Urine flow not stopping -- what does this mean?

Hi Grace

I have had the same thing happen occasionally. It really is distressing when you leave work and say, "I'll have a pee when I get home." You drive and drive, then get there and feel fine. Get out of the car, and whoooaaa!! wet knickers! It doesn't happen every time, but when it does, I really know about it.

I have always had some difficulty in stopping the flow, but have come to the conclusion that my bladder gets so low that it kinks my urethra and squashes it down so I couldn't pee if I tried. When I get out of the car and move, it straightens out, and I'm in trouble.

I have found it much less of a problem since I have adopted a very upright posture in the car (see my other post from today). The other thing I do is get out of the car and bend right forward from the hips, so my bladder moves up higher into my pelvis, then pause and squeeze tight before standing upright again. Extra special posture and leave all heavy objects in the car - walk quietly in to the toilet and have a big pee where we are all supposed to have a big pee! Works almost every time, and is heaps better than wet knickers or worse. Then I can go out and get all the heavy stuff. :-)

Whoever thought I would be saying this to the world at the age of 53? LOL

Cheers

Louise

I think you're on the right track to be concerned about this before it gets worse. Do you have Christine's book? There's something in there about how stress incontinence can be a precursor to prolapse. And yes, I started having stress incontinence and inability to stop urine flow gradually after birth of first child almost 8 years ago. It wasn't until after birth of my third child that I felt the prolapse (he's now 1). So, I hate to confirm your fears, but I think that now is a great time to begin to address it because you don't have prolapse symptoms yet! Nip it in the bud!

If I were you I'd start with the WW exercise program and doing the sitting and standing postures. This might not be popular, but I've used the kegelmaster 2000 for 4 months and it's gotten rid of my stress incontinence (but not the prolapse). There's a previous thread on it that I recommend you read.

I'd also do accupuncture and herbs with someone who understands prolapse (a doctor of traditional chinese medicine) as a preventative measure. I also hear that there are cranial sacral therapists who specialize in prolapse. Also, look into maya massage. I've had a doctor giving me dhea supplements to strengthen adrenals.

So, there's a lot out there you can try to strenghten your whole system while you work on the posture. Again, I think you are fortunate and wise to be noticing the symptoms now. I often wish I had noticed them enough to have done something sooner, before the prolapse developed.

I'd also really be interestged to hear what Christine would advise for you as preventative measures at this stage.

Blessings for healing.

Marie

Hi Grace,

First of all, damage to the area between vagina and rectum can certainly result in pudendal neuropathy, which in turn affects support of the bladder and urethra. The most medial band of pelvic floor muscles themselves can also sustain injury so that the urethra is no longer adequately drawn up and forward during the voluntary contractions that create continence. The very front portion of the pelvic floor serves as a secondary sphincter to the urethra and actually has different points of attachment to the pelvis than the posterior portion, which acts more like a basic diaphragm distending up and down. This is why Marie’s SUI has responded to kegels.

Who knows what caused your big leak, but I think Louise gave us a good clue and we can also learn a bit from one of the basic laws of fluid dynamics: Resistance of flow in any tubular structure is inversely proportional to the diameter of the pipe.

This means that the larger the urethra (i.e. not being squeezed together either by its own involuntary sphincter or by the pelvic floor muscles) the less resistance it has to the flow of urine from the bladder. The bladder is just a container for urine with a muscle wrapped around it that contracts when it’s time to go. The pelvic floor muscles must relax in order to start the stream.

The pelvic floor muscles contract at the end of peeing, which draws the urethra up and forward and squeezes out the last drops. If you can feel no contraction, you may have a bit of neuropathy. Interestingly, it may be because you’ve had so few episodes of leaking and those being pretty far in the past now, that your bladder has come down a bit and created a somewhat artificial sphincter.

All these organs pull away from the front of the body and in the worst cases of urinary incontinence the top of the urethra becomes “vesicalized”, or opened wide to the bladder so that it works just like a funnel…swoosh-h-h-h. I think this is pretty common after hysterectomy, hence the millions of sub-urethral slings out there. However, I also think the right positional circumstances can be created (and avoided) for this to happen like you and Louise described.

Personally, I think it’s kind of a blessing that the bladder comes down a bit to sit on the urethra. Slight cystocele is a far lesser disability than unpredictable episodes of incontinence in my opinion. We certainly don’t want a prolapse to progress to the point of having to lift it out of the way to pee, which many women must do, but to stabilize it all at the highest level of functionality possible.

Christine

Hi Grace

I would have been mortified if my little episode had happened in an office full of men. I think you displayed such wonderful presence of mind and lateral thinking skills. A man would not have dared to ask you what you were doing. In fact it would have looked so odd that by the following day they probably all thought they had imagined it ;-) and wouldn't have mentioned it to another man in case they had imagined it!

It is very easy to feel bad about the fact your body doesn't work the way books say your body should work. I have had stress and urge incontinence all my life to one degree or another, and have basically done all the right things that I could, so I have always taken with a pinch of salt the books that say you should be able to stop the flow. Sorry, but my only reality is a body that can't, so in my case the book is wrong. Any sentence that has the word "should" in it, is loaded with guilt-inducement. What it means is probably that some women can't. Full stop. Whoever said that books that are published contain no lies? Wrong. You just have to decide for yourself. (And remove the word "should" from your vocabulary. It doesn't seem to have a function other than inducing guilt. Who needs more of that?)

By all means strengthen your pelvic floor muscles by any means that you can. They are very useful for good sex, but there are many posts on this site that warn against overdoing Kegels, because in isolation, they can aggravate prolapse.

However, the other posters are right. It is probably an early signal that all is not well down there. How lucky you are to have this revelation before experiencing prolapse.

The posture and other things that Christine advocates are such useful things to know and do for all women, and once you understand all the mechanics of the pelvic area (some of which is still gobbedegook to me) you will see why you owe it to yourself to adopt this posture and food and general lifestyle habits as a matter of course; and how the way we are taught posture and exercise and birthing is misleading for women who want to maintain the integrity of their bodies. Unfortunately, it seems that so many health professionals have been barking up the wrong tree for many many years, and are not about to say tomorrow, "We were wrong to tell you to tuck your butt under". However, it is no longer mainstream to insist that women labour flat on their backs, so maybe there is hope. I certainly hope so, for the benefit of our children and grandchildren.

Cheers

Louise

Hi Grace & everyone,

I was on the internet the other day and somewhere saw this ad for this bladder control supplement for women. It is herbal and one of the ingredients happens to be red raspberry. However, there are 20 some odd other herbal ingredients in it. Here is the link www.betterwomannow.com. I thought it was interesting and maybe worth a shot for those with urinary incontinence issues. It was written up in Life Extension Magazine and a small study showed some good results.... Be well all, April

Hi All

I think it is important to look out for remedies which may help us all, but I think it is also important to dig deeper into these little studies and trials and find out whom they are published by, and how the study was funded. Menopause Journal purports to be a peer-reviewed scientific jounal, but appears to me to be a pretty low-brow magazine for family doctors, which promotes products that they may want to recommend that patients purchase.

The American Menopause Society appears to me to be not a professional organisation with academic research credibility, but a registered charity. Who knows what the relationship is between the product in question and the publisher of the journal? I realise that I may be completely wrong here, but everything is not necessarily what it seems!

It is interesting though, that red raspberry leaf keeps coming up time and time again.

I know we are what we eat, but I think what we do with our bodies has far more to do with managing incontinence and prolapse than pouring our money into the purses of those who market magic bullets. Call me a cynic if you will, but I just think we need to stop looking for magic bullets, and get on with good posture, good quality diet, appropriate exercise and clothing. I'm not saying it is not worth a try, but I would rather spend my $$$ on posture aids, good reading matter and good teaching than stuff to pour down my throat. Any comments??

Cheers

Louise

April checked out Better Woman website. Sounds like the miracle remedy I have been looking for. Have to check with my Dr. first. Thank you for the information

Hi Louise,

I couldn't agree with your more about the number of companies out there looking to take advantage of people. I don't know much about the American Menopause Society, but I trust you are correct on them. However, Life Extension Foundation has a very good reputation. I also agree with you about using the posture more, taking responsibility for your health with a good diet and such. However, I don't know what it's like to deal with incontinence and how awful that must feel for anyone who loses control of their bladder. It must feel humiliating for a woman to have to deal with that in public. Our society here in the U.S. is very unforgiving and women (except for in this forum) don't share their personal prolapse or incontinence struggles even with their closest friends, so they must feel so very alone! I don't know anyone else who has a prolapse -- which I find very odd. I do know there is no magic bullet, but it's worth a shot because I don't know how else one would go about "toning up" their internal organs. Perhaps the key is a combination of all the above -- posture, good self care, diet, lifestyle, exercise, positive mental attitude, etc. But, still it couldn't hurt to try it. After all, they offer a complete 60-day money back guarantee. And if it works, wouldn't that be so worth it?And yes it is quite interesting that the red raspberry leaf keeps turning up... Take good care, April

With a 60-day guarantee, you can't really lose, can you? And I hope it is a solution. Having had some incontinence all my life, I know the distress it can cause.

Re the American Menopause Society, I went to the site where the product was advertised, checked out the link to the trial, which came up with an Abstract of a paper published in Menopause Journal, (from memory, described on its site as a peer-reviewed scientific journal) published jointly by the Association and a company which, when I linked to it, sells resources to doctors online, ie an online bookshop. The Association is a registered charity (it says so on the Association website), and does not purport to be a professional organisation, simply an interest group, which no doubt has philanthropic aims. I am not sure what registered charity means in USA, but in Australia it means that donations to it are tax deductible. In Oz it does not, to my knowledge, give any automatic credibility to any research they choose to publish in their publications, though the AMP are, no doubt a retputable organisation which has to account for all monies at a federal level.

I am not picking on this particular product or organisation or journal, simply using them as an example of something I researched (with my academic library skills) and came to my conclusions on. Any person can follow links to the source. You don't have to be a library para-professional. I give you no guarantee that I am correct, but it is an example of how ordinary women (and men) can follow links on the Web to check out whether or not the research results we see are likely to be good research results, impartially obtained, from rigorously conducted professionally run trials designed to seek the truth, not endorse a product. We don't know who paid for the research to be done, so we don't know who has a stake in the results.

If it is not genuine research, it may still be an effective product, and we should in future see more proper research results that will endorse it. My own experiences have shown me that there are treatments out there for various ailments that have not been demonstrated by proper research to be effective, but that have worked for me, and for others.

As an aside to this I have checked out all the research cited by Christine in Saving the Wholewoman. All the medical research that she cites has been published in well-respected peer-reviewed scientific journals. There is no arguing with this very well-compiled collection of information about the various surgeries offered to women and the risks and possible complications is totally factual and backed up by the research done by medical specialists and endorsed by their peers at the highest level. This gives Christine great credibilty as a writer and advisor.

That's why I think Saving the Wholewoman is essential reading for any woman considering surgery for prolapse or incontinence or related conditions.

Cheers

Louise

Hi April and Louise,
I know what you mean about women suffering in silence with all of this! I have a very strong belief that prolapse and incontinence issues are a great deal more common than we realise. Since I have had these issues and made them public, I have encountered perhaps five other women with prolapse issues, and many more with serious urinary incontinence issues not previously revealed to me. One of these is my own sister, and another her best friend! I think we are doing a great service to many out there by discussing this stuff and it is about time don't you all think! We need not feel alone with this as so many have done before thank goodness. :)

Has anyone tried Better woman? I am thinking of trying it,and would like some input on it. thank you