Stress Incontinence

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Anxious about surgery for stress incontinence

May 2012

I am considering having surgery for ongoing stress urinary incontinence (SUI). I've done my kegels, I ''squeeze then sneeze'' etc. but since having # 2 ( 8 years ago) I have never been able to do any even moderate-impact exercise without leaking. I wear Poise pads now whenever I run and that works, but is obviously a huge drag - and I just sit out the improptu running games at the park. So I'm looking at surgery. BUT there are several approaches used AND there's now an FDA investigation into some of the mesh used to in these procedures.

I've had successful hernia repair surgery in the past (so reacted ok to use of a surgical mesh product), but I'm trying to sort through which procedures the FDA is investigating, because apparently the high complication rate is only with some approaches and not others. But even the information forms my MD (Dr, Margulies, Kaiser) sent me are not totally clear. Has anyone had surgery for SUI recently? (FDA investigation started last year) Does anyone know if the problems are with the retropubic approach vs. transobturator approach vs. single-incision sling? Any medical professionals who can explain the difference in approaches in lay language? Do they all go through the vaginal wall (yoikes!) Would love to hear any and all thoughts/experiences. thanks so much longing not to leak

Hi, I stressed about having the surgery for so long! I am only 46 and really active. I had to wear pads for years and practically had a panic Attack when I ran out. It was awful, couldn't run or do any activity. I couldn't walk without leakage. Had the surgery at Kaiser Vallejo And it changed my life. I feel like a new person. I had a couple of days Recovery and a little tenderness for a couple of weeks. I had two incisions internal and two Tiny ones on pubic area. Worst part was Kaiser's bikini Wax and no sex for 6 weeks. You will feel like a new person. Happy gal

You are right to do your homework! I have 20 years experience doing these surgeries. The good news - the surgeries do work well for stres incontinence. The surgeries that I have experience with are: TVT (transvaginal tape), TVOT (Transvaginal Obturator Tape) and the Burch procedure (which hardly anyone does anymore, but still worked well, back in the day). The TVT and TVOT use mesh, but a small piece just near the bladder neck. My understanding about all the mesh lawsuits is that they are mostly related to the ''mesh kits'' used for repair of cystocele (when the bladder bulges into the vagina) - sort of like a new ''hammock'' for the bladder. That is a separate procedure from the incontinence surgery.

A lot of women that have stress incontinence also have prolapse symptoms, so make sure your doctor knows how to fix those too, if you should need them. The success rate for these surgeries is about 85%, which is pretty darn good. Other non-surgical options are biofeedback and use of a pessary (a diaphragm like device that you wear in your vagina to hold up the bladder neck). Biofeedback, in the right hands, has a 70% success rate.

Good luck with your decision. Any surgery is a big decision, but women rarely regret having this surgery. a BPN Ob/Gyn

Hi- I had repair work done in January by Dr. Margulies. Mine surgery was pretty extensive (hysterectomy, etc...), but included a mid urethral sling. I too was overwhelmed by all the info, choices, etc. I did a TON of research and made the decision to go with the sling as the amount of mesh used is really small. It seems like most of the mesh issues are from using it for suspension of vagina. There is a lot of info on the Hystersisters website.

Long story, short: I am so glad I had the surgery and my urinary issues that I had from having 3 kids in 4 years, have basically subsided. I no longer pee when I sneeze, laugh, or turn the faucet on to do dishes. I am not running to the bathroom every half hour and I don't worry about HAVING to be on aisle seat for movies, concerts, etc as not annoy others. You really need to have support post surgery, so plan that in. Finally, I really trusted Dr. Margulies and felt she really is an expert in her field. You are welcome to get in touch with me if you want to. Best of luck! K.

I have the same problem as you since my second child. I might have to contemplate surgery in the future (I think the problem will likely get worse after menopause), but in the meantime, I've found a satisfactory solution: using a menstrual cup when I exercise. These are sold online or at the Berkeley Bowl West as the Keeper (latex) or the Mooncup (silicone). It goes in your vagina and over your cervix by suction and provides a gentle pressure on the urethra which prevents bladder leakage. I run 18-25 miles/week and have done two half marathons without leaking. If I don't wear it, I totally look like I peed in my pants (which in essence I did). You might want to try it and delay surgery. The downside is that its use may provoke bladder infections. I used to use it during my periods as an eco alternative to disposable products, but noticed I would get more frequent bladder infections, so now I only use it for my workouts, but still get a bladder infection a few times a year. stress-incontinent athlete mom

I had a TVT (Tension-Free Vaginal Tape) procedure with Dr. Margulies in 2009. To give you some scale of my problem, I couldn't run without completely filling a large pad, and decided I couldn't take it any more when I couldn't jump on a trampoline with my daughter during her gymnastics class. I too, tried Kegels 'till I was blue in the face, but my urethra was prolapsed so all that was wasted energy.

Some small downsides of my surjury. I couldn't pee immediately after the surgery and had to go home with a catheter (which I understand happens in some small percentage of cases) but after 24 hours I was back to peeing normally. Recovery was a drag (no lifting for 6 weeks) but after that everything was great (and you will be familiar with these restrictions from your hernia repair). But after that, I was 90% better, which has made a huge difference to me. I am running competitively, and every once in a while for mysterious reasons I have some leaking but nothing like it was.

I found Dr. Margulies to be very approachable, and if you have questions, I think you should talk to her about your concerns -- she's an urologist, and this is her area of specialization. I found her to be frank, intelligent, and caring. The surgical team at Kaiser Richmond (where I had my surgery) was fantastic.

Feel free to contact me with any questions -- I think urinary incontinence in women is pretty common, and I'm surprised it doesn't come up more frequently. M.

Checkout the Pelvic Floor Goddess Leslie Howard she is at I was having problems and I took her daylong workshop she gave at 7th Heaven Yoga in the East Bay (she teaches throughout the Bay Area and travels the States and the World) and I have relief! She has simple exercises and she knows so much about the Pelvic Floor to inform us about our own bodies & how they work. Take time to investigate it is worth it. She also gives you the straight shoot on the operation which every women contemplating it should know. Be Well! I.

Female Incontinence - Physical Therapy / Surgery

Feb 2012

After giving birth vaginally to two large babies, I have female stress incontinence, so I can't run, jump, cough, sneeze or dance without wetting my pants. I've seen a uro-gyno at UCSF and am signed up for some physical therapy and the doctor encouraged me to do 3 sets of 15 kegels everyday - which I do, but the kegels don't seem to make a difference. The doctor said that because I am young I am a good candidate for surgery. Does anyone have any successful experience with physical therapy for female incontinence? Does anyone have any experience with the sling surgery for stress incontinence? Did it work? Thanks. Anon

I had the same problem, although mine didn't fully manifest until my 50s. I tried kegels and PT with absolutely zero results, so I opted for the sling surgery. Not only did it totally work, but it was an easy surgery with a very quick recovery. I recommend it- the relief is fantastic. C.

I saw your posting and have not had any experience myself with incontinence, but as a yoga instructor and Restorative Exercise Specialist, it is important to look at your whole body to address this issue. It is likely due to weak pelvic floor muscles that may have been an underlying problem before you were pregnant and become much more evident after giving birth. Kegels are important, but it is essential to also look at whether the pelvic floor muscles are weak or are they tense/overly contracted. Otherwise doing the Kegels just puts more stress on an already over-stressed muscle and will then cause what is happening. I can go into much more detail and discuss and show you some exercises so that you can address your incontinence issue which may be affected by much more than your pelvic floor muscles. T.

Hi! I've been through two successful rounds of physical therapy (I delivered 2 kids in a short span of time as well). I thought physical therapy sounded crazy, but I did not want to have surgery even if I was a ''young, ideal candidate,'' if it could be fixed without, nor did I want to wears pads the rest of my life. I did the first round not long after my 2nd child was born, I did the second round after I had a bout with a nasty stomach bug that left my pelvic floor weak (Give the kegels a chance while you wait to get into physical therapy (it takes time). The physical therapist will expand from basic kegels, and ask if they use biofeedback. If you are considering having any more children, wait on the surgery, as you will likely have to have the repair again. And keep up with your kegels after physical therapy ends! Goodluck! happy to have fixed the problem without surgery

Stress incontinence- considering tvt procedure

Feb 2011

I am seriously considering having the TVT (transvaginal taping) procedure done as I am at the end of my rope with my stress incontinence- can't play games with my kids or join in a game of soccer or kickball without a good chance of wetting my pants these days and kegels haven't helped at all. Has anyone had experience with this procedure and, if so, what doctor? My OBGYN has recommended another doctor in her practice but I am wondering if I should consider a second opinion with a urologist? I am also wondering about the recovery- how long until I will be back to feeling normal?? Any advice is helpful...thanks! anon

For 6 years I had stress incontinence resulting from pregnancy and/or birth. I tried physical therapy (kegels and other core exercises), and finally gave up and got a ''periurethral sling.'' I don't know why I waited so long, as I'm completely cured! I don't know what a TVT procedure is - it was never mentioned to me - but you might want to look into the sling too. It was surgery, I was totally under, but it felt very minor and was a simple recovery. (My physical therapist recommended it to me. She was Stephanie Prendergrast - My surgeon was out of CPMC in SF: Heidi Wittenberg, Pacific Gynecology and Obstetrics Med Grp. 415-923-3123. Good luck. Gimmie a jumprope!

I've had the procedure done and highly recommend it- everything about it, including the recovery (I was not bedridden and was only moderately uncomfortable), was quick and easy. I was just miserable with leaking before and now am DRY, even when I sneeze!

I had it done at Kaiser Richmond by a wonderful urological gynecologist, Dr. Rebecca Margulies, and I think that someone in that speciality is the best choice. C.

Before you go the surgical route, please consider

I also suffer from stress incontinence and was discussing it with a friend just before I had my third child 2 weeks ago. I had a prolapse with my second birth and my friend had one with her third. She told me about whole woman and said she went through the exercises and can now jog daily with no leakage. I play a lot of soccer and once I recover from this birth, will look into this natural remedy first.

Just a had been on my mind, too. Good luck! anon

I have had the tvt. Life changing really! It doesn't have many down sides, but I am probably in that 10% that has had a couple problems. Regardless, it was completely worth it. I'm pretty new to the parents network so I'm not sure if my email address shows up, if so please, feel free to contact me directly and we can talk in more detail. R

Is incontinence common in older moms who deliver vaginally?

March 2009

Hi, I'm wondering about -- this is kind of delicate -- but whether many women who've delivered vaginally in their late 30s/early 40s have developed sporadic incontinence problems in the years after birth? Friends of mine who have had 2 and 3 vaginal deliveries at around my age have cautioned me about this. I'm considering a vbac versus planned c-section for my 2nd baby (1st was an unplanned c-section) and wonder if this whole incontinence thing is a common problem with older moms who deliver vaginally? Active mom

I was thirty-nine when my son was born after induced labor, and I had significant incontinence for months afterwards -- I couldn't walk down the street without wetting myself. I suspect that this might have also been due to the fact that I had an epidural and perhaps pushed harder and sooner than I should have. But I don't know that with certainty. I was a jogger and could no longer jog for, say, six or seven months. I did kegels and wore pads. After a while I could jog again (partially because I decided that I would just deal with the incontinence), but always with a pad. In fact, I wore pads every day just to go out for quite a few years. Now I experience only occasional problems (I have to wear a pad for a long hike or a jog), but the problem is nowhere near what it once was. So two things: if you have an induced vaginal birth, you could indeed have problems with incontinence, but the problem definitely diminishes with time. I would consult a doctor about the risks and tribulations of Caesareans versus the problem of incontinence. You may find that you would rather do the vaginal birth anyway. mostly dry now

Oh yes, you bet. One vaginal birth at 37 (from one pregnancy total), and I've totally lost my iron bladder. Before my son, I could go 8 hours without a restroom; since my son, the max is probably 3 hours, and one ill-placed sneeze can result in a change of clothing. As an added issue, my body doesn't give me all that much warning about the need to defecate. I find myself just needing to go NOW. This is one thing they don't tell you that much about, but apparently it's not uncommon. anonymous

This problem is all too common after vaginal delivery. You can try doing lots and lots of Kegels. You can get a medication from your doctor to ''dry you out,'' but it gave me really dry mouth. Or, I wear a liner pad when I run, to avoid accidents. I have found I can't jump anymore either, like skipping rope, without leakage. Fact of life. Apparently there is also surgery, but I don't see the leakage as that big an inconvenience. Most women are already used to using liners anyway. A Little Leaky

I had two natural, vaginal births at ages 38 and 40 and yes, a year after the second birth, I do experience some incontinence when I exercise. It's annoying, and I'd be eager to hear if others have ideas for what to do about it. That said, in regards to your situation-- I feel very fortunate that I was able to have unmedicated births and certainly do not wish I'd had c-sections, despite this lingering effect. anon

Pilates can really help you with that. I used to have the same problems till I started to work out and do Pilates. Pilates strengthens the core muscles including the pelvic floor. I can highly recommend Synergy Fitness Pilates studio at the bottom of Solano avenue in Albany. Also, I'm a personal trainer and can show you exercises that will help you strengthen your pelvic floor and core muscles. It's really not hard to do, just takes being consistant. Good luck June

For what it's worth, I had a successful VBAC at 40 and my kid is 5 months old now and I have had no problems with incontinence. I was worried about this too as I've heard it can be a problem, but I can't think of anyone I know who it has actually happened to. So I personally wouldn't let that be a factor in deciding whether or not to go with a VBAC. Good luck!

The research evidence seems to point not to vaginal birth but genetic make-up as the primary cause of stress in continence: The benefits of a VBAC really do outweigh the repeated cesarean unless there's a specific medical reason for it. ICAN has information on VBAC that may be of help to you:

Incontinence from natural birth is normal and natural but you can prevent or at least reduce that by doing Kegels exercises.

I am more so than before children (born at 35 and 40 naturally). I did my kegels regularly after both and probably should continue to do so even now! I think we all get a bit incontinent w/age either way and don't see why those muscles can't be toned/trained like the rest of our body's muscles. Good luck with whatever you decide. *anon.*

Your friends are good to caution you about incontinence after giving birth. But I'm not sure how much of the problem stems from the actual delivery method, and how much stems from just carrying the baby for 9 mos. Or other factors: I had a very long prodromal labor, which some say is why I experienced severe urinary incontinence for about 7 - 10 mo.s after giving birth (vaginally), which eventually tapered off to ''mild and sporadic'' and stayed there. Forever. :-( You should talk with your OBGYN (and maybe even see if you can consult a urologist), and ask them for the straight dope! Maybe you can do something to prevent it, maybe you can't. I wish the topic had come up, ever, in the 9 months of pre-natal OB visits, or 8 weeks of childbirth classes! I felt so humiliated and frustrated - until the day I saw a TV commercial for ''Depends.'' (Swear to god!) And guess who was in it: not an old lady or old man. It showed a 30's-ish woman running around on the beach, playing with her toddler! That was an ''Aha!'' moment. And either way, start practicing your kegels! ;-) anon

Boy can I relate to this concern! I only have one child, and I have a really annoying problem of leaking when I sneeze if my bladder is not completely empty. I had a 3rd degree tear during the birth, so maybe that has something to do with it, or maybe nothing. All I know is that if I don't empty my bladder very frequently, I will inevitably sneeze and leak. Not a lot, but enough that I have to change my underwear, which is a real pain if I'm home and obviously is not possible if I'm out. I probably go to the bathroom easily 10X a day just to avoid this! I've also started wearing pantiliners more frequently, like if I'm planning to be out for a while and maybe not near a restroom (I tend to avoid yucky public restrooms). I try to contract my pelvic floor muscles when I feel a sneeze coming on, but it's usually impossible. Sometimes it happens if I laugh too hard, but at least that's something I can control. I'm sure kegels would help, but I just have never been good about doing them. I'd try the kegels, and also be open to the idea of keeping your bladder empty at all times. sneezy

I had two natural births around that age, but have always done Kegels, so have never had any problems with incontinence. From what I have heard, the real key is to do Kegels -- the type of birth doesn't make a difference. doing my Kegels now!

Incontinence from natural birth- if you have any rip in the vagina because of the birth- is to be expected. It can be fixed by surgery- painful to even think about where they put the anaesthetic needles. However, if you have a birth at a hospital, the certified nurse midwife (in my case) fixed it right away, about three minutes after the baby is born, rather than having to have a separate surgery. I strongly endorse the latter approach, rather than having to schedule a separate, later surgery to fix the vaginal tear. Been There, done that.

I had a friend who experienced exactly this. I recall her mentioning that she would leak urine when she laughed hard after the birth of her daughter. Several years after the birth of her child, she had this problem surgically corrected and now she is fine. Talk to your ob about this. Best to you

Oh yeah, it's real. And age has nothing to do with it. I've had incontinence related to my first natural childbirth ever since, and I was 23 (now 36). Kegels only do so much.

I had my last child right before my 42nd birthday. I did experience some urinary incontinence after the delivery. They also don't tell you about the poopy incontinence, but that happens too. This probably lasted a couple of weeks. I really can't discern any difference in my functions now 2.5 years later. Good Luck

I had both of my normal sized babies the old fashioned way. (I did have an epidural). I was 38 and 40. NEVER had a problem with incontinence. I am fit, I excerise. I did some kegels but not a lot. It was never an issue. anon

Yes, it is possible to suffer from incontinence from a natural birth. I had my first child at 28 and my second at 30, both vaginally. I suffered problems for a year after the birth of my second, before my ob/gyn finally listened to me and worked to resolve the problem. It took 2 months of physical therapy (sounded odd to me too), but I was able to avoid surgery by simply following the program and strengthening the kegels (like any muscle these need to be worked too, and can loosen as we age, regardles of pregnancy/birth status, so do your kegels!). My ob/gyn said it was unsual for someone my age to develop these problems, but it does happen. She also told me, despite what so much of the info out there says, it's not always the delivery part that causes it, but rather the pregnancy (or pregnancies) themselves. In my case, she believed it was caused by having two pregnancies so close together (2 years), and the excess weight I was carrying after the first and into the second, since it took only about 6 pushes to get number one out and 2 pushes (preemie) to get number two out. So, if it does occur, it can be fixed, but chances are slim it will.

Time magazine recently had an article about the risk of multiple C-sections, even as few as 1. I would risk the incontinence (since it is such a low risk) over another major surgery (the C-section), as long as your ob/gyn is supportive of a VBAC. I was up and moving within a half an hour after the delivery of my second child...can't beat that! You will have to decide what is right for you, but you heal so much better and faster from a vaginal delivery, and it's such a small risk to take. Good luck! Do your kegels! Hope you have a smooth delivery! been there, but it's fixed

Hello, I gave birth to my daughter at age 40. I delivered naturally, and have stress incontinence. It's not bad, only when I'm running (and since running was hard on my knees, I've just given it up and found other forms of exercise that work for me). I took an incontinence class through Kaiser and learned that its the pressure of the baby during pregnancy, not delivery, that contributes to incontinence (I started having problems being able to hold my bladder during pregnancy, so this makes sense). I also learned that close to 1/3 of women develop incontinence at some point, due to gravity taking it's course (muscles sagging, etc.) over time. It IS a delicate subject, and I wish more women would acknowledge that it's a common problem. I'd urge you NOT to get a C section, or at least to talk to your doctor and not just your friends who are in fact theorizing about the likely cause of their problems. don't make me laugh

Are you talking about Pee? Nah, don't worry about it. If you do pelvic squeezes after birth it will be fine. I had my kid late, late 30's and am fine. When I cough really, really hard (like occasionally with my recent bout of Bronchitis) I might leak a tiny abount of pee, but then again in my young 20's I would leak pee if I threw up. If you are talking about Poo, after the first 3 months, no discomfort and completely normal. BTW way I had a drug free, episiodomy-free vaginal birth. I P Freely - not!

I saw the previous responses and wanted to add something. Yes, this can happen, and Kegels aren't always enough to fix the problem. What I learned from my doctor is that it tends to be genetic. In other words, if your mom had/has incontinence issues, you are likely to have them, too. Ask your mom

Leaky bladder when I run or jump rope

August 2006

I am having a really embarrassing problem and am hoping that someone can suggest a solution. Like many women, I experienced incontinence after giving birth to my child. With regular kegeling, I no longer wet my pants when I sneeze or really need to go but can't quite get my belt undone quickly enough. However, when I run or jump rope, it's a different story. I wet my pants regularly. I always empty my bladder before a run or work out. But, because I drink water throughout the day, a tiny amount of water can enter my empty bladder while I am running. It's not very much so I don't have the sensation of needing to pee. But the pee comes right out, everytime my foot hits the ground. I've noticed it's worse when I am in the 2nd half of my cycle. I've only had one child, albeit a big one, that I pushed for more than 3 hours to get out.

Anyone out there have the same issue and found a solution? I can't imagine running in an adult diaper, so please don't suggest one. Ditto for refraining from running or jumping rope. Open to anything else. Isn't motherhood so glamorous?!

Thanks in advance!
kid potty trained; mom not?

Don't worry. You have a common, but easily remedied problem. Check out or do a search on Kegel exercises. The exercises strengthen the muscles around the bladder and the vagina. They are easy to do. No one will know you are doing them. You will be able to rectify the problem AND at the same time, you may find there is a beneficial effect on your sex life. Good luck JOANN

I had stress incontinence since having my second child. Kegels didn't do it for me, but I wasn't religious about doing them. My OBGYN, Dr Wharton, suggested an Athena Pelvic Muscle Trainer. It was expensive: $360 and still trying to get insurance to pay for it. BUT it worked miracles. After a month of using it, I no longer leak. Don't know if it will work for running or jump rope, but it's worth checking out. Website is Good luck No More Leaking

You didn't say how long it has been since you gave birth. My son is nine now. Right after he was born, I couldn't walk down the street without a pad, and I cried in frustration when I tried to go back to aerobics class or run. Finally I decided to put on pads and exercise through it. Nine years later after kegeling (sporadically at best :) and exercising and just slowly recovering some of my muscle tone, I can walk down the street and sneeze and even run (if my bladder is not full).

Still, I run long-distance and if I can't empty my bladder after about eight miles, I will wet my pants. My solution (don't get grossed out, everyone) -- I wet them. So what. I'm sweaty and yucky anyway after a run. I go straight home, take a shower, change, and wash my clothes. I've decided that it's more important to me to stay in shape than to worry about a little pee. My mother was mortified when I tried to bring up this topic with her. She had four children and had terrible incontinence and felt unable to exercise for years. But it was mostly a sense of shame that kept her from talking about it and from exercising. I think that we should chuck the attitude that we have to stay bone-dry when exercising. If you are going to jump rope you will sweat and maybe pee a little. Go for it, I say!
not willing to be ashamed

Unfortunately I am experiencing the same problem. It doesn't really happen when I run but when I jump rope it does, a big problem in a group exercise class. I have resorted to wearing a maxi pad because fortunately it is a small amount so I don't quite need an ''adult diaper''. I tried using larger pantyliners but during exercise they sometimes shift out of the needed area so the pads work. Hopefully someone else knows how to eliminate this problem! I have heard of some sort of surgery but not to do it until you are done having kids. Good luck!
Glad I'm not the only one

I had the same problem and decided to get a ''sling'' under my bladder, which was surgically placed (through the vagina). I had the surgery in my early 40s and am SO glad I didn't wait. I didn't want to have leaking problems for years just to decide 20 years later to do something about it. It's been 5 years now and I haven't had any leaking at all. Probably not what you wanted to hear (surgery), but it was a great solution for me Been there, too

My gyno recommended using lite tampons when jumping or running. I sympathize with you! anon

dear leaky,
After 2 kids I too was at the point where even walking ''hard'' might cause a leak. Ditto sometimes with leaky bum - despite a zillion kegels done pretty rigorously. I went to see a specialist in the ''whole picture'' - a urogynecologist, who will really evaluate the whole pelvic floor.

I had the bladder/urethra alignment problem, a prolapsing uterus (which I knew was happening from my annual exames) and less than 65% of the ''ring muscle'' left that handles the squeeze/stay closed function of the anus. That 3.5 hours of active pushing with my first kid 10 years earlier... yes, it really does do permanent damage down there, or can.

Had surgery (hysterectomy, bladder sling, anal muscle repair) 2 years ago; worked great. If kegels alone help you, GREAT. If not, get evaluated! I worked with Dr. Eugene Kaplan in WC 925.979.9969 and recommend VERY HIGHLY.

good luck
- Leaky No More

Keep up the kegels, wear mini pads every day and don't worry about it if it's not too bad. If I don't wear pads, just about the time that I think I'm not leaking anymore, I end up having to change my pants or shorts. Mini pads are easy, and they can hold a little leak, and are easily changed. Your OB can also prescribe something for it if it's really bad

Ask your gynecologist for a referral to a physical therapist for incontinence issues. There are different kinds of incontinence and they require different strategies. The therapist can also show you how to get the most bang for your buck from the Kegels. Anon

Losing urine more and more frequently

March 2005

A little problem which is creating more and more frustrations: I am losing urine more and more frequently when I run (a real embarassement!), when I jump (playing basketball with my kids), and let's not talk about trampoline! I can still stop the flow of urine when I go to the bathroom and can always contain the need to go to the bathroom. A friend of mine had such a problem and had surgery, with mixed results. Any ideas? experiences? Advices? Thanks
embarassed mom

This isn't a solution, just a tip for the present. I had the same problem (in my case I eventually tracked it down to a side effect of a medication I was taking), and I bought those expensive pads for incontinence at the drugstore to avoid the mess and embarrassment. Then I had a better idea- cheap and easy. I went to a diaper service and bought some old diapers and cut them up into pad size pieces which worked very well. good luck with solving the problem! anon

It sounds like what you have is Stress Incontinence (the other main type is called Urge Incontinence, and that's when you suddenly have to go and feel like you can't hold it). I had the same, horribly so, after delivery (7 months ago) and what did the trick for me was physical therapy. Kaiser Richmond has a Biofeedback Pelvic Floor Physical Therapy program and if you do the exercises carefully, it is great! They use a program called Beyond Kegels, and if you have Kaiser but through another facility, you can ask your OB/GYN for a referral to the Richmond program; they don't yet have it at all facilities. If you don't have Kaiser, well, at least now you know what your problem's called and what to start looking for to fix it! Good luck; it's embarrassing, I know, but it can definitely get better.

11 days post-partum: Depression AND incontinence!

August 2004

I have just given birth to my first baby (11 days ago) and, to my surprise I am having to deal with much more than sleepless nights.

At the hospital, I've noticed that I couldn't hold the urine and talked to my OB who told me that he would address the issue in my 6-week post partum visit. I don't want to wait that long to get some info on this. Sometimes I can wait to release the urine sometimes, I can feel it dripping down on my way to the restroom. Once the urine is release I cannot interrupt the flow at all. I thought I would be getting a bit better with time, but I haven't noticed any improvement. Any info that eases my fears of wearing diapers for the rest of my life would be a Godsend.

On top of that, I've noticed that I was getting increasingly sad since I got back home. Much more than I was comfortable with. I would cry for no reason, and all the known symptoms of depression. I was also feeling some 'weirdness' physically and since I have a history of depression in my family, I decided to look for help. I am now taking Zolof and I am a bit better (I wouldn't be able to sit down and write this post two days ago, believe me!). If you have any info on post partum depression and any info that can help at this point, I would be most grateful.

Thanks to all, Not so excited new mom.

I was like you - very concerned about incontinence after my 10- month old was born. It was v. bad at first: I wasn't able to stop the urine stream. Jumping, lifting, laughing, sneezing, coughing, etc. all made me pee myself. My laundry hamper smelled of pee. I changed clothes 4 times a day, etc. It was scary and well, icky. I asked my Dr. about it and he shrugged it off, saying it will improve with time. This made me angry because I felt like he was making light of the situation. Now for the good news - it did improve and today is ALMOST gone. Sorry I can't say it's gone completely but when I drink alcohol it returns. Also, when I have a cold it worsens. Not sure what these two things do to my bladder. Anyway, in normal life I don't think about it at all and I'm not bothered by it, but sometimes it does sneak back. One thing that I can say is that it did imrpove, as the Dr. predicted, but it happened slowly. Keep trying to stop that urine stream - I think it helped the muscles down there. Andrea

Greetings, Congratulations on the birth of your baby. I know that it is an incredible time of transition and often full of unexpected and stressful surprises. My name is Lee Safran and I'm a marriage and family therapist with an office in Albany. I specialize in pregnancy, postpartum and parenting concerns and I am offering a group for postpartum stress (depression and anxiety) in Berkeley at Waddle and Swaddle.

I'm sorry to hear about your incontinence and the sadness that your are noticing. I can share that for most women the incontinence DOES get better, slowly, even though that seems hard to imagine. You may also be aware that the majority of women experience'''the blues'' after having a baby and it usually passes by 2-3 weeks postpartum. This includes tearfulness, irritability, anxiety and poor sleep. Also, up to 20% of women have some type of post partum emotional distress beyond ''the blues.'' So, you may well be feeling better soon (and I urge you to get rest and support from others to help this along) or you may be someone who has more to contend with.

Here are some resources: You can contact Postpartum Support International at and Depression after Delivery at They are both excellent organizations. You can look at an on-line assessment at Also, I would be happy to send you an educational brochure about postpartum emotional stress and/or to speak with you further, if you would like. Take good care, Lee

ELEVEN DAYS? Darling, of course you're going to feel crazy 11 days after the birth of your first child. You've just gone through a profound life change AND had the physical equivalent of a truck running over you. It's TOTALLY NORMAL! Everyone goes through some variation on this. I cried for three weeks after the birth of my first daughter. And really over nothing. It was just so intense and my newfound motherlove terrifed me. Talk to your pediatrician. Get yourself to a new mom's group immediately - your hopsital will have one already going. Nothing helps the post-partum blues like sitting with a bunch of other moms, lactating and crying over the joy and craziness of it all, together. Talk to your mom, or sister, or friend who's had a baby before you. Or just go hang out in the park until another new mom sits down next to you and asks you how your labor was. Don't isolate yourself! Buy some books on the topic. Most of all, don't over-analyze how you feel. Go with it. Don't worry that you can't get dressed before 5 pm. and don't seem to have a brain cell anymore. Just float. Stare at your baby all day. Get to know him or her. I promise you that by three months you'll feel 200 percent more on top of things. I promise. Mom of Two who remembers

I'm sorry to hear that you're having such a difficult time, I was also very emotional in the weeks following my daughter's birth, and had many of the same concerns, but after time, my hormones leveled out a bit, and I found myself enjoying motherhood a great deal. I would suggest,

1) finding a mother's group, it's amazing how much the extra support can be helpful, and to know that other mom's are going through the same thing.

2) inquire the possiblity of hiring a postpartum doula. They have a lot of experience with newborns, and newborn moms, and really know about the physical and emotional changes. I would call Waddle and Swaddle on Shattuck, or look on for any doula reccommendations.

3) breast feed as much as possible, and sleep whenever your baby sleeps. Let the house work go, and foucs on sleep!! It's amazing how much sleep will change your out-look on life!!

4) it never hurts to talk to a therapist. there are so many changes that you are going through, physical, emotional, spiritual, hormal, not to mention the obvious lifestyle change. I questioned my ability as a parent, as a person and so on. My therapist was a great relief to me, as well as a cognitive ''check in'' on how I was really handeling things.

5) make sure you are eating really well. all the physical and homonal changes create a much greater need for nourishment - if you can, ask friends, neighbors and parents or realitives to help with meals.

6) get support wherever you can, don't be ashamed to ask for help - we are all in this together as parents, we all have the same goals to raise healthy, happy children, and enjoy ourselves as much as possible in the process. We NEED each other, and we, as families, deserve support and love!! Good luck to you jent

Urinary stress incontinence happens to almost everyone after a vaginal delivery. Because the pelvic floor muscles are lax (stretched out) and sometimes traumatized after delivery, they just don't contract very efficiently. But there is no reason to wait for your six week follow up. In fact, ''Kegels'', or voluntary contractions of pelvic floor muscles should be started as soon as possible after delivery. Weakened pelvic floor muscles can also contribute to uterine or bladder prolapse, a more serious condition where the organs drop down and sag into the vaginal wall. When performing pelvic floor contractions you want to be able to close both the anal and vaginal sphincters and also lift the entire area up into your abdominal cavity just a little bit. First squeeze the anal sphincter closed as tightly as possible, then close the vaginal sphincter. To help yourself find these muscles use mental imagery and words that you would use to yourself if you needed to use the bathroom and none was available. Then imagine that you can pull your pubic bone and your tail bone closer together. This will contract and lift your entire pelvic floor upward. As an alternative, some women like to imagine an elevator rising up from the pelvic floor to help lift the area. Hold the contraction as tightly as you can for five or six seconds.

Completely relax your muscular effort and allow your muscles to soften.

Don't be concerned if you feel your deep abdominals co-contracting with your pelvic floor muscles. In fact, the deep abdominals, pelvic floor and deep spinal muscles are designed to work together to provide internal support and stability for your torso.

A single \x93Kegel\x94 should take only 10 seconds or so. Repeat the sequence 10 times to complete one set. These muscle fatigue easily, so you\x92re going for volume here. Repeat the entire sequence of 10 repetitions 5 or 6 times throughout every day. Pelvic floor contractions are particularly helpful to do after every bowel movement. After childbirth, you are finished reconditioning your pelvic floor muscles when you can clamp off a full stream of urine without any leakage.

If you have trouble finding your pelvic floor muscles, you can learn how to contract them by trying to stop a full stream of urine while using the bathroom. However, do not practice \x93Kegels\x94 while urinating. This can interfere with complete emptying of the bladder which increases the likelihood of urinary tract infections. As to your emotional state, if your feelings of depression are continual and deepening, please call your doctor right away and get a referral to see an expert and treatment for postpartum depression. Most of us experience some amount of the ''baby blues'' after childbirth, but these feeling are transitory and not overwhelming in nature.

Best of luck and congratulations on the birth of your baby.

Helene Byrne author, ''Exercise After Pregnancy: How to Look and Feel Your Best''

Hang in there!! The first few weeks are really hard, and it takes a LONG while for your body to recover from giving birth. I have a 4-month old baby, and had quite a hard time for the first three months, when it suddenly got a lot better. I cried every evening for the first few weeks... It's not unusual. The urine problem is also not unusual (I know, why don't they tell you about that in childbirth preparation classes?). My advice is to do your Kegels. I had a similar problem holding urine and doing Kegels helped (make sure you do them right, and do them several times a day). They're frustrating at first, because it seems that you just can't squeeze those muscles at all, but after 2-3 weeks I started noticing a difference, and now I can hold my urine just fine.

You should know, however, that it can take months (even a year) for all the muscles, nerves and ligaments to heal completely, so you may not be 100% back to normal for a while.

As for the depression, sounds like you're doing the right thing (taking an anti-depressant). Other things that may help: join a new moms group (Alta Bates has one, for instance), ask friends to visit, and make sure you have some help at home. For me, going back to work at 3 months was the best help. I finally felt like a human being again. Things do get better. Good luck, anon

Dear ''Not so excited new mom'': I am sorry to hear about your postpartum difficulties and I want to address the postpartum depression aspect of your letter. My name is Dr. Mirjana Kelava and I am a licensed psychologist with a private practice in Berkeley. One of the areas that I focus on in my practice is postpartum mood disorders/adjustment. I also present information on postpartum mood disorders and adjustment to some of the childbirth prep classes at Alta Bates Medical Center (run by Jennifer Marks). I would like to give you some information on postpartum adjustment and mood disorders. It is estimated that between 50% to 80% of new mothers experience what is know as the ''baby blues.'' Symptoms of the ''baby blues'' may include periods of sadness/moodiness/irritability, tearfulness and feeling overwhelmed and stressed. Symptoms may come on within a few days to a week postpartum and last anywhere from a few hours to about two weeks. The ''baby blues'' are thought to be the result of: 1) rapidly changing hormone levels, 2) the physical demands of childbirth, 2) and sleep deprivation. While many women may experience the ''baby blues,'' the symptoms usually resolve a few weeks after the baby's birth and the ''baby blues'' is not considered a true psychological disorder. However, 15% to 20% of postpartum women do experience a postpartum mood disorder. You mentioned that you gave birth to your first baby just 1! 1 days ago, so you may have been experiencing the ''baby blues.'' However, the fact that you have a family history of depression does increase your chances of experiencing a postpartum depression. The symptoms of postpartum depression affect your daily functioning and may include: feelings of sadness/anxity/irritability/guilt/hopelessness, of frequent crying, sleep and appetite disturbances, of loss of interest in activities that were previously enjoyable, and of lack of feelings for the baby or discomfort around the baby. In addition, new mothers may also experience a postpartum Panic Disorder, Obsessive-Compulsive Disorder, PTSD, or postpartum psychosis. Postpartum depression is treatable and you should not have to suffer.

I understand that you have started on Zoloft and I am glad to hear that you are experiencing some relief. You may also find psychotherapy to be helpful. Please feel free to contact me with any questions that you may have. In the meantime, it is important to take care of yourself! You may want to ask your physician to check your thyroid levels, as thyroid dysfunction may also occur in postpartum women and these women may experience symptoms of depression and anxiety. Make sure that you are eating well and get as much sleep as you can (sleep deprivation has been linked to depression). Ask for and accept support - with childcare (try to have someone watch the baby while you make some time for yourself....take a walk, go outside by yourself) and with household chores. Be gentle and take care of yourself and lower your expectations (it is difficult to be a perfectionist when you have a newborn!) Some helpful and informative websites include:, and Good luck to you and please feel free to call me with any questions. Mirjana Kelava, Ph.D.

Hi. I can't comment on the post partum depression, but had a similar experience with incontinence after my second child was born. Initially, I basically couldn't hold my urine. I was also worried it was not going to get better. I went out and bought incontinence pads (serenity or whatever) and did LOTS of kegel exercises. And the incontinence gradually got better. At the beginning, I couldn't really feel my muscles even moving with the kegels, but I just stuck with it and gradually the muscles returned to normal. I don't remember how long it took, but I think over 3-4 months it gradually improved (from complete incontinence to just leaking with laughing/coughing/jumping to no problem now). Good luck and hang in there. anonymous

Hi, I didn't see your original post, but my only child is now 5 and I am still dealing with ''stress'' incontinance. I've just dealt with it for years because my gyno would just tell me to try a vigorous regimen of kegel exercises, and each year I saw her again, I couldn't honestly say I tried them long enough to conclude that the kegels just didn't work. Just this spring I asked my Gyno to check again, and got a thorough pelvic exam. I am now slated for a minor surgery for cystocele...which in laymen's terms is a surgical insert of a sling for my bladder to hold it in place, and a consequence of vaginal delivery of a child.

So, enjoy your baby, try kegels, and if it persists, keep at your OB/Gyn because there are alternatives to soggy undies! JBS

When I sneeze, I pee

June 2004

Two years after the birth of my second child, I still have to cross my legs when I feel a big sneeze coming on, and can no longer run without feeling that I am going to pee in my pants. No, I am not a fanatical kegel-er. Do they work?! Are they the only solution? Is there hope for me, or must I start looking for pull-ups in a size 30 to 40 yrs (no Disney Princesses, please)? anon

As a perinatal exercise specialist I can tell you that YES!, Kegel exercises do work, no matter how far postpartum you are. Pelvic floor muscles are small and thin, so when performing Kegels, you need to go for volume. Plan on doing 8 to 10 repititions in one set, and performing 5 or 6 sets every day. It may sound like a lot, but one Kegel only takes about 10 seconds, and they can be done anywhere without anyone knowing that you are doing them.

I recommend that you do a urine test to evaluate how strong your muscles are now, so that after a few weeks, you can see your progress. Urine test: Use the bathroom with a very full bladder, and start peeing. After three or four seconds try to clamp off the flow. Estimate what percentage you can stop. That will be your benchmark. Be aware that you should not practice Kegels while urinitating as this can interfere with complete emptying of the bladder which can contribute to urinary track infections.

If you have trouble locating your pelvic floor muscles, or getting a good enough contraction, feel free to contact me,, and I can teach you how to do them in more depth. And please note that squeezing the thighs together is not advised, (they are leg muscles, not pelvic floor muscles) when performing Kegels. Helene Byrne author, ''Exercise After Pregnancy: How to Look and Feel Your Best''

Do your boring, insanely annoying kegel exercises. They do help. You'll probably still pee from time to time. I pee every time I jump, but less so when I keep up on the exercises, and can sneeze freely when I keep up with them. Otherwise, just wear mini pads every day, which is almost more of a pain. anon

I feel for you. Right after my son was born I could scarcely walk down the street without peeing in my pants. This went on for a couple of months, and then things slowly started to get better -- but I would still pee if I laughed, sneezed, coughed, went to my aerobics class, ran up the stairs, etc. etc. I did do kegel exercises, but the problem persisted, albeit in a milder form. My son is now seven years old, and there are still some things (like play soccer with him, chase him around the playground, jump rope, and yes, sneeze) that I can't do without leaking a small amount of urine. But things are much, much better, so part of the answer may be time. Here's what else I did to help myself:

1) exercise. I started working out nearly every day when my son turned five. I train on cardio machines and weight machines and go running once or twice a week. I also ride my bike. I believe that this more than anything else got my muscles toned, including those interior ones!

2) pads. I wear incontinence pads (the ''Poise'' regular or generic equivalent) nearly all the time. Usually it's just a precaution, but it makes me feel secure to know that the pad is in place just in case. When I exercise the pads are a must.

3) giving up. That is, for a long time I felt ashamed and downhearted about the fact that I was leaking urine and I didn't want to get out and jog or dance. Now I just tell myself to let go. I will wet my pants if I run or dance, so I put on a pad. If a little urine leaks out on my running clothes, them's the breaks. I'll change pads in the middle of a dancing evening if things get too humid. I think that I actually made things better by deciding that it was OK to wet myself a bit. When I first started having this problem, I confided in my mother and she was horrified. She told me that she had always had this problem but was unable to discuss it with anyone, including her friends. She was too embarrassed to buy pads at the store, but used menstrual pads instead! Now, really, I ask you girlfriends -- is this or is this not something that happens to us in the normal course of events, about which we should try our best not to be ashamed? Sure, no one wants to smell bad or have sopping clothes, but we should be able to take care of this problem matter-of-factly.

Original poster, I liked your sense of humor. It should carry you far. And things will get better. not ashamed anymore

I suffered with this problem for 12 years after our second child, and I can't believe I put up with it all that time. I kegeled up the wazoo to no avail. Even with pads, I had to stop jogging, and the problem worsened over the years until I had to stop walking for exercise (I'm not kidding). I finally had bladder sling surgery which is a fairly simple procedure, and have been totally cured for 6 years, a new person. Sort of - now I'm too old to jog! What a shame to suffer. You should certainly try kegels, and there is a biofeedback version which is supposed to be more effective than going it alone. But if these approaches don't work, surgery will, and I promise you it's not a big deal. You need to find someone with specialized training though, may be a urologist or a gynecologist. I'd recommend my surgeon, but he is no longer in Berkeley. Good luck. surgical success

Kegels definately work. I did them my whole pregnancy and 6 months later I'm fine. Sex is great. I never peed on myself or even a trickle. I was determined to do Kegels in my pregnancy because I was afraid it would make sex hurt. Kegel, kegel, kegel. They aren't that bad. I would make a game out of it, seeing how long I could hold it for. Try it. Good luck! zenasia

Hi - I was fine until my third child, but now - whenever I see a particular friend, whose birthday it is today, I laugh so much that I pee - when this first happened I was astonished. Now I do Kegels and hope - and go to the toilet before I see Jonny. Just to say you're not alone! I'm hoping as time goes on it will improve - but somehow I don't mind too much, because it only happens when I laugh...a lot... anon

Stress incontinence since giving birth 6 months ago

February 2004

I'm experiencing stress incontinence after giving birth to my child 6 months ago. It's extremely frustrating that I'm not able to exercise, or even to be out walking for long without having to use the restroom. Kegels have not seemed to work much. Does anyone have any advice on what else may help? Any recommendations for a Specialist/Urologist? Thank you in advance for any advice!

Stress incontinence is definitely no fun. I had it pretty bad for quite a while after the birth of my baby- my first. I'd heard about it happening but wasn't prepared for how bad it was the first few weeks postpartum. I'd head for the bathroom and I'd be peeing even before I sat on the toilet. My midwife promised it would get better and it did. I did lots of postnatal yoga with kegels (I think sex helps too!) but I think part of the problem was that I was just sort of numb down there for a while and couldn't even feel the kegels. But I kept at it and it kept getting better. I have no problems now.

There's a lot of info about incontinence on the women's health web site, -- articles about various forms of incontinence and treatment recommendations. Just go to the site and enter a search for stress incontinence. Good luck! anon

I could not help but reply. I had the same problem after the birth of my son and found it quite distressing, especially because I could not exercise. I discussed it with my Ob/Gyn. She suggested I use a diaphram when I exercise. It works great. It has not solved all of the problem, but it allowed me to resume exercise. Talk to your doctor. It is very common. Good Luck. anon

Stress incontinence after having two kids

April 2003

I have stress incontinence after having two kids. My OB/GYN examined me and said that I don't have it ''that bad'' and kegel exercises should work. What experiences have people had? Do they work? How long and how often did you do them? Has anyone had surgery to fix the problem?

I've had similar problem...and finally got serious about doing the Kegels...after about a month of doing Kegels several times a day, I found that my incontinence troubles had diminished significantly. I still don't do any trampolining though! Anon

I am a perinatal exercise specialist and can tell you more than you probably wish to hear re:Kegel exercises. I'd be happy to spend a few minutes on the phone with you to get you started in the right direction. Helene Byrne

I have terrible stress incontinence since giving birth. My mom also had it most of her life until she got surgery, she never found kegels did much. I unfotunately inherited her anatomy and her opinion about kegels. What I have tried:
1-it helps a ton to wear Poise or other incontinence pads (look like sanitary napkins but hold more)
2- A pessary, ring-shaped device that goes in the vagina and holds things up. Prescribed by my OBGYN. THis didn't help me much.
3- My MD prescribed Ditropan, which I understand is for frequency but sometimes helps with incontinence. It helped at first and then stopped helping with leakage, but allows me to sleep through the night without getting up to pee. So I still take it for that (it decreased my problems with insomnia)
4- I will look into surgery at some point (my mom was very happy with hers).
5-And, gee, I feel like I should re-try serious kegels after reading the other posts! Anon

I suffer from the same problem - after my first and only child! I saw a urologist who told me to give it time, because the ligaments and nerves take a long time to heal. He was right - it took more than a year to feel like I was more well than unwell, if that makes sense. I feel about 85% - 90% healed. But at 17mo.s out, that last 10% is still no fun.

My OB's office recommended a Physical Therapist who specializes in pelvic floor rehabilitation. Her name is Em Squires, and she works near Lake Merrit in Oakland. (510-206-5790) She's the only one in the Easy Bay who does this work, so your insurance should cover her. I went to see her recently, so I can't yet quantify the results. But her approach is to examine the tissues, muscles, etc. in the pelvic floor to determine more specifically where the weaknesses are. She then teaches you exercizes that target those areas. They are ''Kegels,'' (along with exercizes that strengthen the abdominal and lower back areas) but she teaches you that a Kegel is more than just clenching, and helps you to do them in a way that makes them more effective.

I just want to mention here that I was shocked to find out how common this problem is, and how little it was ever mentioned or talked about when I was pregnant. Not in the OB's office, not in my childbirth prep. classes, not by my doula. I've since learned that it is quite possible that my prolonged labor contributed to the condition, if it wasn't the sole cause. I've also noticed many more TV commercials for urinary incontinence ''personal protection'' products (like ''Serenity pads'') that feature younger women playing with their small children. Are they talking to us, or what?!

An upside? Now my post-menopausal mother and I have something in common! Best of luck to you... I'm right there with you! Anon

Kegel excercises do work. You have to keep them up, and you have to do them frequently. Beats medication, though, and certainly beats wearing a diaper. Plus, you are protecting yourself from more serious medical problems. There are devices designed to make your Kegel exercises more effective -- I bought one, called the Kegelcisor -- but just doing them the regular way is probably good enough, and anyway I've found the Kegelcisor hard to use. anon

I've been leaking since #3 was born 11 years ago!

April 2003

I have reached the limit of tolerance with my leaky bladder! I have had four big babies (now aging between 15 and 3). NO MORE PLANNED. I've been leaking since after #3 was born 11 years ago. My GYN had me consult with Physiotherapy Associates who gave me exercises to help strengthen the muscles. I noticed a very small improvement. I now use giant pads for exercise and I even have leaking problems all day long. My Gyn is not a fan of surgery, but I wanted to ask other mothers. Anyone out there had a procedure done that has helped reduce or eliminate the problem? I am 43 years old and I can only see this getting worse. I'm paranoid about the smell too. Kegels is not the answer anymore. Help?
mom with a leaky bladder

I have not had surgery, but I can recommend trying (or at least asking about) a pessary. It is a ring that is inserted into the vagina exactly like a diaphragm; it has an enlarged area that puts pressure on the urethra to prevent leakage. It has been enornously effective, though not 100%. I still wear a pad sometimes, just in case, but I rarely need it. anon

I work at an outpatient surgery center -- and there are gynecology surgeons who treat women for this problem all the time (the official term is ''urinary stress incontinence). It is a common problem out there, particularly for women who have had multiple births. It is called ''Anterior and Posterior Repair'' or ''Bladder Lift'' -- I highly suggest calling a gynecologist who is comfortable doing this surgery. It is an outpatient surgery, and you wil go home with a foley catheter (which depending on the surgeon, is removed anywhere from 3-7 days post-surgery). Not all gynecologists are focused on surgery, go to one who is.

Hope this helps. Anonymous

For professional reasons, i.e, not as a patient, I've been talking to Leslee Subak, M.D. at UCSF. Tnis is one of her research specialties. I highly recommend you get her advice. There is no real regulation of surgical repair for urinary incontinence, with the result that women regularly serve as guinea pigs for experimental surgical approaches with varying results. I think you can trust Leslee to give you state-of-the-art advice and to feel real compassion and understanding. Anon

I can recommend an excellent surgical gynecologist who is also very interested and skilled in bladder/urinary aspects of gyn, ie urogynecology. In addition, he has a very lovely bedside manner. He could talk to you about all the surgical options, including anterior-posterior repair, and a new procedure called the tension free vaginal tape, which has had high success rates. First, he would see if you were a surgical candidate at all, then he would determine which surgery was best for you given your symptoms. You should at least set up a consultation with him. His name is Dr. Ed Blumenstock, and his office is in Oakland (and sometime Lafayette) 510-893-3193. He does surgeries out of Summit and Alta Bates Hospitals.
-Goodluck, another gyn