As a parent, watching children grow up and become independent means that reaching a 50th birthday and beyond can become a new era when finally you find some free time, discover new hobbies and interests and start focusing on yourself. It is a time when many of us think about our health, the food we eat, getting exercise and taking care of our bodies. As part of that suddenly we may notice we are not as fit as we used to be and for some women it may be a time when we start experiencing life’s little leaks. A cough, a sneeze, a laugh, picking up the grandchildren or lifting heavy objects, exercising or even during sex – what may have been fine 10 years ago, now suddenly creates an embarrassing accident.
As our bodies get older our muscles become weaker and that may also mean the pelvic floor muscles. I call it “the baby badge” and is a problem that more than one in three mums suffer with after childbirth – incontinence. Accidentally wetting yourself is the sort of subject that goes on the “put up and shut up” list.
However, as the taboo begins to break down more women are seeking help from the medical profession. Which is great news. What is not always successful, however, is an operation offered to women to fix the problem. A 20 minute day case procedure to fit a mesh sling to support weakened pelvic floor muscles, which is given to around 13,000 women a year on the NHS. Called a TVT or a TVTO, a piece of polypropylene plastic mesh is used to support the urethra. For some women it is the fix they have always dreamed of – but the operation comes with a risk that is important to understand before agreeing to have the procedure.
Some of the risks include:
Hospital literature suggests one in 30 women suffer mesh complications but in reality the number is thought to be more like one in six due to problems of under reporting.
Before opting for surgery try your local hospital gynaecological physiotherapist who can teach you how to properly exercise your Kegels with, if needed, devices like weighted cones, bio feedback or electrical stimulation. If your incontinence only hits during impact exercise then consider using one of two tampon-like products on the market – Incostress or Impressa which pushes against your urethra to stop leaks. For some this is still not enough which is when treatments like botox injections or fillers may be given. For stress incontinence a medication called duloxetine can be prescribed to increase the muscle tone of the urethra while for urge incontinence a range of medications can help control an over active bladder. For night time incontinence, medications can encourage the kidneys to produce less urine to ease the problem. If nothing helps and surgery is the only fix then consider asking for a more traditional option like a natural tissue sling or a Birch colposupsension, which is in crude terms a hitch and stitch.
So if the baby badge is bothering you please seek help, but if opting for medication or surgery then do your research. The best starting place is online mesh operation support groups on Facebook and Twitter including Sling the Mesh, TVT Mum, TVT Info or Scottish Mesh Survivors.
Fixing incontinence can make a real difference to a woman’s quality of life – but so can surgical risks – do your research and don’t be too quick to go under the knife
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