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Pelvic Organ Prolapse (POP) Community
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Avatar universal

New and questions

In the past year leakage from incontinence has gotten worse.  I realize it's not nearly as bad as some ladies may have.  I'm thinking it's a mixed bag of types involved.  However, I don't believe that POP is involved, especially since I have to imagine it would have been noticed for the GYN part of a recent appointment.  Definitely it's stress involved, ie coughing, low situps, jumping.  There's some leakage occurring during the daytime although it's not an amount I can measure.  There is definitely a urine smell though.  For close to a year I've been wearing the light type of Poise or Tena pads.  If working out, and definitely if working on situps, have to wear a moderate type of the pad.  

This has been building up prior to the past year.  For the most part, I thought that perhaps I was just heavy and sweating a lot.  But...sweat doesn't have an odor of urine.

I spoke of this at my annual physical at the VA Hospital the other day and am being sent to Physical Therapy.

Any thoughts or suggestions?  Thanks!
24 Responses
Avatar universal
Oh dear...hopefully I'm not in the wrong forum since POP isn't involved.  Thanks
1569750 tn?1295592754
I can relate I had this too and finding the cause is a daunting task. I went through ultrasounds, to meds, to possible urethral infections, to seeing a urologist who discussed surgery then finally we found a large cyst on my ovary causing pressure on my bladder. That all took a year plus ugh. It could be caused by a number of things...have you had children, age, like you noted stress, but I would suggest to keep searching for an answer that you know is right bc the end result will hopefully be relief of this terrible occurance. One thing that helped me with the odor was keeping feminine wipes for the frequent trips to the bathroom. I've never heard of physical therapy but something to consider is practicing kegels I was told they could strengthen the muscles. Exercising is also helpful bc losing a little weight could relieve some pressure on the bladder. Last resort surgery but exhaust all resources in the search for the problem before chosing this method. Best wishes BB
Avatar universal
Thanks.  I'm 51, not yet in menopause, with 1 child although there were multiple miscarriages before he was born.  While I do need to lose weight, when I had lost 30 lbs last year on the South Beach diet and weighed 157 is when the condition really picked up and ran off.  A good point, but it's not an ovarian cyst.  I know this because annually I've been checked by ultrasounds to ensure nothing anatomically wrong due to messed up menstruation.  For the past few years, I get too many approximately one-half of the year.  A private Dr I see (not the VA) ran hormones and thinks I shouldn't ever have my cycle again.  Well he doesn't quite know that since I've had three since then.  My Estrogen is quite low, almost bottomed out, yet I still get cycles.  Supposedly in November I had a UTI but no pain or anything.  If I did have one, it was the first in my entire life.  

The wipes is an idea I'd thought of but personally haven't ever known any one that uses them.  The therapy I'm sure is to help see if any thing can be done about the muscles without going to last resorts.

Thanks for your answer and I appreciate it.  

Sal
1128665 tn?1269277071
Hi Sal,

I'm Sher, the CL of this forum. First up I'd like to say that physicians typically don't pick up on POP, it is not screened for during a pelvic exam (although it sure should be-I've been banging the drum on that perspective!). Even when gyns do pick up on POP, they usually aren't able to tell what degree you have, you should have a definitive diagnosis of type/degree and that usually takes a urogynecologist (specialist for POP).

Urinary incontinence is the most common symptom of POP but certainly not the only one. UI is also almost always tied to POP issues. Please read the following post for POP basics, see if you recognize any other symptoms.

http://www.medhelp.org/posts/Urogynecology/Taking-Pelvic-Organ-Prolapse-Out-of-the-Closet/show/1271553

There are many treatments available for  POP and I highly recommend women try them b/4 proceeding to surgery. Many women use a pessary, others see a PT for treatment but it is important that the therapist you see is a women's pelvic floor specialist or it won't be of much benefit. I have a link I can forward to you if you need this info. Myofascial release therapy is also beneficial for many women both in early stages of POP as well as women post surgery who still have some restrictions to address. Kegels are always beneficial to all women but they have to be done properly. Here's a link to an article I posted on our health pages.


http://www.medhelp.org/health_pages/Womens-Health/KEGELS-AND-KEGEL-BREATHING/show/1133?cid=591

There is a possiblity of course that the incontinence is not related to POP but it almost always is. I am hopeful you will find a physician to address this; if you decide you want to see a urogyn and don't know how to find one let me know-I can private message info to you.

Good luck Sal,
Sher
Avatar universal
thanks Sher!  there's definitely several of the causes that are Me.  as for the symptoms, I can't tell about any of the sex ones.  Nothing to base that on for a while.   I've no doubt the muscles have gone to hell in a hand-basket since when I began doing sit-ups and ab exercise with a Bender Ball is when I had to be certain to wear a heavier pad.  That little ball put the positioning angle just so that it had a major effect...yet regular sit-ups don't so much.  Go figure.

The information about a Gyn examination not necessarily picking up on POP is quite interesting.  I see the Gyn at the VA next month.  The physical therapist I'm seeing is at the VA too, so I highly doubt she's specialized in this.  At least they have me seeing a woman though.  :)  I've worked with her before for therapy on a bad shoulder.
1128665 tn?1269277071
Most women have more than one POP cause, personally I had 5-most women in our age pocket have at least 2, vaginal childbirth and estrogen loss. On the situp path, I noticed some time ago (I'm a big believer in maintenance post surgery for POP so I pay attention to exercises I do as far as how they impact the pelvic floor) that how I do situps makes a difference.  However it is vital in your state to be extremely careful with any ab exercises you do-since I've had surgery to repair my POP issues, I am in a different stage than you are so if you try any of these, be extremely aware of how they make your body feel. It could very well be that none of them will work right now. With lower estrogen levels impacting your muscle tissue strength and integrity, that will impact how much benefit you get as well.

When you go see the gyn, question her on POP, take a list of symptoms and bring the topic up-typically if women bring symptoms up and question POP, the drs will address it. I would shy away from any suggestions to have surgery done by a gyn however, the pelvic cavity is extremely intricate and you want a specialist to do surgery if you go that direction. Same goes with PT, bring up POP topic, if she is not famliar with POP issue, maybe someone else in her department is.

Good luck, keep me in the loop!
Sher
Avatar universal
Thanks for the input.  Turns out the Therapist I'm seeing is the only one at this VA Hospital that is certified for PFT.  She finally convinced the Therapy group there was enough of a need for the specialty and she's permitted to see Four appointments for this weekly.  So, needless to say...she's b-o-o-k-e-d since the Women's Clinic has learned of her and sends patients her way.  She agreed that it could be missed by a pelvic exam and wasn't even by Gyn.  Just an exam for a Pap.  She was upset that the Personal Trainer I had before had remarked when I spoke of the bender ball causing the problem was like "oh, that happens with women your age and it's normal.  just keep working it and things will get better.  or better yet, use a mini tramp to work those muscles"  Said it is indeed not "normal" nor acceptable.  I suppose it doesn't help that my timing pattern of urination is rather frequent.  I was shocked when she asid the average Bladder is meant to go 3-4 hours between urination.  Holy COW...I'm every hour at times and with a large volume too and am LUCKY if I can make it through an entire movie without having an accident on the way out of the theater.  That's a race to get to the bathroom before others so I don't have to wait.  A road trip?  Oh hell...if I can last for more than an hour it's because I haven't drank much liquid.  

So I'm definitely speaking of it with the Gyn.  I do sincerely doubt that unless something were extreme that the VA would even speak of surgery.  It's just not their style if they don't have to.  

So yes, there's a few things occurring with me.  I thank you, truly!

Sal
1128665 tn?1269277071
I am so happy Sal that your PT is educated in pelvic floor, what a great stroke of luck! And from the feedback you've given on what she had to say, she will be able to guide you well. And I agree, whenever I hear comments like "it comes with aging" or "that's what happens when you have babies" it sends me through the roof. Since she is booked so far ahead, you'll have to do some work on your own to find out what helps you until you see her-I am hopeful your gyn will be of some help but.... Treatment wise, pessary, kegels, core strengthening exercises like Pilates or Pfilates, support garments, Incostress can all help. Therapist might utilize biofeedback, electrical stim, myofascial release therapy. Many options to try. Typically women utilize more than 1 treatment at once. I'm going to send you a PM (private message) with additional thoughts.

Sher
Avatar universal
Thank you for your time Sher.  Therapist does utilize those options you spoke of btw.  Said her goal was to get me to being 80% better.  I'm sure that losing weight would be of a great help.  But...the hormones are all out of whack for me and even if at the gym 6-7 days a week combined with eating correctly, the waist and lower abdomen gets worse despite the rest of the body getting better and toned and muscled.  Sigh

Some times feels like too many issues all at once.

I'm curious though on thoughts how things work out when in the dating scene.  Rather afraid to go there with this going on.

1128665 tn?1269277071
Yes Sal, it is so hard to get your body in balance when the hormones are out of wack. I use bioidentical hormones and have been very happy with them but you do need a dr who dances on the holistic side to rx them. Until they are in balance it will be extremely difficult to get wasteline fat and bloat under control and then you add POP on top of it...if you want more info on this let me know- I know a great book that explains it well.

On the dating scene, this is a topic that I truly want to get more dialogue out there on but it is hard to find venues open to my touching it-I have conversations with women about it though. How on earth can single women be comfortable approaching the dating scene with POP issues-how on earth do you divulge such personal info? I recommend establishing a good base relationship first of course so you are more comfortable discussing this stuff and then make it clear that you are interested in intimacy but have a health issue that you are not comfortable revealing-at the point you feel the man involved is ready you could disclose. I would suggest you make sure you drink lots of water the day of intimacy to make your urine more diluted (but stop a couple of hours prior to sex so you don't need to continually run to the bathroom while with your partner) and make sure you pee prior to sexual activity to reduce risk of leakage. Being on the bottom with traditional man dominant position will help reduce risk of leakage. You might want to express that it may be uncomfortable for you to have intercourse so you want to go slow (even if you don't have pain with intercourse, it will give you the upper hand with controlling the pace). If you have tissues bulging out of the vagina that give you concern, I would just express to the man that you are not comfortable with oral sex because of discomfort, in all honesty it is doubtful that he will realize tissues are bulging unless he sees them and sensation wise it may increase his pleasure because the penis is "wrapped"more snuggly in additional tissues.

Just take it slow and if the man is a worthwhile partner, it should be fine.

Sher

Avatar universal
Glad my questions helped get some discussion about this and dating in the open.  :)
1128665 tn?1269277071
It's brave women like you that help establish recognition of these health issues, thanks again Sal!
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