FLUID MOTION

What happened when one writer’s bladder rebelled

BY ANNE-MARIE COOK – from the May, 2015 edition of Australian Women’s Health

One in three. That’s how many women wet themselves when they go for a run, jump around with their kids or even simply sneeze. Here’s my confession – I’m one of the ‘one’. I first noticed it five years ago when I started running again after a hiatus.

I thought it was short-term, but no luck. So I did some research and learned about Kegels – tried them, gave up, tried again. I had an embarrassment or three – running to meet a friend and being so wet down there by the time I reached our meeting place I texted her to say I was ill while ducking into a nearby
public toilet to dry off under a hand dryer. I walked home trying not to cry.

I love running and this problem was stopping me from doing it. Time to make changes. First stop: my GP. During my pap smear I casually bring up my issue and she gives me a label to hang onto – urinary incontinence, or UI – and refers me to my second stop: a gynaecologist.

Lowdown on UI

Dr Jenny Cook (no relation) from Goals for Women clinic asks me the history and habits of my UI. Yes, I’ve tried quitting sugar, alcohol, citrus juice and caffeine, with varying effect.

I learn from Cook there are two types: stress and urge incontinence. In stress UI, leakage happens when you put strain on your pelvic zone; with urge UI you suddenly need to pee, no option. I was pretty sure I had the former, but it’s possible to have both (jackpot!). She checks me for prolapse (when your organs drop through the pelvic floor). I don’t have one of those, phew.

Here’s the thing: I haven’t had a baby, I’m 35, in the healthy weight range and have always been fairly active. I shouldn’t have this problem, right? Cook tells me that the pelvic floor is a sling of muscles that holds my bits (bladder, uterus, bowels) in place. They’re designed to stretch (when you’re preggers they really need to). So while excess weight and babies are two main predictors, running and other bouncy movements can also weaken the pelvic floor until it no longer supports the neck of the bladder properly.
Basically, my pelvic floor is like a bunch of over-stretched rubber bands. Nice.

Cook outlines the plan of attack. Step one: working with a physiotherapist who specialises in pelvic floor weakness and dysfunction. Step two: urodynamic testing measuring bladder pressure, which can feel pretty invasive (a catheter filling my bladder with water, no kidding). Step three: surgery (if required). Pelvic floor exercise does the trick in 80 per cent of cases, Cook says, but adds that she regularly performs ‘mini-sling’ surgery with success. I feel reassured. I think.

Reps, reps, reps

I book in with physiotherapist Shamara Lurie from Pelvic Floor Physiotherapy who delves even deeper into my bladder’s history and habits. Next, another physical exam. If I’m ever going to get over my embarrassment it’ll be now. Lurie gloves up and (professionally and courteously) inserts two fingers into my vagina. I close my eyes and try to go to my special place, like during a pap smear, but that’s not an option – I need to concentrate. She has me imagine dropping a pebble into a pool… only in reverse. Riiiight. So pulling in and up. Lurie asks me to try harder, but then notes I’m engaging my bum and thighs. I try again but now I’ve lost the “pebble” movement. A few more tries and I’m getting it: lift the floor, engage the right bit of the core, no bum. That’s one Kegel; the first I’ve ever done properly.

She writes me a program of 10 reps of three exercises three times a day, to start off, then shows me some devices that can help with my form and progress (yep, there’s an app for that, see the Pericoach at right).

It’s been a month since my consult and I’m preferring the device-assisted moves (see right) over the raw Kegels. I’m doing 20 minutes of exercises daily, split between the electro stimulation and vaginal weights, then measuring my progress with the app. Like any workout program, it takes three months to see serious results. But today, I sneezed. And for the first time in a long while it was not a big deal. Which is a big deal to me.

womenshealthmag.com.au