Sixty percent of women have pelvic floor problems, according to new research from the Royal College of Obstetricians and Gynaecologists. I am one of them.
By ‘issues’, let’s be clear here, I mean leaks. Stress incontinence is characterized by the NHS as ‘when urine leaks at times when the bladder is under pressure; for example, when you cough or laugh’.
Short story: I was always someone who needed to cross my legs when I sneezed.
Even as a teenager, the trampoline was problematic. Childbirth then made things worse and recently, in my late 40s, perhaps due to hormones or just aging tissue, there has been another decline.
It’s an issue that comes with a degree of shame for me and one that prevents some women from seeking help.
Sixty percent of women have pelvic floor problems, according to new research from the Royal College of Obstetricians and Gynecologists.
In the aforementioned study, 53 percent of participants who had experienced pelvic floor dysfunction had not discussed it with a health professional; of those, 39 percent thought their symptoms were normal; and 21 percent were too embarrassed to share.
Stress incontinence is a loss of pleasure and a destruction of the soul. It means not giving it your all on the dance floor, saying no to a tennis match with the kids, or nervousness about an ‘accident’ when you’re laughing out loud with your friends. Here is my story…
First, let’s rewind to my early 20s and my early experiences with fitness classes.
The instructor said ‘activate your pelvic floor’ and I tried it, but it was a mistake. When everyone else was apparently “taking the elevator to the top” I was struggling to get on the ground floor.
Then in my 30s, after having children, my stress incontinence got worse. Once out of the baby mist I went to my GP who referred me to an NHS physiotherapist.
He was very kind and gave me some exercises to do, which I followed diligently for two months. They involved peeing into a measuring jug and trying to locate and contract my pelvic floor muscles three times a day.
Honestly, it made a minimal difference. I also tried those internal pelvic floor trainers that claim to do the hard work for you. No change.
Totally dejected, I gave up. Of course I blamed myself, I must have done it wrong. So now I felt guilty and ashamed.
Jump forward five years. He was divorced and on the dating scene. A man asked me on a date and I realized that to achieve this shamelessly he would need nothing by mouth for 12 hours beforehand. He put the problem in sharp relief.
A few weeks after that run date, I was invited to Knightsbridge to try Dr. Galyna Selezneva’s Lady Garden Lift, which claimed to significantly improve pelvic floor strength and reduce stress incontinence by combining two non-surgical ‘touch-ups’. Dr. Selezneva told me that she has seen many women with stress incontinence and was confident that she could help.
Rosie Green says that stress incontinence reduces pleasure and destroys the soul and limits opportunities, like giving it your all on the dance floor.
First, she recommended the Emsella treatment (£2,000 for six treatments, drritarakus.co.uk), which consists of a plastic chair that you sit on fully clothed.
They carefully positioned me so that my nether region was in the center and then, wow, the electrical pulses began. They were quite strong, not painful but intense. Some women get sexual pleasure from them. Unfortunately, I didn’t.
The procedure takes 30 minutes and ideally you would do six sessions. By third I felt a difference and was dribbling 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. He made me undress and assume the smear test position.
The doctor then placed the probe into my vagina and emitted a radio frequency, triggering collagen production to help support the bladder, create internal tension, and increase sensation during intercourse. (That last part sounded like a huge side effect for someone dating again after 15 years of marriage.) It was a little weird, but not unpleasant, just a little annoying.
The two combined improved my situation by maybe 50 percent. I posted it on Instagram. Many women were intrigued, but the method also has its critics. One of them texted me.
HE COULD RUN AND DANCE WITH VERY MINIMAL LEAKS WHILE COUGHING AND SNEEZING WERE PROBLEM
It was Lucy Allen, a pelvic health physical therapist (lucyallenphysiotherapy.com). She told me: ‘This is not a long-term solution for incontinence. The pelvic floor needs regular training. Research on this chair has shown improvements at three months, but there are no longer-term studies or tests.’
She added: “Please see a pelvic health physiotherapist as this is really treatable.”
Slowly, over the next six months, as she had predicted, the benefits of the Lady Garden Lift treatment began to wane.
I got disappointed and parked the problem. Again. Then a year ago my pelvic floor issues got worse and I was forced to refocus.
I went back to my GP who referred me to an NHS gynecology unit. I was put on a (long) list to see a consultant. While I was worrying about the delay, I met a friend for dinner. She was delighted with the effects of a private urethral enlargement operation performed by Professor Stergios Doumouchtsis (stergiosdoumouchtsis.co.uk).
With my long-awaited NHS appointment postponed for another four months, this time due to the Queen’s funeral, I booked to see him.
Urethral augmentation, Professor Doumouchtsis explained, involves injecting a substance (polyacrylamide hydrogel) into the walls of the urethra, which creates a narrowing at the neck of the bladder. Result: ‘Your own body needs to work less to keep continence intact.’ He was clear that the success rate is less than desirable (60-70 percent).
The duration varies from patient to patient. In fact, one in four women needs a supplement, either soon after the original operation because she needs more filler injected, or long-term, due to her lifestyle or simply the aging process.
It’s a considerable sum of money (op, tests and consultations cost over £3000) 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 a lot of water, jumping to assess the extent of my problem, and urinating into a toilet to see the strength of my flow. Not very dignified.
The day of the operation I was put under general anesthesia. I woke up a little sore but nothing that paracetamol couldn’t alleviate. I felt a slight burning when urinating and was unable to have sex or exercise for four weeks.
On my first post-op stroke I felt a familiar moisture, but realized it was only a very small amount. Over time it became clear that the surgery had really made a big difference, maybe 80 percent.
Essentially, and we’re going to be granular here, I could run and dance with minimal leakage, while coughing and sneezing were still problematic. From time to time when it runs out
or suffering from a UTI, I would experience something like my old problem. But it’s been transformative, all the same. Now I can run at any time of the day whereas before I could only do it first thing in the morning, before I had anything to drink.
Having tried normal, however, I wanted to be completely dry. Miracle of miracles, I got an appointment with the NHS. I saw the consultant at my local hospital and he told me that he believed that with a urethral augmentation it could leave me 100 percent 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 at this time last year, my progress has been nothing short of miraculous.
And that dance floor is mine.