Sixty percent of women have problems with their pelvic floor, according to new research from the Royal College of Obstetricians and Gynecologists. I am one of them.
By “problems,” let’s be clear, I mean leakage. Stress incontinence is characterized by the NHS as ‘when urine leaks at times when your bladder is under pressure; for example when you cough or laugh’.
Short history: I was always one to cross my legs when I sneeze.
Even as a teenager, trampolining was problematic. Childbirth then made it worse and recently when I was in my late 40’s, maybe due to hormones or just the aging of tissue, there was another decline.
It’s a subject that I’m a little embarrassed about and that puts some women off getting help altogether.
Sixty percent of women have problems with their pelvic floor, 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 spoken about it with a health care professional; of them, 39 percent thought their symptoms were normal; and 21 percent were too embarrassed to share.
Stress incontinence is pleasure-sapping and soul-destroying. It doesn’t mean giving it your all on the dance floor, saying no to a game of tennis with the kids, or being nervous about having a belly laugh “accident” with your girlfriends. Here’s my story…
Let’s first go back to my early 20s and my first experiences with fitness classes.
The instructor would say ‘engage your pelvic floor’ and I tried but it was awol. When everyone else seemingly “took the elevator to the top,” I struggled to get in on the ground floor.
In my thirties, after the kids, my stress incontinence got worse. Once out of the baby fog I went to see my GP, who referred me to an NHS physiotherapist.
She was very friendly and gave me some exercises which I followed diligently for two months. They involved peeing in a measuring cup and locating and contracting my pelvic floor muscles three times a day.
Frankly, it made minimal difference. I’ve also tried those internal pelvic floor trainers that claim to do the hard work for you. No change.
I gave up in despair. Of course I blamed myself – I must have done it wrong. So now I felt both guilty and ashamed.
Jump forward five years. I was divorced and in the dating scene. A guy asked me on a date in progress, and I realized that to achieve this without embarrassment, I shouldn’t take anything 12 hours in advance. It brought the problem into sharp focus.
A few weeks after that running date, I was invited to Knightsbridge to see Dr. Trying out Galyna Selezneva’s Lady Garden Lift, which claimed to significantly improve pelvic floor strength and reduce stress incontinence by combining two non-surgical “adjustments.” Dr. Selezneva told me she saw many women with stress incontinence and felt confident she could help.
Rosie Green says stress incontinence is pleasure-sapping, soul-destroying 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 involves a plastic bucket seat on which you sit fully clothed.
I was carefully positioned so that my nether region was in the middle and then – wow – the electrical pulses started. They were quite strong – not painful but intense. Some women get a sexual pleasure from it. Unfortunately not.
The procedure takes 30 minutes and ideally you would do six sessions. By the third I felt a difference and leaked less, after six I was able to run with much more confidence.
The next weapon in Dr. Selezneva was the Ultra Femme 360 (from £3,200).
This is a machine connected to a probe. I had to undress and get into the smear position.
The doctor then placed the probe in my vagina and it emits a radio frequency, triggering collagen production to support the bladder, create internal constriction and increased sensation during sex. (The last part sounded like a great side effect for someone who’s dating again after 15 years of marriage.) It was a little weird, but not off-putting — just a little awkward.
The two combined improved my situation by perhaps 50 percent. I posted about it on Instagram. Many women were intrigued, but the method also has its critics. One of them messaged me.
I COULD RUN AND DANCE WITH VERY MINIMAL LEAKS, WHILE CUGING AND SNEEPING WAS PROBLEMATIC
It was Lucy Allen, a physical therapist who specializes in pelvic health (lucyallenphysiotherapy.com). She told me, “This is not a long-term solution to incontinence. The pelvic floor needs regular exercise. The research on this chair has shown improvements after three months, but there are no long-term studies or evidence.’
She added, “Please see a pelvic physio because this is really treatable.”
Slowly, over the course of the next six months – as she had predicted – the benefits of the Lady Garden Lift treatment began to wear off.
I became disillusioned and parked the problem. Again. Then, a year ago, my pelvic floor problems got worse and I had 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 about the delay, I met up with a friend for dinner. She was delighted with the effects of a private urethral bulk surgery performed by Professor Stergios Doumouchtsis (stergiosdoumouchtsis.co.uk).
As my long awaited NHS appointment had been postponed for a further four months, this time due to the Queen’s funeral, I booked an appointment with him.
Urethra entrapment, Professor Doumouchtsis explained, involves injecting a substance (polyacrylamide hydrogel) into the walls of the urethra, causing a narrowing at the bladder neck. Result: ‘Your own body has to work less to keep continence intact.’ He was clear that the success rate is not desirable (60-70 percent).
How long it takes varies from patient to patient. In fact, one in four women needs a top-up – shortly after the original surgery because they need more filler, or long-term because of their lifestyle or simply because of the aging process.
It is a considerable amount – the operation, tests and consultations cost more than € 3,000 – for a procedure without guarantees, but I saw it as an investment.
Professor Doumouchtsis sent me for a urinary dynamics test, which included drinking plenty of water, jumping up and down to assess the extent of my problem, and peeing in a changing table to see the strength of my flow. Not very dignified.
On the day of the operation I was given a general anesthetic. I woke up a little sore, but nothing paracetamol couldn’t relieve. I felt a slight burning sensation when urinating and was unable to have sex or exercise for four weeks.
On my first run after surgery, I felt a familiar wetness, but realized it was just a tiny bit. Over time, it became clear that the surgery had really made a big difference — perhaps as much as 80 percent.
Essentially – and let’s get more detailed here – I was able to run and dance with very minimal leakage, while coughing and sneezing were still problematic. Occasionally, when due
or suffering from a urinary tract infection, I would experience something like my old problem. But it has been transformative nonetheless. Now I can run at any time of the day, whereas before I could only do it in the morning, before I had a drink.
However, after tasting the normality, I wanted to be completely dry. Miraculously, I have an appointment with the NHS. I saw the consultant at my local hospital and he said he believed he could get me 100 percent dry by refilling urethral bulking.
I am now on a waiting list and I am also seeing Lucy Allen in the meantime.
Even if nothing changes, compared to where I was at this time last year, my progress is nothing short of miraculous.
And that dance floor is mine.