incontinence

Body: 

hey all:

haven't been participating lately -- though i do read these forums all the time still. life is just...busy and i've been feeling stretched too thin but i still think this site is just the greatest. ever.

so here's what's up with me and i'd love any thoughts and/or feedback.

though i have read here many times that for lots of women the rectocele is the most problematic of all the prolapses, i must say, that with maintaining the posture (as best i can) and keeping a good eye on eating a high quality, organic diet with lots of fiber, the rectocele is...dare i say it? something i hardly think about? i mean, i need to think about it just to keep being thoughtful with the life style basics, but as to any feeling of it or difficulty...really, not a blip on my radar. amazing. i NEVER would have thought that 6 or 7 months back. never.

however, the leaking...ah, yes, the leaking. now THAT is turning into a drag for me and i'm wondering what i can do to support myself with this, besides what i'm already doing. though i don't have a significant cystocele, the leaking (sorry, i really do hate the word incontinence and though "leaking" isn't much better, it just bothers me somewhat less, for some reason...) is problematic. i am doing various herbs (chinese herbs along with some western ones) and doing acupuncture. still doing kegels as, for the other pelvic floor issues, they've been supportive. i'm just wondering if any one has any other thoughts with this, any other ideas? AND/OR, i guess i'd love some support along the lines of these issue might be able to change, that just because i'm leaking pee these days DOESN'T mean it might last forever. (and, no, surgery is definitely not an option for me.) i need to break out of the box with this and i'm just struggling to do that these days.

thanks for any input with this, everyone.

much gratitude.

susan

Hi Susan,

I saw your post and wanted to respond...even though I'm officially off the forum. I'm absolutely swamped here with both family and work for the foreseeable future.

Just wanted to share a few thoughts with you. Do with them what you will. I can't give you instructions because (1) I have no idea what exactly to do or whether or not it will work and (2) I can't take responsibility if your condition actually worsens.

The thing is, the reason incontinence procedures (tvt, tot, etc.) are almost always successful (never mind the negative impacts nor whether a woman will even be able to pee afterward) is because they work by way of an obstructive mechanism. They create a more exaggerated angle between bladder and urethera. It is a fact that the lion's share of female incontinence is GEOMETRIC in nature - it is almost always a problem of having lost the bladder/urethra angle.

It is also a fact that when women develop more severe cystocele, urinary incontinence ceases to be an issue (if it ever was.) This is because the backward-falling bladder actually ends up sitting on the urethra, providing a kink in the opposite direction. Frankly, I think this is a blessing because I would much rather deal with a vaginal bulge than leaking.

That being the case and knowing what you do about your anatomy, what could you do to experiment with changing the relationship between your bladder and urethra? If you stand up, place two fingers in your vagina and gently bear down you will be able to feel all these structures and exactly how they are moving under pressure.

Wouldn't it be amazing if someone came along and developed specific internal exercises, which women could only do themselves, that quite simply moved the positions of the organs within the pelvis. I do this with my own uterus - literally holding it up while bearing down so the vaginal walls can bulge around it a bit and help keep it more elevated. I wonder what would happen if the lower front wall (urethra) was stabilized with two fingers barely inside the vagina while bearing down in a standing position.

If you were standing with your tailbone tucked under, the forces would probably press the bladder against the front vaginal wall - my guess is this exercise would create or exacerbate development of the classic cystocele/rectocele so many women deal with. But would it help incontinence? I really don't know.

If you were standing with a strong curve in your lumbar spine and doing the same thing, would your bladder be forced out in front over your pubic bone as it is in natural anatomy and would this serve to reclaim your original bladder/urethra angle? Again, I have no clue.

I do know I would experiment intelligently until I found out one way or the other.

I can't believe the body develops chronic conditions that are unresponsive to therapies aimed at reversing causal factors.

Christine

hey christine:

thanks SO MUCH for this interesting response -- it gives me a lot to think about. and it is interesting what you note about the more severe cystocele minimizing any incontinence, should that have been an issue.

you know, my body's response to this work was so notable with my rectocele, that i simply must remember that and hold on to that self same positive vision in terms of the cystocele and incontinence. i think i will definitely be experimenting with posture and some exercize and movement. i will think hard on it and let other's know how it works out. again, as with the rectocele which conventional views hold is unworkable, the posture and diet guidance here shifted it utterly. had i simply listened to my gynecologist back in november, as well intentioned as she was, i would have done none of this and i strongly suspect i would still be walking around feeling like i had a ball in my vagina -- or worse. its stabilization is remarkable.

now time to work with equal seriousness on the leaking...

as always, enormous thanks for your input here, christine.

and anyone else with thoughts? bring 'em on!

susan

So do you leak when you jump and cough or is it when you walk around? Or when you are just sitting there? Or when you go from sitting to standing? For some reason I think it would make a big difference in the way you respond to it- depending on when the leaking actually occurs. Also, do you know when you are going to leak? or do you just feel the moisture and know? Are you 100% sure it is urine?
Glad to hear you are doing so well with your prolapse-

so, you ask very interesting questions and -- i know this might sound strange -- but i can't really figure out the pattern with it. save for one, that is. i DO notice things with this issue are worse right after my period ends. weird, huh? leading up to my period and during it, i really don't notice much leaking at all. about a day or two afterwards, the leaking really picks up. i'm there right now, in fact, and, well, crap...it's unpleasant.

also, definitely not when going from sitting to standing -- often leaking just when walking around. it's like a feel a small pool of wetness right in my vagina -- and, yeah, i really am quite certain it's urine. again, though, it's not like it happens CONSTANTLY when i'm walking around -- a lot, but not with totaly constancy. and, as to sneezing and coughing -- usually no leaking then either. i know. i'm probably not helping you out much, am i? but this is a puzzle for me, too.

as to stress....well, there is BOATLOAD of that in my life right now. absolutely. on so many fronts, it's overwhelming. (i used the metaphor of being squeezed from all ends the other day, noticing afterwards the connection between image of squeezing and the urine leaking out -- no accident, i suspect.) sometimes in my head, i add the leaking urine to the stress list, worrying that it will be like this forever -- or get worse! and, yes, honestly, that does scare me. i'm 43 and the leaking makes me feel a numberlessly old amount. the other elements of the prolapse are so managable for me at this point -- i'm very unphased by them. but this...no. right now, this feels scary.

anyways, got off the thread of my thoughts here but i needed to get the truth of that out. it's been clogging my brain for a while now and i know here is a very safe place to express these things.

what else can i add? not sure anything comes to mind. do feel free to float some more questions my way! maybe it'll help a lightbulb go off with this.

great thanks to you, alemama.

susan

Hi Sue

Its funny you know, when you get really used to the posture and food habits and clothing and you think you have it all fixed, then you realise that its not? Been there.

No caffeine or other bladder irritants? No physical irritation of the urethral opening? No UTI's or other unidentified irritation?

Another thought. I just posted under Backache Ideas Needed, about the relationship between menstruation and labour. You know Christine's explanation of the way a woman's posture changes at term and the lumbar curve flattens and opens the pelvic floor for the baby's passage? Well, my theory, which Christine says resonates her ideas, is that labour and menstruation almost identical processes in many ways, that menstruation is a 'little labour'?

Remember also Christine's theory about postpartum prolapse possibly being related to the lack of reestablishment of the lumbar curve and Wholewoman posture, via resumption of normal movement, straight after labour? Well, I wonder if we need to actively reinstate Wholewoman posture straight after menstruation, and fine tune our bladders in the same way as after labour, every month? Maybe the weeing department is not only stretched and beaten up by labour, but there are other forces at work messing things up after menstruation as well?

Keep us posted.

Cheers

Louise

hey louise:

wow! i loved your thoughts on this -- makes a lot of sense to me, actually. A LOT of sense. i was thinking just yesterday that possibly things gets better right before and during my period is the uterus is fuller, perhaps gently shifting organs into a slightly different position? it was just a thought though i think not unrelated to what you wrote. and i think to then purposefully reinstate the posture right at the end of my cycle (again, it takes a couple of days for the leaking to start up, suggesting the bladder was gently eased into position and then shifted back, i would think?) yup. this really makes sense to me.

BUT, also as to the irritants...well, in fact, it does occur to me that there may have been more diet irritants lately. i have a list of foods that might provoke bladder irritation -- i'm going to get it out and look through it and be very careful with my diet for the next few weeks, weeding out things like might be exacerbating bladder irritation. and definitely not a UTI -- i had that checked out recently just to be sure. as to urethral irritation -- would i be physically sore if i had that because i'm not -- but i can't rule that one out, i guess, as i just don't know.

thanks again for your thoughts on this, louise. really helpful.

susan

Hi again Sue

I found this info about bladder irritants on http://www.mayoclinic.com/health/bladder-control-problem/WO00122.

"Bladder irritants
Some foods and beverages can irritate your bladder as well. Caffeine and alcohol both act as diuretics, which means that they increase urine production. This can lead to increased frequency and urgency of urination.

Certain acidic fruits — oranges, grapefruits, lemons and limes — and fruit juices, spicy foods, tomato-based products, carbonated drinks, and foods that contain artificial sweeteners may irritate your bladder. Why these foods sometimes cause irritation isn't exactly understood, and bladder irritants differ from person to person. A food that might be a bladder irritant to one woman may not bother another woman at all.

If caffeine or alcohol is a regular part of your diet, try eliminating it from your diet for about a week to see if your symptoms improve. Avoid foods that might be bladder irritants for about a week. Then gradually — every one to two days — add one food back into your diet, making note of any changes in urinary urgency, frequency or incontinence.

You might not even have to eliminate your favorite foods entirely. Simply cutting down on the amount you consume might help, too."

Is like your list or do you have some other suspects you could share with the Forum? I realise that you are talking about a specific time of the month but it would be interesting to list all the foods that women have found to be irritant.

Has anyone else found different foods to be irritant?

Cheers

Louise

the list i have, louise, has the foods you mentioned along with others that i HAVE been eating more of in the past two weeks -- caffeine, of course and chocolate/sugar, in particular, can be quite irritating and i've just had lots of occassions in the past two weeks where i've had plenty of those things. so that's an obvious place for me to cut back altogether (in the case of the sugar and chocolate) and shift down to one cup of caffeine. other irritants on my list include dairy (which i've also had some of in the past few weeks -- VERY unlike me) and vinegar -- also, have had lately while i generally don't.

so, in other words, when i look honestly at the foods i've eaten recently that are potentional known irritants, there are a lot there. and, if i already have a propensity for leaking what with a minor cystocele and stress, i think you have a recipe for lots 'o leaking. which i have.

so. time to get serious here. let's get these things out of my diet and see what's what. and let me re-focus on the posture as well.

i, too, though, would love to hear from other women about things that might irritate the bladder. i realize it will be so different from woman to woman. it will be interesting to see if anything shifts with the food changes. any thoughts?

susan

So interesting!
Quite a few years ago I was VERY ill with stomach symptoms. Then bladder irritation started. Basically it was like I had constant UTI's, always feeling like I had to pee even if I didn't. Was ready to have exploratory surgery it was so bad, and kept thinking there must be a simple reason!

So one week I cut out gluten, and within days I was a new person--no UTI, no irritable stomach, energy back.... Accidentally ate it, and it all came back.

I mentioned it to the urologist who said it couldn't be connected, but I know it is--cancelled the surgery and that was that. My son is gluten intolerant too and when he eats gluten wets the bed (common reason for bedwetting I have read).

So many connections in our body... but so hard to find the culprits sometimes!!!

Yay Sue, you have some more things to try now! I was interested in the idea from the Mayo Clinic page about dropping a food, then reintroducing it slowly. Is that what is called an Elimination Diet? I have heard about it with dairy and gluten, but never thought about trying it with foods you think may be causing bladder irritability.

The vinegar might be irritant as it is an acid food. That was one of the groups in the Mayo Clinic page, or maybe one of the other sites I searched? I guess the Coke/Pepsi addicts of this world would be in for a double whammy with the caffeine and the acid content.

If you are going to seek input from others I suggest that you start a new topic with Bladder Irritant Foods, or something like that, as the subject. That way it will draw Members' interests to that specific topic at the top of the list of New Posts. There may be some Members who do not even know that there are foods that can irritate the bladder! This string will still come up in searches along with the new topic.

One of the small irritations about this Forum is the way that the subject of a string changes almost day by day, and it may become totally unidentifiable with the original subject, but there is nothing on the New Posts page to indicate a change of subject.

Cheers

Louise

did you leak before you found your cystocele?

what i mean is :-

do you still feel the urge to go during the day?

do you still pass urine as much before?

do you still feel as though you have emptied properly?

hey alemama:

i did leak occasionally before i discovered the prolapse. i'm quite certain the cystocele was already there but i was just asymptomatic save for the occasional leaking when i laughed too hard, or something like that so i really didn't give it any thought at all.

and babs...you, too, ask interesting questions. i've ALWAYS been someone who's peed a lot. i drink tons of water and its been something of a joke in my family about how frequently i pee. i still feel as though i empty my bladder -- i pee as frequently as i did before, no sense of my bladder not emptying or having an urge to go suddenly and yet i can't. just this damn constant wetness.

i'm also getting into a tricky cycle with this...i'm getting sort of obsessive about going to the bathroom and checking just HOW wet i am. i know, sounds obscene. i wish it were so exciting. but, in fact, it's making me sort of crazy and i've got to stop THAT piece of it. i know it's not helping.

so this feels like such a puzzle to me. it really does. minor cystocele with this sometimes constant wetness. i AM doing some herbal things as well -- horsetail (high silica content), chinese herbs and acupuncture. i am so certain there's a solution to this (and, i need not say, of course, we are talking non-surgical, naturally! :-) ) but i feel like i'm missing something that would be helpful. again, i simply can not believe i this can't get relieved somehow.

(hm. perhaps i should pee in the morning in the position christine recommends in the book -- i did that when i was initially diagnosed. maybe it all ISN'T getting out?)

can you tell i'm stumped??

thanks all for the support with this. what a great family of women.

susan

i think you should keep a fluid in fluid out diary for a week, just to make sure you are getting rid of it.

also see if you get rid of more peeing on all fours.

i have a male relative who ended up with an overstretched bladder when he wasn't peeing right, and my own drs were worried about this when i had diffs peeing during my last pregnancy. if i had been retaining they would have catheterised me to protect bladder function.

a change in pattern, constant dribbling etc., shouldn't be ignored.

likewise if you have had abdominal bloating or anything i would get myself along to a doctor, just incase there is something else pressing on the bladder, eg ovarian cancer.

sorry to be so negative, but it is important to keep an eye on these things too.

its your body and you know best how you are feeling.

best wishes
babs

thanks for the thoughts, babs.

i actually have my yearly gyn appointment early next month, so i'll talk to her then, though i did see her in may for uti test and quickie check up because of the leaking. she felt that it was prolapse related and discouraged my from going down the surigcal route as she said, "it will be all about slings and stuff and you don't want to go there." amen, sister, i said to that. so i'm really not worried about anything catastrophic brewing -- and my deep sense about this is certainly in alignment with that.

i'm not really sure what "peeing right" means -- funny, isn't it? my pattern really hasn't changed -- just my compulsive with it has shifted, not any urge to be going more or less, if that makes any sense. ultimately, my strong sense of this is about anatomical shifts (it got more noticable after i took a hard fall on my ass this winter -- cleary, something shifted.) and i know christine has said that frequently minor cystocele's can create more of a leakage problem than major ones -- again, that makes sense to me. also in the way it shifts in the cycle -- mid way through my cycle, it will ease up.

anyways, we shall see how this moves and changes. and i'm sure it will.

susan

Hi Susan:

Sorry to hear of your recent problem. I was just wondering though. Are you 100% certain that it is urine? I ask being that the weather is so hot here, you may tend to sweat more there. That combined with any discharge may appear to be urine.

For as long as I can remember, I too have some issue with this. Typically I notice it more in hot weather.

Just something else to think about. Wishing you peace.

- Lilly Anne

have you been doing that exercise where you sit with your legs straight out in front of you and belly relaxed and toes touching (turned in) and contracting your pelvic floor muscles?
Remember that one?

Sue, did you say you had a fall? And did you get treatment for it? Maybe you have something stopping your body from standing correctly and need some physical therapy of some sort to get your body flexible and straightened out again so you can do Wholewoman posture properly again. Sometimes these injuries seem to heal but actually leave us with residual stiffness that needs attention. Just a thought.

Cheers

Louise

hey louise:

yup, i did have a fall in late winter and that's when things really started to change. i actually have an appointment with the pt person on friday (mind reader that YOU are!) and we'll talk about it then.

and, alemama, yes, i do remember that exercize. it wasn't effective for me, unfortunately, though i'm sure it works for other women. but thanks for thinking of it.

and, lily anne -- so good to hear from you! i am actually not 100% sure that this is all urine leaking. sigh. what comes out is often very watery like urine although it has virtually no odor.

it's funny. i'm getting very caught up in the anxiety with it, sort of like i felt at the initial prolapse symptoms. many of the same feelilngs are coming up with it, the obsessiveness, the loop of fear, the hyper focus. THAT is certainly far more damaging that any leakage which i CAN also band-aid with cloth pads while trying to figure this out.

ack!

susan

Hi Sue

So it is leaking enough to need a pad? Hmm. I was just thinking today (which is day 8) that I am getting damp patches, but I have also noticed the start of clear, runny mucous which I think it comes from. When I was practising natural family planning I used to record clear,wet, ovulation style mucous for about 7 days before ovulation, before it went off and lost that real wet, elastic quality. But I don't need a pad. I'll keep an eye on my knickers. Have fun at the physiotherapist. LOL.

Cheers

L

ah...this site is the best. it really is.

so, i made an interesting discovery in the last few days. much of what i was thinking was urine is actually a vaginal discharge -- utterly clear, totally odorless. i think it was lilly anne who put it in my head with her post -- thanks for that, lilly anne! i put a tampon in the other day and left it in for the morning. no"pee" leakage (or barely a blip, i should say) but the tampon had absorbed this "discharge." interesting. i will be addressing it with the gyno in a few weeks when i go, though i do recall just recently reading here about increase in secretions that some women experience with prolapses. i strongly suspect that is what's going on, along, perhaps with some fun perimenopausal, hormonal action. but i will check it out -- though i imagine my gyno, after looking into it and checking me thoroughly will shrug her shoulders and tell me it's nothing.

anyways, in the meantime, i will just watch it and not worry. and as to what IS the minor pee leaking, that i will live with, maybe come back and re-read the great thread again about what IS incontinence. sometimes i can put so much energy into fighting the change, fighting the reality about what IS -- fear driven, i know, but there it is -- instead of just breathing with it. i know for me, it all comes down to my mortality -- yes, even dealing with my prolapse -- it's just a reminder for me of the impermance of everything, most especially myself and that can just scare the shit out of me! again, that's only my truth and my make up, not anybody elses but i have really noticed it in me. i can spend time thinking about what it was like a year ago, before the "diagnosis" though i do realize the prolapses, no doubt, were there already, and really, did anything THAT dramatic shift from one day to the next? no, not really. just my consciousness with it. perhaps today i might have a moment in my day of just accepting things as they are, at that moment, and realize that, ultimately, everything really is fine. maybe. :-)

thank you all, women!

susan