why the leaks?

Submitted by saddleup on July 30, 2009 - 6:55pm
Body: 

Hi, all:

"Sister Cele" and I enjoyed a lovely trip to London in June. She behaved herself quite well, though by the end of a day of me pounding the sidewalks sightseeing she felt a little droopy sometimes. While flying, with the usual getting up and down and walking to the loo (love that term) on the airplane (who can sleep, anyway?), no urinary incidents occurred.

During most of the summer, the prolapse has not bothered me much at all. However, a long drive in the car last weekend (with a bunch of closed service centers along the road) led to one incontinence incident. Later, I may have provoked it by dancing at a wedding reception, but nothing awful happened.

So, back in the usual routine, I went riding twice this week. Both times, even though I had my sports tampon in place, there was urine on the mini-pad when I was done. This concerns me, because I really hope I haven't been wrecking up my pelvis by continuing to ride a horse. Before this, it seemed that the tampon did a good job of holding the bladder in place and keeping it continent. The first time, I could feel the tampon working its way down toward the exit, but I was in no position to do anything about it. The second time it felt okay, and I was unpleasantly surprised by the leakage.

So, I'm looking for educated guesses. I wonder if I'm just going through a "down" phase, and I'm hoping against a deterioration. I may need to go see the uro-gyno again to check things out. I had two really great horseback rides, though! Thanks for your thoughts.

louiseds

July 30, 2009 - 10:39pm

Hi Saddleup

Sorry to hear about this setback. We all have them occasionally. It sounds like you have been challenging that Sis of yours over the last week or so. I would leave off riding for a bit, and just let your body recover from all the travelling, for a few days. Period may be around the corner? Visit the situation again in a week or so. I find that travelling upsets my body. Different bed, stress, carting luggage around, hurrying, bad furniture, out of routine, etc. I am usually right again in a week or so.

L

saddleup

July 31, 2009 - 10:54am

Hi, Louise:

You may be right about the travel. It is so unnatural to sit in cramped positions for hours on end while getting from one place to another. With the cystocele, I knew that once I really felt the urge, I might be unable to "hold it" till the next available rest stop.

I think I will leave the riding to my DD for a few more days, just to make Sister Cele happy. No period is due--I gave those up several years back. Thanks for your help.

Saddleup

Christine

July 31, 2009 - 11:30am

SUI is always about the angle of the bladder/ bladder neck. A sharp angle protects against increases in intraabdominal pressure - just like a kinked hose. Straighten the hose - even a little bit - and you’re less protected. For almost all with significant cystocele, where the bladder has fallen backward to kink the bladder neck in the opposite direction, leaking isn’t a problem - until a pessary or tampon is worn. This may straighten the angle again and cause leaking. Stay strongly pulled up into the posture and see how things change.

saddleup

August 2, 2009 - 8:27pm

Thanks for lending your insights, Christine. I really appreciate it.

The odd thing is that, until recently, I could wear a sports tampon and feel like my bladder was normal again--strong urine stream when voiding, and no accidental leaks. I have used tampons for the past year for riding and other high-impact activities. I thought the tampon was putting the bladder slightly more forward and making the sphincter do what it's supposed to do.

My understanding was that women used a pessary or a tampon to keep things in place and avoid SUI, so I am puzzled by your comment to the contrary. I could live with the whole POP thing way better if I could get back to some level of confidence that my bladder would not inadvertently leak. That is the POP symptom I find most distressing, and it hasn't really resolved. That's the issue that messes with my attitude about life in a big way.

I don't know that I can stay strongly pulled up into posture all or even most of the time. Maybe the posture issues I have struggled with since my childhood are making it more diffcult. I do the exercises from the book and throw in some firebreathing a few times per week. I just want the leaks to stop! Thank you again, and I truly appreciate your work and the availability of these forums.

Saddleup