Incontinence forum?

Hi Lynn and welcome. Have you gone through the incontinence exercises? I think you will find them very effective over time. Prolapse, hip pain and incontinence are all part of the same story, but Christine does a wonderful job of isolating the movements that can offer the most help for particular issues.

The extent of your surgeries and the resulting adhesions are something that needs consideration in a way that maybe only Christine is qualified for. The natural mobility of the organs is a significant factor in the success of the WW work, which is why we hope women won't compromise that with surgeries that alter the pelvic dynamics and restrict the ability of the organs to move around. To some extent I suppose it's possible that adhesions could have the same effect?

Do train yourself in all aspects of the posture (it takes time and patience but will eventually become automatic). Understanding and results start to happen differently for each of us. Consider a consult with Christine. - Surviving

Hi Lynn,
The surgeries don't necessarily mean you won't have movement of your organs; that's why surviving suggested the consult with Christine. She may have a better understanding of the surgery you had and more input on how to proceed. She actually had a bladder surgery that brought on her profound uterine prolapse, and then went on to create whole woman.
You can still work on the posture, and even try out some of the exercises, especially the pee on/pee off exercises in your incontinence program. Just be gentle, and pay attention to how it is making you feel.

In all the reading I have done, though I’m only a mom and not an expert and can’t give medical advice, I would consult with Christine and ask her about using castor oil packs and or Arvigo Mayan abdominal massage to help the adhesions to resolve. Again, this is a hunch but it’s what I would do. Christine might have other ideas as well but I’d ask her about those two.

Hi Lynn,

First of all, I want to tell you that one of my current students is only in my class because of a highly traumatic urinary incontinence episode. The difference between yours and hers, however, is that she was in a very public setting.

She has no surgical history, and it seems likely that years of expanding rectocele and general pelvic relaxation caused the nerve center at the base of her bladder to fire chaotically, creating detrusor spasm and loss of control.

While adhesions are a given after the level of surgery you describe, it’s impossible to know how they might be affecting the dynamics of your pelvic interior.

We can probably assume that the bladder-urethra angle has been compromised, which I can’t imagine won’t improve with this work. The normal 90º angle acts like a kink in a garden hose to prevent stress incontinence. There is no crisp distinction between stress and urge incontinence and many women have a combination of both.

A sub-urethral sling would create a very unnatural angle, pulling your urethra forward and tethering it to your abdominal wall. You would probably never again lose urine with a cough or sneeze, but it would do nothing to correct the hypersensitivity at the bladder base.

Overwhelming evidence has illuminated the disastrous nature of polypropylene mesh slings for urinary incontinence. However, there is no predicting how a traditional bladder neck suspension would affect your symptoms.

We all are working with what we have. Some women have had only natural births and no surgery, while others have been significantly altered by senseless and damaging pelvic operations. Astonishingly, the work remains the same for all of us, because in the final analysis the only reasonable response is to carry the organs at the front of the body and away from the outlet at the back (creating anatomic right angles between the organs and their channels).

Your story reminds me of the young woman from the UK who wrote in to the forum a few months ago. Her troubles also began with surgery for endometriosis, and ended tragically with several bowel operations and eventually an ostomy bag.

Gynecology is a very blunt instrument at this point in time. However, there is reason for hope that great change is on the horizon as more is understood about the microbiological nature of many of these disorders.

I believe you will improve with this work!

Hugs from Christine

Hi Lynn,

I went ahead and asked my student Monique to give me some feedback on this subject and here is what she wrote:

“After starting the Whole Woman work and learning how to change my breathing and posture consistently for three weeks I noticed that I wasn't leaking when I sneezed. The other notable change is that I'm not experiencing vaginal pressure when my bladder is full. This is measurable for me because the work I do requires heavy lifting and walking with equipment.”

And by the way, Monique visited me last Sunday and it was such a delight to see how beautiful she was pulled up strongly in WW posture!

Bladder nerve damage really isn’t the issue here, but rather the nerves at the base of bladder becoming hypersensitive, which happens to all of us eventually as our tissues thin and become less supportive. Think of the bladder base being squashed down and back by years of pulling the belly in, sitting in soft furniture, etc. Take away the cushioning effect of tissues “plumped up” by our natural, anabolic estradiol, and “key-in-the-door” syndrome becomes something we all become more sensitive to.

As far as surgery goes all operations for urinary incontinence have one objective, and that is to create a more acute angle between urethra and bladder. The normal urethra to bladder angle is an L-shape, or 90º. Incontinence surgeries create more of a V-shape angle, or in the case of sub-urethral slings, Z-shaped angles! Stress incontinence is improved, but urination often becomes more difficult and urine retention and dribbling after peeing are common. In the worst-case scenarios women are left to self-catheterize for the rest of their lives.

With normal stress urinary incontinence, an immediate, but limited amount of urine is lost with increases in pressure (sneezing, etc.). With urinary flooding the entire contents of the bladder empties. This second more severe type of incontinence becomes more prevalent after hysterectomy and other surgeries that disrupt bladder nerves and physiology. A traditional bladder neck suspension (“Burch” or “MMK”) is performed through a low “bikini” incision, and long sutures are placed into the fascia around the bladder neck and then tethered to the inside of the abdominal wall. However, in reality it is the front vaginal wall that the sutures are anchored into, not the extremely fine layer known as fascia. So, at the end of the day the vagina is permanently attached to the belly. This causes “tenting” of the vagina (in normal anatomy the vagina is a long, flattened tube), so the uterus can easily slide down an opened vagina. One problem is traded for other, far more severe problems.

If simply accentuating the bladder-urethra angle cured post-hysterectomy urinary flooding, that would be great! However, we know this is not the case because the next step after failure of suspension operations is sacral nerve stimulation, which uses an electronic device embedded in the butt, and nerves coming straight off the spinal cord, to shock the bladder into behaving. It doesn’t get more macabre than sacral nerve stimulation.

I have no way of knowing if, in the event of increasingly uncontrollable episodes of incontinence like you have been experiencing, your symptoms could be improved with bladder neck suspension.

I do know that generally speaking it is far wiser to work with the natural dynamics of the body to reverse incontinence symptoms.

****These dynamics remain completely ignored by the practices of gynecology, urology, and urogynecology***

Here’s the key:

Even if you are somewhat “glued together” with scar tissue, pulling that very tissue into alignment with the natural dynamics of the pelvis may allow you to also see good results with the WW work.

That’s what I’m betting on!

Christine