The women who suffer stress incontinence: ROSIE GREEN on the problem we don’t want to share
- UK-based journalist Rosie Green has stress incontinence like many others
- READ MORE: Gemma Collins reveals how she has solved incontinence
Sixty per cent of women have issues with their pelvic floor, according to new research conducted by the Royal College of Obstetricians and Gynaecologists. I am one of them.
By ‘issues’, let’s be clear here, I mean leakage. Stress incontinence is characterised by the NHS as ‘when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh’.
Brief history: I was always someone who would need to cross their legs when I sneezed.
Even as a teenager, trampolining was problematic. Childbirth then made things worse and recently, in my late 40s, maybe due to hormones or just the ageing of tissue, there has been another decline.
It’s a topic that comes with a degree of embarrassment for me and which stops some women seeking help at all.
Sixty per cent of women have issues with their pelvic floor, according to new research conducted by the Royal College of Obstetricians and Gynaecologists
In the aforementioned study, 53 per cent of the participants who had experienced pelvic floor dysfunction hadn’t spoken about it to a healthcare professional; of those, 39 per cent thought their symptoms were normal; and 21 per cent were too embarrassed to share.
Stress incontinence is pleasure-sapping and soul-destroying. It means not giving it your all on the dancefloor, saying no to a game of tennis with the kids, or nerves about an ‘accident’ when belly-laughing with your girlfriends. Here’s my story…
First, let’s rewind all the way back to my early 20s and my first experiences of keep-fit classes.
The instructor would say ‘engage your pelvic floor’ and I tried but it was awol. When everyone else was seemingly ‘taking the lift to the top’ I was struggling to get in at the ground floor.
Then in my 30s, post-children, my stress incontinence got worse. Once out of the baby fog I went to my GP, who referred me to an NHS physiotherapist.
She was very friendly and gave me some exercises to do, which I followed, diligently, for two months. They involved weeing into a measuring jug and trying to locate and contract my pelvic floor muscles three times a day.
Honestly, it made minimal difference. I also tried those internal pelvic floor trainers that claim to do the hard work for you. No change.
Thoroughly despondent, I gave up. Of course I blamed myself – I must have been doing it wrong. So now I felt guilty as well as embarrassed.
Skip forward five years. I was divorced and on the dating scene. A man asked me on a running date, and I realised that for me to achieve this without embarrassment would require nil by mouth for 12 hours beforehand. It brought the problem into sharp relief.
A few weeks after that running date I was invited to Knightsbridge to try out Dr Galyna Selezneva’s Lady Garden Lift, which claimed to improve pelvic floor strength significantly and reduce stress incontinence by combining two non-surgical ‘tweakments’. Dr Selezneva told me she saw lots of women with stress incontinence and was confident she could help.
Rosie Green says that stress incontinence is pleasure-sapping and soul-destroying and limits opportunities, such as giving it your all on the dancefloor
First, she recommended the Emsella treatment (£2,000 for six treatments, drritarakus.co.uk), involving a plastic tub chair that you sit on fully clothed.
I was positioned carefully so my nether region was in the centre and then – wow – the electric pulses started. They were pretty strong – not painful but intense. Some women get a sexual pleasure from them. Sadly, I did not.
The procedure lasts 30 minutes and, ideally, you’d do six sessions. By the third I felt a difference and I was leaking less, after six I could run with much more confidence.
The next weapon in Dr Selezneva’s arsenal was the Ultra Femme 360 (from £3,200).
This is a machine connected to a probe. It required me to disrobe and assume the smear-test position.
The doctor then put the probe into my vagina and it emitted a radio frequency, triggering collagen production to help support the bladder, create internal tightening and increased sensation during sex. (The last part sounded like a great side effect for someone dating again after 15 years of marriage.) It was a bit weird, but not unpleasant – just slightly awks.
The two combined improved my situation by maybe 50 per cent. I posted about it on Instagram. Many women were intrigued, but the method also has its critics. One of them messaged me.
It was Lucy Allen, a physiotherapist who specialises in pelvic health (lucyallenphysiotherapy.com). She told me, ‘This is not a long-term fix for incontinence. The pelvic floor needs regular training. The research into this chair has shown improvements at three months but there are no longer term studies or evidence.’
She added, ‘Please see a pelvic health physio as this is really treatable.’
Slowly, over the next six months – as she had predicted – the benefits of the Lady Garden Lift treatment started to subside.
I grew disillusioned and parked the problem. Again. Then, a year ago, my pelvic floor problems worsened and I was forced to refocus.
I went back to my GP, who referred me to an NHS gynaecology unit. I was put on a (long) list to see a consultant. While stewing over the delay I met a friend for dinner. She was delighted with the effects of a private urethral bulking operation performed by Professor Stergios Doumouchtsis (stergiosdoumouchtsis.co.uk).
With my much-anticipated NHS appointment postponed for another four months, this time due to the Queen’s funeral, I booked to see him.
Urethral bulking, Professor Doumouchtsis explained, involves injecting a substance (polyacrylamide hydrogel) into the walls of the urethra, which creates a narrowing at the bladder neck. Result: ‘Your own body needs to do less work to keep continence intact.’ He was clear that the success rate is less than desirable (60-70 per cent).
How long it lasts varies from patient to patient. In fact, one in four women needs a top-up – either soon after the original operation because they need more filler injected, or long term, due to their lifestyle or just because of the ageing process.
It’s a considerable sum of money – the operation, tests and consultations cost well over £3,000 – for a procedure with no guarantees, but I saw it as an investment.
Professor Doumouchtsis sent me for a urinary dynamics test, which involved, among other things, drinking lots of water, jumping up and down to assess the extent of my problem, and peeing into a commode to see the force of my flow. Not terribly dignified.
On the day of the op, I was given a general anaesthetic. I woke up a bit sore but nothing paracetamol couldn’t ease. I felt a slight burning on weeing, and couldn’t have sex or exercise for four weeks.
On my first post-op run I felt a familiar wetness, but realised it was only a very small amount. Over time it became apparent that the surgery had actually made a big difference – maybe 80 per cent.
Essentially – and let’s get granular here – I could run and dance with very minimal leakage, while coughs and sneezes were still problematic. Occasionally, when run-down
or suffering with a UTI, I would experience something like my old problem. But it has been transformative, all the same. Now I can run at any time of day whereas previously, I could only do so first thing in the morning, before I’d drunk anything.
Having tasted normality, however, I wanted to be completely dry. Miracle of miracles, I got an appointment with the NHS. I saw the consultant in my local hospital and he said he believed that with top-up urethral bulking he could get me 100 per cent dry.
I am now on a waiting list and am also seeing Lucy Allen in the meantime.
Even if nothing changes, compared to where I was this time last year, my progress has been nothing short of miraculous.
And that dancefloor is mine.
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