Just sitting there

Submitted by saddleup on July 17, 2008 - 9:52pm
Body: 

How come I experience incontinence with no warning, while I am merely sitting at a desk or in a chair (say, at a restaurant)? I get up, go to the rest room, and discover I have sprung a leak. That's the type of incontinence this cystocele has generally produced. It can also be brought on by exercise, but the most frustrating thing is the "just sitting there" sneak attack.

I understand from the drawings in Saving the Whole Woman how my bladder is now tilted, so the sphincter muscles don't necessarily close in on the urethra anymore. Is there a way of sitting that might prevent the incontinence? Even when I think I'm practicing WW posture, I'm often frustrated with the results. Should I consciously allow more weight to rest on the pubic bones when I sit, as opposed to the ischial (seat) bones?

Also,is there any danger in using the sports tampons frequently? I enjoy feeling a bit more normal when I have one in. Thanks for any advice you all can give.

saddleup

July 17, 2008 - 9:59pm

So, just after I posted the comment with questions about sitting, I discovered the post from Louise about that very topic: "Rethinking Seating." I'd still REALLY like to stop the *&%$#@) leakage.....

louiseds

July 17, 2008 - 11:14pm

Hi Saddleup

I get this sometimes. I suspect it is to do with kinking of the urethra while you are sitting on it, or the chair is pressing your vulva against it. I get it most often when I get out of the car, which involves turning and rising and quite a bit of use of stomach muscles, which might create intraabdominal forces and shove the full bladder around a bit, maybe unkinking the urethra.

The other thing is that there is a thing called a urethrocele, where the top of the urethra balloons out into a conical shape instead of a quite tight sphincter. This means that when you sit there may be a lot of pressure on the bladder, and only the kink is holding the urine in. Therefore when you rise and the bladder moves forward the kink straightens out, causing the leak. I try not to think too much about naming all the different prolapses I have. I just try to understand what my body is doing at any one time, and reposition it so that it is supporting my pelvic organs better, to enable me to do what I want to do, and not be limited by prolapses. These images may help you understand better what might be happening with your bladder and urethra. http://www.netterimages.com/publication/9781929007714/7-477.htm . I just did a Google Image search of the Web for "urethrocele". There are heaps of other illustrations to help you understand. Some of them are on surgical sites and are pretty off-putting, though the descriptions of the surgical procedures make them sound just dandy! ;-)

By the time you have read this you will probably have read my post about Rethinking Seating, and will no doubt have thoughts and questions to raise. Also see my post called Car Seat. Since then I have added a foam wedge under my car seat cover, so the seat is more horizontal and my legs are not jack-knifed. We haven't spoken about sitting for a while so it will be a welcome opportunity to go over it again.

Cheers

Louise

granolamom

July 18, 2008 - 11:19am

what bothers me about this is the fact that you don't have the sensation of 'having to go'. could be this is a typical symptom and just one I've not had. but I wonder about it.
you *should* know when your bladder is full.

then again, the bladder gets lazy and the messages to the brain get wonky after years of inefficient emptying. so maybe that's a piece?
we're going through something like that now with my 7 yo ds. he's got a 'tight internal sphincter' which we never knew about (how could we?) and was having surprise incontinent episodes. theory is pretty much the above. so now we're working on that sphincter and his control is much improved (no incontinent episodes for the last few months) and also doing bladder retraining.

I'm going to read what Louise has to say on sitting, I'm sure its worth reading. and rereading. I do think sitting posture has alot to do with this, but wondering, do others also have this surprise aspect of incontinence?
and is it happening even when the bladder isn't full?