kegels seem to make it worse. Checked techniques at reviews but was told to ise pessaries instead.

im going to ask about Tens machine for strengthening the muscles of pelvic floor (good results in past but short lived - what about long term effect?)

what about Botox for urethra?
Bulkamid injection?
colposuspension?

my issue is really weak PF, not sure i have a prolapse

what else could i ask about?

Bulkamid is the injection, I had it done about 6 weeks ago. The other thing that made the biggest difference for me was losing weight. I've lost large amounts of weight twice in the past 10 years or so, I'm now down to my lowest and it really does hugely improve things. The bulking injection is hopefully to give me the final tweak to get rid of it.

Thank you. I understand the bulkamid is great for stress incontinence which is partly my problem. But did it also give more strenght to your pelvic floor. The other part of my problem is lack of strenght and this is affecting my sex life…
i went on MJ last year and lost all the weight but unfortunately things have gone worse nonetheless…. Maybe a combination of perimenopause (still having regular periods tho) and increased exercise (although i do try to squeeze before the effort)

I don't have a weak pelvic floor but the bulkamid won't have any effect on that, it's literally a gel injected into the wall of your urethra to close down the entrance somewhat, no impact on pelvic floor muscles at all.
I know you say you've seen a physio, but have you seen a good one? I've seen two different ones and the second one was much more useful than the first!

What a disappointment…..
After taking my history and a physical assessment (some loose skin, no prolapse, 2/5 on the oxford scale in terms of pelvic strength) he offered me three solutions:
traditionnal physio
bulkamid
cant temember the proper term but an operation to pull up my uterus/pelvic floor??.
i asked about vaginal tens machine and about the elmsella chair and he said they have not been studied enough to prove effectivemess. He didnt seem willing to talk about it, focusing instead on the injection and the physio…
in the end i asked for a referral to a physio and i will buy myself a tens machine and/or do the elmsella chair… when i said this he looked really confused.
Honestly… if men had erectile weakness, studies would have been done and everything would be available on the NHS!!!