In this post I discuss my experience with stress urinary incontinence and how it negatively impacted my life after the birth of my son. I ended up seeking medical advice as the usual treatment of pelvic floor exercises (Kegals) didn’t make any improvement.
After various hospital visits and tests to diagnose which type of incontinence I was suffering from, I had a procedure which involves injecting Botox into the muscle of bladder. I can’t emphasise enough how it has improved my quality of life, and wanted to share my story in case anyone else is going through the same experience.
Stress urinary incontinence symptoms
Stress urinary incontinence is a common problem affecting millions of women (and men). It is characterised by the leakage of urine during movement or activity that puts pressure on the bladder (such as coughing, sneezing, laughing or movements such as running or heavy weight lifting).
Stress incontinence is not the same as urgency incontinence and overactive bladder. Those conditions cause bladder spasms. This leads to a sudden need to urinate quickly. Stress incontinence is much more common in women than in men.
Leaking urine after giving birth
Following the traumatic birth of my son, which involved an episiotomy and forceps, my pelvic floor took such a battering that every time I sneezed or coughed I would leak. If I ran more than a couple of meters the same thing would happen.
Unfortunately, forceps deliveries are associated with an increased risk of pelvic floor disorders. During my labour I repeatedly said that I did not want the use of forceps, but my son didn’t seem to want to budge. Even after a 36-hour labour and copious amounts of oxytocin to kick start the birth. The doctors thought this was the safest option in the end.
During forceps delivery, pressure on the pelvic floor and surrounding tissues can lead to weakening or damage. The pelvic floor muscles, which support the bladder and control urine flow, may be affected.
I thought that it would get better after a while and that it was just postpartum incontinence. Most women find that it goes away in the first few weeks after childbirth, as the stretched muscles and tissues recover. However, for some women it can take months while others find their pelvic floor never recovers fully. I am one of the ‘others’.
After many poorly attempted Kegel exercises (I could no longer feel that part I was supposed to tense) and a few useless purchases which promised the world, I realised that it just wasn’t getting better. Nothing seemed to work. I resigned myself to the fact that I was never going to run again without the feeling of embarrassment or shame.
It was something that made me really miserable at times, and affected my quality of life.
Leaking when running
Before I became pregnant I was always active and ran frequently. I was desperate to get back out there again as I’ve always found it is the best thing for my mental health.
I suffered from postnatal depression after the birth, which made it all the more important for me to try and get back to some sort of normality.
It took me a couple of months before I plucked up the courage to go for a run. When I did I made it a few hundred meters before turning back feeling deflated. I felt a horrible dragging sensation in my pelvic area and I leaked urine almost immediately.
Managing leaks whilst exercising
I ended up buying some period pads in the hope that they would soak it up and I could carry on. I couldn’t bring myself to buy pads that was specifically designed for incontinence (feelings of shame I think) and thought they would just feel bulky.
More often than not the pad wouldn’t be enough. I would leak and it would go through to my leggings. I bought patterned ones hoping that it wouldn’t be as noticeable, but I was always paranoid when I went out.
I was constantly worried that people walking behind me or driving in cars could see.
I limited my fluid intake before I went running and would try and go to the toilet as many times as possible before heading out the door. More often than not, I was dehydrated, as I would barely drink anything due to the fear of leaking.
I joined an outside boot camp group and was limited at times in the exercises I could do. Star jumps were the worst, resulting in a leak straight away.
I ruled out anything that made me slam down onto the ground. Or exercises which involved jumping, and would adapt a lot of the exercises to cause minimal damage. But it was always the same.
I carried on this way for around 4 years. I just put up with it. I’d wear a thick pad (that felt as though I was wearing a nappy) when I took my son to the trampoline park. Planned running routes that contained at least one toilet stop.
I put up with it, but I hated it and it affected my self-confidence.
Seeking medical advice
One day I decided enough was enough and made an appointment with my doctor for medical advice. I thought that she would brush me off. Tell me to get on with it and do my pelvic floor exercises. That it’s just one of those things after childbirth.
I told the doctor how much it affected my life and explained my loss of bladder control, which was making me miserable. Surprisingly, she was really understanding and booked me into see a specialist at the gynaecology department at my local hospital for a diagnosis.
After a pelvic examination the consultant declared that pelvic floor exercises were pointless for me as I had nerve damage. She booked me in to see another consultant who would go through my options and carry out a urinary stress test.
I was given a voiding diary at my following appointment and told to record each time I passed urine over the course of 3 days. I had to add the time and measure the amount that I had passed and then bring it back to my next appointment.
The consultant informed me that she would insert a catheter at my next appointment and carry out a Urodynamics test to see what the best course of action would be.
I handed over my diary and the consultant confirmed I pass urine at a normal rate and amount. She ruled out urge incontinence, which is categorised by frequent urination and leaks when you feel a sudden, urgent need to pee, or soon after.
The bladder stress test procedure
She inserted a catheter and began filling up my bladder with fluid. Once I reached a point where I knew my bladder was completely full, she placed a sheet on the floor and asked me to do a star jump.
I was initially mortified as I knew what that would entail, but I did what I was told and immediately a huge leak hit the floor.
She confirmed I had stress incontinence and sent me home with a booklet with the options available to me. It set out the procedure with a list of pros and cons and I was told to read it and decide which one I would like to go ahead with.
Stress urinary incontinence treatment
There were 3 options in the booklet (there are more than listed below I believe, but these are the most common and effective):
Colposuspension
Colposuspension involves making a cut in your lower tummy (abdomen), lifting the neck of your bladder, and stitching it in this lifted position.
There are two different types of Colposuspension surgery. One is performed through a large abdominal incision. The other is keyhole surgery which is carried out through small cuts using specialised instruments.
Side effects: possible complications can be difficulty emptying the bladder completely and suffering from a recurrent urinary tract infection (UTI).
Sling surgery
Sling surgery is a widely used treatment for severe stress incontinence. Surgeons create a sling for your urethra providing extra support to close your urethra and bladder.
It is a preferred procedure for the treatment of urinary incontinence due to its long-term safety and effectiveness.
Side effects: a risk of urinary retention and recurrent UTIs.
Botulinum toxin product (Botox)
A dose of Botox is injected into the bladder muscle, providing relief. This type of medicine can sometimes help relieve these problems by relaxing your bladder. This effect can last for several months and a further injection of Botox can be repeated, if it helps.
Although the symptoms of incontinence may improve after the injections, you may find it difficult to completely empty your bladder.
After much deliberation I decided on Botox in the bladder as I thought it would be the less invasive treatment option.
After a consultation with the doctor, it was agreed that I would be booked in for the procedure and that it would be carried out under local anesthetic.
A few months later I received the letter confirming the details, but it stated that I would need someone to pick me up from the hospital as I wouldn’t be able to drive as the procedure would be carried out under general anesthetic. I definitely felt a bit more apprehensive about it at that point.
I had nothing to worry about though, as I was in and out of hospital in a couple of hours and didn’t feel much pain at all. I was informed that it might be hard to pass urine to start with and that I should drink lots of water to prevent UTIs. I was forbidden to do any exercise for about a week.
What to expect after Botox in bladder procedure
- Most people experience mild pelvic or abdominal discomfort after the procedure. There may be a burning or stinging sensation when you pass urine initially
- It’s common to see some blood in your urine, but this should clear up after a day or so
- You may find it harder than usual to empty your bladder, but this should resolve after a few days or weeks
- UTIs are common and it’s important to drink lots of water post-procedure
I didn’t feel any pain at all. I found it harder than usual to pass urine – it seemed to take ages and it didn’t feel as though my bladder emptied completely, but that didn’t last long at all.
I returned to boot camp once I was allowed and straight away I noticed a difference. I couldn’t believe that I could do star jumps, run up and down the field, jump up and down repeatedly and nothing happened. Not a drop!
I had a call with the consultant who asked how I was getting on. I excitedly reported that it had been absolutely life-changing and updated her on what I had been doing at boot camp.
She sounded delighted and said the results were amazing as people usually need Botox administered twice to get to the stage that I was at. If I felt that anything changed then I should contact my doctor again and get booked in.
Long term effects of Botox in bladder
This took place over a year ago now, and although it’s suggested that Botox lasts for 6-9 months, it still feels just as good as when it was first administered. When the time comes, I will not hesitate to make an appointment with my doctor to request a second procedure.
I’ve read that reoccurring UTIs are the main long term side-effect, but I can honestly say that the whole experience has been nothing but positive for me, personally.
Not long after the procedure was carried out, I joined a local gym. I have since completely forgotten about how it used to be, the leaks, the embarrassment, not drinking water before I exercised.
I pound the treadmill, lift weights and leap around just like I did pre-pregnancy.
I have regained my confidence now that the fear of accidents has faded away. I can now focus on living my life fully without constantly worry.
If you’re struggling with incontinence, whether it’s stress or urge incontinence, please don’t suffer in silence. Reach out to your doctor or a urologist.
Treatments and procedures don’t always work for everyone and there can be side effects, but your doctor can guide you through the available treatments and recommend the best options for you.
Lastly, don’t be embarrassed! Remember, healthcare professionals have seen it all. Discuss your symptoms openly and honestly. Don’t suffer in silence.
Good luck!
