Urinary Incontinence After Prostate Surgery: Everything You Need To Know

Incontinence After Prostate Surgery

Undergoing a prostatectomy (removal of the prostate due to cancer) can be difficult. And for many men, finding that they are incontinent post surgery may come as a shock.

But rest assured that there are many treatments available to manage incontinence treatment after surgery. Read below for some of the most common questions we receive about incontinence after prostate surgery.  

What causes incontinence after prostate surgery?

Urinary incontinence is a potential side effect of prostate removal surgery. The prostate surrounds the bladder. Removing it, or using radiation to treat it, can sometimes cause damage to the nerves and muscles of the bladder, urethra, and or sphincter, which controls the passage of urine from the bladder. This can result in urinary incontinence.

Is Incontinence Normal After Prostate Surgery?

Approximately 6-8 percent of men who have had surgery to remove their prostate will develop urinary incontinence. (Cleveland Clinic) The good news is that most men will eventually regain bladder control with time.

How bad is incontinence after prostate surgery?

The degree of incontinence varies from person to person and can be anywhere from full on incontinence, to light dribbles. And, the amount you leak right after surgery will likely lessen as you continue with your recovery and any additional bladder or pelvic floor treatments you may be doing.  

How long will I have incontinence after prostate surgery?

Most men who experience a loss of bladder control have symptoms for 6 months to 1 year post prostate surgery. However, a small percentage of men may continue to experience problems past the one year mark.

Does incontinence go away on its own after prostate surgery?

For most men, urinary incontinence will go away within about 1 year. Performing pelvic floor exercises, also known as kegels, which help strengthen the muscles that are located in the base of the pelvis between the pubic bone may help to speed the recovery process along.

Does incontinence happen if I treat prostate cancer with radiation?

Some men need radiation therapy after prostate removal. During radiation therapy, some of the normal tissues around the urinary sphincter, urethra and bladder may be exposed, causing irritation to occur post therapy, leading to incontinence. This typically subsides within a few months after radiation therapy, however if it persists, additional treatments described below may be helpful.

How can I improve incontinence after prostate surgery?

Want to stop incontinence after prostate surgery? Kegels may be your answer! As mentioned above, kegels are a common treatment option for incontinence after prostate surgery.  Among other things, the pelvic floor muscles help control bladder and bowel function and, like other muscles of the body, if they get weak they are no longer able to do their job effectively.  To improve muscle function, kegels must be done regularly, every day. The good news is that they can be performed pretty much anywhere, anytime, and in a variety of positions (sitting, standing, lying down, etc.). For a complete guide on performing a men’s kegel, click here.)

Biofeedback can sometimes be used to determine if you are performing a kegel properly. And, electrical stimulation may also be used to help re-teach the muscles to contract.

What treatments are available to me if my incontinence doesn’t go away after a year?

While kegels and behavioral therapy work well for most men with mild to moderate leaking, they may not be completely effective for some. Luckily, there are still some options for treating bladder leakage after prostate surgery.

Another surgery is sometimes needed when bladder leaks persist for more than a year after surgery. This may consist of having a urethral sling procedure, or an artificial urinary sphincter.

With a urethral sling procedure, a synthetic mesh tape is implanted to support the urethra. Up to an 80% improvement has been seen with this procedure and some men stop leaking completely.

An artificial urinary sphincter is used in patients who have more severe urinary incontinence that is not improving, or for those patients who may have had a lot of damage to the sphincter muscle after prostate surgery. An artificial urinary sphincter is a mechanical ring that helps close the exit from the bladder.

As will all surgeries, these come with pros and cons and potential complications. Be sure to discuss these options with your doctor. 

Incontinence after prostate surgery forums.

Going through prostate cancer and having your prostate removed can be a physically and emotionally trying time in life. Many men are unprepared for the extent to which they may experience bladder leaks after prostate removal and it can be disheartening to have undergone surgery only to experience a loss of bladder control for a period afterward.

Fortunately, this is usually resolved within a year. During that time though, you may find that you need someone to talk to about your experience. Finding a forum or message board filled with people who can relate can help ease some of the tensions that you may be going through. 

The NAFC message boards are a great way to connect with others who may also be experiencing incontinence, due to prostate surgery or other conditions.  They’re free to join and the forum is anonymous so you can speak freely without the worry of feeling embarrassed or ashamed. NAFC is proud of this amazing group of individuals who visit the forums and courageously share their stories, offer support, and provide inspiration to each other. We encourage you to check it out!

What To Do About An Enlarged Prostate?

What To Do About An Enlarged Prostate

Enlarged prostates are common as you age. Men aged 60 and older have a 50/50 chance of having an enlarged prostate and those who are 85 have a 90% chance. Those may be scary stats, but what exactly does having an enlarged prostate mean? Is it something to worry about? And if so, what are the treatment options? Keep reading to learn more about this very common condition and what it may mean for you.

Anatomy Review – function of the prostate

The main function of the prostate glad is to serve as a reproductive organ. It is responsible for producing prostate fluid, which is one of the main components of semen. The prostate gland muscles also help to transport semen into the urethra during ejaculation.  

The prostate gland sits just below the bladder, where the bladder and urethra (the tube that inside the penis that carries urine and semen out of the body) connect. In early life, it’s about the size and shape of a chestnut, and grows to different sizes throughout a man’s life. 

What causes the prostate to get enlarged?

As men age, the prostate gland grows. It’s estimated than as many as 17 million men have an enlarged prostate, or symptoms of Benign Prostate Hyperplasia (BPH). While it’s unclear why the prostate begins to grow, its thought that an excess of certain hormones may be to blame.

Symptoms of an enlarged prostate include the following:

  • A weak or interrupted urinary stream

  • The sudden urgency to urinate

  • Frequent urination

  • An inability to empty the bladder during urination

  • Trouble initiating urine flow, even when you feel like your bladder is full.

Should I worry? 

Even if your prostate becomes enlarged, it may never become an issue for you. The problems start when the prostate begins to constrict or block the urethra. This can compromise the bladder’s ability to effectively empty, causing chronic retention of urine. And, because the bladder still continues to send signals that it needs to empty, urgency and frequency can occur (this is also known as overactive bladder).  If left for too long, the bladder may become distended, making it even harder for it to empty completely. 

For these reasons, it’s important to see your doctor right away if you start experiencing any of the symptoms listed above. Additionally, the symptoms of an enlarged prostate can also mimic those of other conditions, such as bladder cancer or overactive bladder. Your doctor will be able to help diagnose your condition to determine an appropriate treatment.

What’s the treatment for an enlarged prostate?

There are many treatment options for enlarged prostate, depending on your symptoms.

Active surveillance, or “watchful waiting” is a term used to describe the act of monitoring your condition regularly for any changes. This approach is often used for men whose symptoms are mild and not too bothersome. 

There are several medications that are approved for BPH, but most of them fall into two categories: Alpha blockers and inhibitors. Both are effective at treating BPH and sometimes are even prescribed in combination with each other.  

Non-invasive treatment options include things like laser therapy, which decreases the size of the prostate by removing some of the tissue, or laser vaporization, which enlarges the prostate obstruction and opens the urethra.  Transurethral microwave therapy or transurethral needle ablation are other non-invasive treatment options that destroy excess prostate tissue that is causing blockage.

Finally, surgery is also commonly used to help relieve symptoms of an enlarged prostate. The most common form of surgery is transurethral resection of the prostate, or TURP. This surgery requires no incisions, relying instead on a surgical instrument inserted through the tip of your penis and the urethra. Using this tool, the doctor is able to trim excess prostate tissue that may be preventing the flow of urine. 

Other less common surgeries are also used to both trim excess tissue from the prostate, or to decrease pressure on the urethra in order to make urinating easier. You can read more about additional surgical options here.

Patient Perspective: Julie's Story

Julie's Story - Caring For Her Incontinent Mother

I’ve always been close to my Mom, but after my Dad passed away 5 years ago, we became closer than ever. We talked on the phone every day and I checked in with her every weekend. She was still very active, even after Dad passed, and continued to play golf every month, meet her girlfriends for bridge and walk her dog two times a day.  All of this changed when she had a stroke.

Suddenly, my very independent Mother was unable to do most things for herself.  Without a second thought, I took her in and cared for her as much as possible as she began her slow path to recovery. It was a shock to suddenly watch a woman that I always looked to for guidance become suddenly, completely dependent on me.  

I’m not going to lie - it’s been difficult at times.  She has always been a very proud woman and to have to ask for help for things like using the bathroom, or worse, to need help cleaning up after an accident, was mortifying for her and uncomfortable for me.  

After some trial and error, we finally developed a rhythm with each other and learned which products worked best for day and night. Even though it’s hard, I’m so grateful to still have my mom with me, and I can’t thank organizations like NAFC enough for providing education on management options during this difficult time of life. Help is there if you need it - you just need to know where to look.  

Julie F., Tampa, FL

Patient Perspective: Alice's Story

Alice's Story - Standing up to bladder leaks

It’s a funny thing, aging. I’m 68 years old, but I don’t feel any different than I did at 20. It happens so gradually really, but it feels like it comes out of nowhere. One day, you’re sitting there with your whole life ahead of you, and then suddenly, you’re walking along, you glance at your reflection and you see an old woman looking back at you. But you don’t feel any different. At least I didn’t. Until I started having bladder leaks.

My bladder leaks crept up on me just like getting old did. I had a few accidents here and there after kids, but didn’t start really noticing them regularly until I was in my late 50’s. I told myself I was too young to have this problem; that they weren’t that big of a deal and that I could manage it on my own.

The truth is, I was embarrassed. I didn’t want anyone to know about my leakage problem. I hid it well, or so I thought, but after a while, it started to weigh on me. Always packing a spare change of clothes, always scouting out the nearest bathroom in case of an emergency. It wasn’t until my daughter finally confronted me that I broke down.

I was visiting her at her house when I had an accident and had to change my pants. My daughter noticed and finally decided that enough was enough. She told me how she had watched me for years try to “hide” my problem, and urged me to get help. She also told me how she herself had talked with her doctor after her son was born and she had started experiencing leaks too. “The good news,” she said, “is that I’m doing so much better, and I hardly have any leaks at all anymore. I want that for you too, Mom.”

Talking to my daughter really opened up my eyes. She was right, and I couldn’t believe I had spent so long trying to hide the issue. Worse, I couldn’t believe she had gone through it too. If I had been open about it, maybe I could have offered some comfort to her, but instead she had had to deal with it on her own. I felt ashamed and embarrassed – not because of my bladder leaks, but because of my silence.

So, I decided to finally get help. After so many years of living with the problem, I didn’t realize how much it had taken over my life. And now that I’ve started taking medication for my bladder leaks, I am so much happier and freer.

I am 68, but the 20 year old still lives inside of me. And now, I can proudly say that I feel just as good today as I did back then.

Don’t wait to get help. Take the initiative to talk to your doctor and get the help you need. We can’t all do this alone and life is too short to let a day go by where this condition is controlling you. Suck up your pride, realize that we all need some help once in a while and just do it. I promise you, you’ll be so glad you did.

Alice B., San Jose, CA

Ask The Expert: How Do I Talk With My Husband About His Incontinence?

How Do I Talk With My Husband About His Incontinence

Question:  My husband of 47 years has recently started experiencing incontinent episodes. He’s a very proud man and doesn’t want to admit them to me, but it’s starting to become a problem due to the increased laundry, smell and his overall depressed attitude about it. How can I get him to open up and talk with me about it?

 

Answer:  This is a common problem in marriages, especially pertaining to men. Most men don’t want to admit they have a problem with bladder control. They feel ashamed, and hate the idea of wearing protection. He may never come out and admit it to you on his own, so here are some tips to broach the subject with him:

1. Make him feel comfortable.

As you’ve already figured out, incontinence is a very uncomfortable subject for your husband. Make him feel at ease and approach him about his bladder leakage in a way that is not threatening or accusatory. Find some neutral territory and talk to him at a time when he feels good. Don’t try to broach this subject right after he’s had an accident.  That will only make him feel more embarrassed and ashamed.

2. Show him that you are understanding and want to help him with his bladder leakage.

Before you talk with him, do a little research on incontinence and learn what may be causing the issue. Did he just have prostate surgery? Is there something else that has changed recently that could be contributing to his accidents? Read about the causes, and the many different treatment options and management strategies for bladder leakage. Show him that there are ways to manage the condition and that he doesn’t have to just live with it. Let him know that you care about him and want to help. Show him that you are a team so that he doesn’t feel so alone.

3. Encourage him to seek treatment for his incontinence.

Incontinence can often be a symptom of an underlying condition. Let your husband know that you want him to talk with a doctor to make sure that there is nothing serious going on, and to help him get the problem under control. He may be resistant to speaking with his doctor, but press on (slowly). The sooner he confronts his incontinence with a professional, the sooner he can begin treatment and start feeling like himself again. (Find a specialist in your area with our Specialist Locator.)

4. Be his advocate for care.

Because your husband is so embarrassed about his incontinence, you may need to be his voice when seeking out treatment options. Help him research incontinence so that you both can learn more about it. Write out questions that he can bring with him to the doctors office to ensure he doesn’t forget anything important. Be sure to voice any concerns over treatment options. And help him stay the course on his path to treatment.

5. Introduce him to the NAFC message boards.

The NAFC message boards are a great place for your husband to explore and ask questions – anonymously! There are many people on the boards who may be experiencing the same things he is who he can talk to. Plus, with so many people dealing with incontinence in the same spot, there are lots of learnings and tips he may be able to pull from to help his own situation. (As an aside, the message boards may also be a great spot for you to do some research too.  Talk with other caregivers to get some ideas. Or ask other men living with incontinence how you might be able to best approach your husband about the topic.)

It’s never easy talking about incontinence to a loved one – especially men. But by being a caring and supportive spouse, you’ll show your husband that you are in his corner, and that you are there to help. Good luck!

Is Sitting Making You Older?

Is Sitting Making You Older?
Is Sitting Making You Older?

We’re sure you’ve all heard the dangers of sitting too much. Being too sedentary can cause all sorts of issues, including organ damage, muscle degeneration, leg disorders, back pain, and even a greater risk of mortality. 

But did you know that sitting for too long actually ages you too?

A recent study looked at just how much sitting can affect your “age”. The study, performed by Aladdin Shadyab from the University of California San Diego, took blood samples from 1500 women, and measured their daily activity levels using accelerometers. The researcher then looked at the impact sitting had on the women’s chromosomes. The study found that women who did not meet the recommended 30 minutes of physical daily activity, and spent more time sedentary (roughly 10 hours) were about 8 years older than those who were also inactive but not quite as sedentary. However, women who met the recommended daily activity level seemed to show no association between their chromosome age and how much they sat. This seems to suggest that exercise may counteract the aging process.  (Read more about the study here from Time.)

While the research is still out on exactly how much exercise you need to do daily to negate the aging effects, getting in the daily-recommended 30 minutes is a good place to start.  Wondering how to fit in 30 minutes a day? Here are a few ideas

  • Brisk Walking
  • Biking
  • Dancing
  • Resistance training (be sure to hit all the major muscle groups, including lower and upper body)
  • Running
  • Bodyweight cardio, like jumping jacks

Beyond that, try to avoid sitting for too long. Working at a desk job can make this challenging, but there are things you can do there too that can keep you from being too sedentary. Many work places have instituted standing work stations to combat the negative effects of aging. You may also try sitting on a balance ball, which helps to activate your muscles more than sitting in a normal chair. If these are not options for you (or even if they are), even just setting an alarm every hour to remind yourself to stand up and walk around a bit can help.  (Read this article for some more ideas to combat sitting during the workday.)

If you’re home all day, don’t get caught in the sitting trap. Take up a new hobby, such as gardening, or golf. Move around the house regularly. Find a friend to take a walk with. Clean the house. Anything you can do to stay active will help you in the long run.

How To Have An End-Of-Life-Care Talk With Your Parent

End Of Life Care
End Of Life Care

It’s not something we ever want to think about, much less discuss. But we all get older, and sooner or later, there will be decisions that need to be made when it comes to how we, and our loved ones, want to be cared for toward the end of our life.  Talking about dying is not fun, but it is necessary to do it ahead of time to ensure that everyone’s wishes and needs are met – especially in the event that a loved one can no longer make those wishes heard on his or her own.

When talking with a parent, approach them directly, and let them know that you’d like to talk about how they’d like to be cared for as they get older.  This involves asking them questions about how involved they’d like to be in their medical care (do they want their doctors to do what they think is best or do they want to have a say in every decision), how much they want their family involved, what to do in the event of life-support or a terminal illness, etc. Talking about and documenting these wishes early will help prevent confusion later on and can ensure that your parent’s end-of-life wishes are carried out the way they would like.

Need some help getting things going? The Conversation Project is dedicated to helping people have discussions on end of life and has a great starter kit available on their website. Download yours here.

How Seniors Can Age-In-Place Comfortably And Safely

How Seniors Can Age In Place Comfortably And Safely

How Seniors Can Age In Place Comfortably And Safely

Many seniors can continue to live vital and active lives well after retirement, but safety is always a concern when a senior is living alone. As our bodies age, the risk of falls, broken bones, and other injuries increases, and for some, staying in the home may not be feasible. This is especially true when the home contains stairs, clutter, or walkways that aren’t accessible to wheelchairs or walkers. That’s why it’s imperative for seniors to assess their home to see what dangers might be lurking, to repair or replace any broken appliances, and take a good look at what their needs will be in the coming years.

Here are some of the best tips for senior safety while aging-in-place.

Update

If you have lived in the same home for many years, it’s possible that several updates need to be made in the kitchen and bathroom areas. Take a look at appliances and fixtures such as the stove, refrigerator, and bathtub and consider replacing worn-out technology with newer models. Many appliances now come with “smart” features--such as alarms and automatic shutoff--that would be extremely helpful for a senior. As for the bathroom, add non-slip rubber mats to the floor and tub, as well as a safety bar and shower seat.

Assess

Take a look at your home through the eyes of an older version of yourself. Will you be able to climb the stairs easily, or navigate through walkways? Remove any clutter, old rugs with turned-up corners or slippery backs, and furniture that could provide a trip hazard. Add lighting to stairwells and main living areas to ensure visibility; nightlights are a wonderful tool to have in every room. It’s also a good idea to make sure bedrooms and bathrooms will be accessible from a wheelchair and that doorways are wide enough, especially in older homes.

Security and home safety

For peace of mind, it’s always nice to have door alarms or motion sensors on the property, but they can also be helpful in reminding you to lock up. Consider investing in an alarm service and having motion sensor lights installed around the perimeter, which will aid your vision at night.

It’s also a good idea to make sure there are up-to-date fire extinguishers in the kitchen and in any living space where there might be candles or smoking. Install carbon monoxide and smoke alarms in living spaces.

Consider getting a pet

Dogs and cats can be wonderful companions, and for seniors, they can also be service animals. These animals do much more than provide loyal company; they also help lower stress levels and can be extremely helpful for individuals living with dementia or Alzheimer’s disease.

Aging-in-place may seem like a big undertaking, but if you take it one step at a time and plan well, you might be able to stay in your own home for the rest of your days.

About the Author:  Caroline James is the co-founder of Elder Action, which aims to provide useful information to aging seniors.

Your Guide To The New Prostate Screening Guidelines

Prostate Cancer Screening Guidelines

The new guidelines on prostate cancer screening have left some men wondering what they should do. Here’s a quick breakdown on what the US Preventative Services Task Force recommends.

Prostate cancer is the 3rd leading cause of cancer death in men in the US, with about 1 in seven men being diagnosed in their lifetime.   You may have recently heard the news that, despite previous cautions against getting screened for prostate cancer, new recommendations from the US Preventative Services Task Force are now recommending that men ages 55 to 69 at least have a discussion about prostate-specific antigen (PSA)-based screening, including the risks that go along with it.  So, what’s the deal? Will the test help or hurt you?

It depends. Back in 2012, the USPSTF recommended no routine screening at any age, because of the potential harm that could result after testing, including:

  • False Positives: A fair amount of PSA testing has suggested that prostate cancer may be present when there is in fact no cancer. Elevated PSA levels can be caused by many other things that don’t have anything to do with cancer. This can lead to worry and anxiety, and follow up tests that may not be needed.
  • Risk of infection with additional tests. In order to dig deeper after a PSA test, follow-up tests are done, which can potentially cause complications (fever, infection, bleeding, urinary problems, and pain).
  • Even if prostate cancer is diagnosed correctly, it sometimes never causes a problem for men. However, it’s difficult to tell what cancers will, or won’t be an issue later on, so most of the time, aggressive treatment is performed.
  • Treatment for prostate cancer can lead to other side effects, including erectile dysfunction, or urinary or fecal incontinence.

Due to these potential risks, the USPSTF recommended against screening men, since the benefits of screening really didn’t really outweigh the expected harm that could result. What has changed? 

The US Preventative Services Task Force now recommends that men ages 55 to 69 years of age should talk with their doctor about the potential benefits and harms of PSA screening for prostate cancer, and should make individualized decisions on how to proceed. This decision was made after determining that the potential benefits and harms of PSA tests are closely balanced in men ages 55 to 69. However, men over 70 are still recommended to not receive PSA screening.

Really, what all this boils down to is you. No longer should you just ignore the test if you are within the 55-69 age range. After all – it has been shown that of 1,000 men screened, testing may prevent up to 1 to 2 deaths from prostate cancer and up to 3 cases of metastatic prostate cancer over the course of 13 years.

But, you should weigh your options. Have an open dialogue with your doctor about your specific risks – your background and health history, your lifestyle, your healthcare beliefs and wishes – these are all important factors to take into consideration when deciding if and when to get tested.

You should also talk with your doctor about what the course of action would be if your PSA levels do turn out to be on the high side. While this could be a sign of cancer, it may also be caused by something else, such as enlarged prostate, which can be treated.

In the end, the Task Force is really just recommending a discussion. Which is something you should be having with your doctor anyway. Talk with your doctor about the risks so that together you can make an educated decision about your options.

It's Never Too Late To Take Charge Of Your Health

it's never too late to take charge of your health and incontinence

We’re wrapping up Women’s Health Month this week and we wanted to leave you with just one thought. If you take away anything from this past month, it should be this: 

No matter what your age, it’s never too late to seek help for incontinence.

Whether you are a new Mom in your 20’s or 30’s, or have just finished menopause, there are treatments available that can help you. Talk to your doctor and formulate a plan of action. Don’t be embarrassed – you certainly are not the first woman to discuss bladder or bowel health conditions with your doctor and you won’t be the last. They’re there to help you. And if, for some reason, they do brush you off, or attribute your bladder leakage to aging, then we have news for you: it’s time to get a new doctor. Because living with bladder leakage is really no way to live, no matter what age you happen to be. And if you've looked around this site at all, you know that there are many ways to treat leaks.

Take charge of your health and learn how to live a life without leaks!

Need some inspiration from others like you? Head on over to our message boards. You’ll find a supportive and open community to share tips, struggles and personal stories.

Staying Young With A Positive Outlook

stay young with a positive outlook!

Getting older is inevitable. It will happen to us all at one point, but just because we’re all aging doesn’t mean our life has to decline. The power of positivity is a real thing, and research shows that those who are optimistic about getting older, and who follow the mantra “you’re only as old as you feel” actually do fare better than those who are more likely to attribute aches and pain to old age.

In a study from the Journal of American Medical Association, researchers looked at the effects of positive age stereotypes to see what effect it had on helping people recover from certain disabilities. Participants (aged 70 years or older) were asked to relay 5 words or phrases that came to mind when they thought of old people. None of the participants had a disability prior to the initial questioning, but they did experience at least one month of disability during the 11-year follow up. The people who had given more positive age stereotypes were 44% more likely to fully recover from severe disability and were able to perform daily activities better as they aged than those with negative age stereotypes.

Positive thinking does matter. Even as we age, we are still in control of our own life. How we view it, and our health, make a big difference.  Nothing could be truer when considering a condition like incontinence. At NAFC, we hear from people all the time who think incontinence is simply a part of getting older. They’ve already resigned themselves to the fact that it will happen and there is nothing that can be done. But that is simply not true. (And if you follow this blog we hope you know that by now!) Lifestyle changes, medication, simple medical procedures, and even surgery can often correct the problem (or at least greatly improve the symptoms).  Don’t let your health decline simply because you’re marking another year on the calendar. Take charge of your wellbeing and attack any health concerns head on now, to enjoy a long and happy life.

Here’s a quick exercise to try each day.

Close your eyes and think of a time when you were at your optimal health. Think of your vibrancy at that age, your energy, how you felt. Now think of yourself as that age – not just in this exercise, but throughout your day. Associate yourself with that vibrant, younger version in everything you do. And, if research is correct, you may just start noticing the difference!

Have some tips to share on how you “think yourself young”? Share them in the comments below!

Coming Out Of The Closet About Pelvic Organ Prolapse

This is a guest post from Betty Heath, of The Rejoicing Soul.

During the past twelve years I have shared much of my life’s journey with you. Well, today I am coming out of the closet.  Stunning isn’t it? I was recently diagnosed with Pelvic Organ Prolapse. How many of you can identify with me? The current estimate of the number of women in the U.S. with this condition is approximately 4.3 million. According to a recent study by the World Health Organization guestimates indicate that there are 36 million women world-wide with this condition. The reality is that it is difficult to know what the real numbers are because women are reluctant to be talk about it or be treated for it.

Pelvic Organ Prolapse (POP) is quite common among today’s female population. Many women have the symptoms but because they are embarrassed to discuss them with anyone they suffer in silence.  POP can occur when the pelvic floor muscles weaken and one or more organs shift out into the vaginal canal and even bulge outside of the body.

My journey with POP began sometime in the spring of 2016. I began having symptoms of POP which include pressure, pain and/or fullness in vagina or rectum or both; sensation of ‘your insides falling out’; bulging in the vagina; severe back pain and incontinence. Every time I went for a walk or even sneezed I thought my insides were going to fall right out onto the ground. I began staying home more often and said little about it to my friends. At first I attributed these symptoms to old age and laughed them off. After all, I am approaching the ripe old age of 80. We hear and see so many TV ads regarding incontinence and because the causes are never addressed we become oblivious to what they might be.

This past fall I finally decided I didn’t want to spend the rest of my life worrying about my insides falling out and was tired of dealing with this issue so I made an appointment with a gynecologist. After the initial exam I was referred to Dr. Alexander Shapiro who is a specialist gyn/urologist in Denver. That exam took place in early December and was one hour and thirty minutes.

After the exam I told him I never dreamed I would be sitting in a gyn/urologist office at the age of 79. He smiled and replied, “We do have ways to keep popping up in your lives, don’t we.”  I then told him this was the most disgusting, gross thing that has ever happened to me. He said, “Right now your insides are a total mess. This is a very intimate surgery and is a major surgery. This is who you are right now and you can’t allow this to define your life. I promise you I can repair the damage and relieve the pain and discomfort”.

The four-hour surgery took place on Monday, January 30. I told my physician that most women my age are having face lifts and here I was having a butt-lift. I went home Tuesday and Wednesday as I was having breakfast I suddenly realized that the fullness/pressure feeling and the back pain I had prior to surgery were totally gone. Oh, what a relief it is. I cried tears of joy. I’ve experienced minimal pain with this surgery.

Today, if you are a woman reading this (or a man who has a woman in your life with this condition) I urge you to make an appointment to at least talk with your physician about your problem. There is help and hope for women with POP. New treatment options evolve daily to control, improve and repair this cryptic health condition.

Join with me in taking Pelvic Organ Prolapse out of the closet and make it common knowledge for women of all ages. Don’t allow this condition to define who you are or how you live your life.  Don’t wait! Call for your appointment today.

Betty Heath
Betty Heath

About The Author:  Betty Heath lives in Colorado with her husband. She is “retired from work, but not from living”, and has a weekly column called “As I See It”, which appears each Sunday in the Longmont Times-Call, owned by the Denver Post. She enjoys writing, cooking, gardening, and quilting. Betty also volunteers in the St. Vrain Valley School District, helping students learn how to write from their heart. For the past six years, she and her husband have volunteered as Santa and Mrs. Claus for the Holiday Festival in the Carbon Valley. You can read more from Betty at her blog, The Rejoicing Soul.

What To Expect Post Menopause

What To Expect Post Menopause - common ailments

So, you’ve made it through menopause – now what? While many of the symptoms that came along with menopause will go away, because of some of the changes that happened during menopause, you still need to be on your A-game to remain healthy.

Here are some of the common things to watch out for

Vaginal Bleeding

As your estrogen levels drop during menopause, the vaginal lining becomes very thin and, as a result, may be easily irritated, resulting in bleeding. Polyps (usually non-cancerous growths) can also occur. Bleeding after menopause is not normal, so if you experience this, be sure to see your doctor right away to get checked out to ensure it’s nothing serious.

Risk of Osteoporosis

After menopause, a woman’s bone breakdown overtakes bone buildup, resulting in a loss of bone mass. Overtime, this can develop into osteoporosis. Prevention is key here – be sure to exercise on a regular basis (weight bearing exercises done regularly are great at making bones stronger). Eat high calcium foods, such as low-fat milk and dairy products, canned fish, dark leafy greens, and calcium fortified foods. Vitamin D is also essential, as it helps the body better absorb the calcium you’ll be taking in. You can get Vitamin D naturally by exposing your skin to sun for about 20 minutes daily, but you may also get it from foods like eggs, fatty fish, cereal and milk. If you feel you are at a risk for not getting the calcium or vitamin D you need, talk to your doctor about taking supplements.

Risk of Heart Disease

While menopause doesn’t cause heart disease, women are at an increased risk for heart disease after menopause has occurred. Some believe that lack of estrogen may again be to blame, but other changes are in effect too – increased blood pressure, increased LDL cholesterol (this is the “bad” one) and higher levels of fat in the blood can also increase after menopause.  Diet and exercise are as important as ever (to keep your heart healthy and prevent other conditions). Just 30 minutes of physical activity - walking, dancing, and swimming are all great options – 5 days per week can give you a good aerobic workout. And be sure to eat a healthy diet while avoiding too much red meat, or high sugar foods and drinks.

Vaginal Dryness

Because of low estrogen levels, you may still experience some vaginal dryness. Over the counter vaginal lubricants and moisturizers can help ease these symptoms, but if that doesn’t work, talk with your doctor about using some type of estrogen treatment – there are many available, and in different forms (tablets, rings, creams).

Life after menopause can be a wonderful time provided you take the time for self care and work to maintain a healthy lifestyle.

The Pelvic Floor As We Age. A look at how it changes through the different phases of life (pregnancy, menopause, etc.).

The Pelvic Floor As We Age, Pregnancy, Menopause.

A Guest Post By Michelle Herbst, PT

As women age, their birthing history and overall muscle weakness may catch up with them.  A healthy pelvic floor can be achieved as we age but often little attention is paid to the pelvic floor until it starts to fail. It can be difficult for women to seek medical attention due to feelings of embarrassment and despair. But, advances in health care and knowledge of the aging process allows today’s women to seek effective treatments.

Let’s step back and take a closer look at the pelvic floor as we age.

The pelvic floor is a sling supporting our abdominal and pelvic organs. It is made up of our muscles and connective tissues which I like to think of as our active and passive pelvic support structures. The pelvic floor muscles, or active pelvic support structures, create a muscular sling whereas our passive pelvic support structures are made of connective tissue called fascia. Fascia is a spider-web like material traveling through and covering the pelvic floor.

The active and passive pelvic support system are one in the same. They are knitted together interlacing creating a dynamic basin of support. Healthy pelvic support system work together controlling our sphincters, limit the downward descent of the pelvic organs and aide in sexual appreciation. Damage or weakness to the pelvic support system may result in symptoms of pelvic floor dysfunctions resulting in leakage and pelvic organ prolapse.

The pelvic floor over time.     

Pregnancy, child birth and the post-partum period is a time of great change. The interlacing nature of the active and passive pelvic floor support systems protect the mother and baby as they both grown. Child birth calls on the pelvic support system to push and slide the baby out into the world. The pelvic floor muscles can heal in as quickly as 6 weeks after delivery. But, the physical strain of living and creating new life can be taxing on the pelvic support system leaving it overstretched and weak.

The prescription is often kegels and post-partum kegels can be hard to do. The muscles are lengthened, very weak and trying to ‘reconnect’ to their nerve supply. In an attempt to ‘get it all done’, the post-partum mom is often multi-tasking while doing kegels. Their brain is preoccupied, sleep deprived and foggy. Despite good intentions, many new mothers ‘muscle their way through’ relying on other muscle groups to assist or do the job of the pelvic floor. Overtime with due diligence and a sleeping baby – the brain fog lifts, kegels are consistent and pelvic floor muscles recover allowing the new mom to return to and enjoy life’s pleasures and adventures.

Life continues to click at a fast pace.  The biological process of aging ticks away. The passage of time can be bittersweet. In the 3rd through 5th decades of a woman’s life, she will begin to experience a gradual loss in overall muscle strength and tensile strength of their connective tissue. In their 4th and 5th decades, peri-menopause ushers in a decrease in circulating estrogen and progesterone. The conclusion of these gradual changes are marked by menopause which is typically complete during the 5th decade. Life starts to catch up with you. The birthing of children, past injuries, the development of chronic health conditions and your family history may predispose the active and passive support system to overall weakening and loss of integrity resulting in leakage, organ prolapse and decline in sexual function.

What Can you do To Strengthen The Pelvic Floor?

1.     Protect and strengthen your active pelvic support system by engaging in a strength program and doing your kegels. Peak muscle strength occurs in twenties or thirties. And, unless a woman is engaging in a strength program she will begin lose muscle mass and strength.

2.     Protect the passive pelvic support system by avoiding straining during bowel movements and avoid holding your breath while lifting, pushing and pulling. The passive pelvic support system can not ‘fix itself’ and will need to rely strength of the active pelvic support system. So, revisit number 1 again and again and again …

3.     Stay healthy and seek out your doctor’s advice when you are sick or notice your first sign of leakage or prolapse. The treatment often times isn’t as bad as you think it will be.

 
Michelle Herbst, PT

Michelle Herbst, PT

 

Staying Strong And Preventing Bladder Leakage During Menopause

preventing #bladderleakage during menopause

It’s estimated that a whopping 6,000 women reach menopause each day in the US. Menopause happens to every woman, and is the shift in hormonal changes that result in the cessation of menstruation.

While many women know about the common symptoms of menopause (Hot flashes! Insomnia!), there are certain changes that come about in menopause that are often surprising to women. One of these is loss of bladder or bowel control

A number of things occur during menopause that can contribute to you suddenly experiencing a bit of leakage

Weakening Of Pelvic Floor Muscles

Your pelvic floor muscles play a huge role in controlling your bladder and bowel. As the muscles weaken, it can lead to more urgent needs to use the restroom, and more leaks. Weakened muscles can also lead to an increased risk for pelvic organ prolapse.

A Less Elastic Bladder

Changes that occur during menopause can cause the bladder to lose it’s elasticity and the ability to stretch. This can cause increased irritation in the bladder when it fills with urine, and can impact the nerves that regulate bladder function, which can sometimes cause overactive bladder (OAB).

Vaginal Dryness

During and after menopause, the body produces much less estrogen, which results in an increase of vaginal dryness. This dryness has a number of consequences, which can include an increase in the amount of urinary tract infections.

Anal Trauma

While anal trauma is usually the result of childbirth, many women may not see the results of it until menopause, when that, combined with a weakened pelvic floor can increase the risk of fecal incontinence.

It’s important to know that while these changes can lead to bladder or bowel leakage, the symptoms can also be avoided or eliminated by taking proper care of the pelvic floor. It’s never too late to start strengthening things up.

Here are some ways to increase the strength of your pelvic floor as you go through this period

Get Active

As simple as it sounds, simply staying active is great to keep your weight, and overall health in check.  Gentle exercises, like walking, that don’t place too much pressure on the pelvic floor are best.

Try Squats

Squats are a great way to build up your glute and core muscles. To perform one, stand with feet shoulder with apart. Keeping your knees over your feet (don’t let them move past your toes), lower your bottom down as if you are sitting in a chair, being careful not to lean too far forward. Raise back up to starting position.  Aim for 10 reps per day. (Note, if these feel too difficult for you, try wall squats, which use the same movement, but are performed with your back to the wall for extra support.)

Kegel

When done correctly, kegels can do wonders for helping women with incontinence.  They help strengthen the muscles that prevent bladder leakage and also help to avoid or reduce the symptoms of pelvic organ prolapse.  Remember that when performing a kegal, learning how to relax the pelvic floor is just as important as learning how to tighten it. In some cases, women have pelvic floors that are too tight and cannot relax, and if this is the case, kegels can end up aggravating your condition. If you’re concerned about your pelvic floor, or just can’t get the hang of how to do a kegel, visit a pelvic floor physical therapist for help.

Hormones! They Are A Changin'. Top 3 Myths About Menopause - Debunked!

Top 3 myths about menopause - Debunked!

Menopause will affect every woman at some point in her life. Menopause occurs when hormonal changes cause the menstrual cycle to stop. Whether you are on the verge of this life change or right in the middle of it, there are things you can do to manage the side-effects. But first, it helps to know what is and isn’t true.

Here are some common myths about menopause and the reality behind them

MYTH #1: MENOPAUSE BEGINS AT A CERTAIN AGE.

Fact: While the average age for menopause to start is 52, this is not a steadfast rule.

Women can begin menopause as early as their 30s and as late as their 60s! Technically, menopause begins when you have stopped having a menstrual cycle for 12 months. But symptoms can start even before this begins – perimenopausal symptoms can last anywhere from a few months to several years before actual menopause starts.

MYTH #2: HOT FLASHES ARE THE BIGGEST SYMPTOM I NEED TO WORRY ABOUT.

Fact: While hot flashes are a commonly talked about symptom of perimenopause and menopause, there are many symptoms that can occur (although not all women experience all symptoms). Irritability, fatigue, anxiety, mood swings, low libido, forgetfulness, weight gain and vaginal dryness are just a few of the symptoms that women may experience during this stage of life.

MYTH #3: INCONTINENCE THAT COMES AS WE AGE IS JUST A RESULT OF GETTING OLDER AND THERE’S NOTHING I CAN DO ABOUT IT.

Fact: It’s true that menopause can increase the risk of urinary incontinence. During menopause, estrogen levels decline, causing a number of changes to the body. Without proper care, pelvic floor muscles can become weaker, increasing the possibility of leakage, or even pelvic organ prolapse. Vaginal dryness can occur as the lining of the vagina produces less mucus. And a decline in bladder elasticity can increase bladder irritation and impact bladder function, which can cause overactive bladder (OAB). But while hormonal changes that come with age can influence symptoms, there are many things that can be done to prevent or manage incontinence, starting with taking proper care of your pelvic floor. If you are experiencing any of the above symptoms, talk with a licensed physical therapist who specializes in women’s health as soon as possible so that they can evaluate your symptoms and set you up on a proper treatment plan.

Ask The Expert: Is Urinary Incontinence A Normal Part Of Aging?

Is Urinary Incontinence A Normal Part Of Aging?

Each month, we ask our expert panel to answer one of our reader's questions. To learn more about the NAFC Expert Panel, and how to submit your own question, see below.

Question: Is Urinary Incontinence A Normal Part Of Aging?

Answer: We get this question all the time, and suspect that many people believe this, even though it’s not really true. Here are the facts:

While incontinence should never be considered a normal occurrence, our chances of getting it do increase as we get older. Certain life events (childbirth, for example) can cause the muscles and tissues to weaken, and, over time can result in urinary incontinence. Other conditions can also play a role – neurological conditions such as MS or Parkinson’s Disease, being overweight, or prostate problems in men can all contribute to bladder leakage.

So, in a way, yes, as you get older, you may be more likely to experience urinary incontinence, but it’s typically a symptom of something else. And it most certainly can be treated. Lifestyle changes, such as diet and exercise (especially performing moves that increase the strength of the pelvic floor) can do wonders in improving symptoms of incontinence. And, if that doesn’t work, medications, minimally invasive procedures (like Botox injections or InterStim) or even surgery are all options for treating the issue.

The most important thing to take away is that having bladder leakage is not a lost cause. If you live with this symptom, find a doctor and talk about your options. Life’s too short to live with a condition that has so many options for treatment.

Are you an expert in incontinence care? Would you like to join the NAFC expert panel? Have a question you'd like answered? Contact us!

Pre-pregnancy And The Pelvic Floor - It's All About Prevention

Preparing Your Pelvic Floor For Pregnancy

If you’ve never been pregnant, it’s likely you’ve spent little time thinking about your pelvic floor. And yet, now is exactly the time that you should be focused on it.  A healthy pelvic floor can prepare you for a great pregnancy and a safe delivery, and it can prevent a host of problems that may occur after childbirth. The pelvic floor works as a basket of muscles, holding your uterus, bladder, and rectum in place.  When you’re young, and your pelvic floor has not suffered the effects of age or childbirth, you usually see few complications. But sometimes, strain on the pelvic floor (like carrying a growing baby for nine month, giving birth, and the natural effects of gravity over time) can cause problems like bladder leakage. The good news? These effects can be lessened, or even eliminated, if proper care is given to the pelvic floor now.  Here are the steps you need to take to ensure that you’re taking proper care of your pelvic floor, and yourself, prior to becoming pregnant.

How To Prepare Your Pelvic Floor For Pregnancy

Assemble your squad.

Finding the right team of professionals is key to keeping your health in check.  If you haven’t already, do your due diligence and start seeing these health care professionals on a regular basis.

  • Gyno
  • Primary Care physician
  • Dentist
  • Dermatologist

Need help finding a health care professional? Use our Doctor Finder!

Keep a healthy weight and develop a workout routine.

If you’re planning to get pregnant, don’t fall into the trap of thinking that weight doesn’t matter pre-pregnancy – the healthier you are now, the healthier you will be during your pregnancy, and the easier it may be to shed those extra pounds after baby arrives. Not only that, but keeping your core and pelvic floor strong now will help better prepare you for pregnancy and childbirth.

Maintain a healthy diet.  

Eating right is always a good idea, and it can really help you maintain your weight. In addition, keeping your diet in check can help you prevent diabetes (a condition that is on the rise in the US, and that, in some cases lead to neurogenic bladder.)

Routine Exams

Get a well-woman exam every year – be sure to talk with your physician about general health metrics like blood pressure levels, diet, weight, and any stress that you may be experiencing. Have a regular Pap smear every 3 years if you’re between 21 and 30. While you’re at it, be sure to have a yearly breast exam to check for any unusual changes. Do your own monthly exams as well and become familiar with how your breasts normally look and feel.

Quit those bad habits

If you haven’t heard, smoking is really not cool anymore and even if you don’t believe that, consider this – aside from a host of other health problems, smoking can contribute to a leaky bladder

Uncover any risk factors that you may have by learning your health history

Talk with your family to learn about any risks that you may have health-wise. Knowing these now can help you prevent possible health threats down the road.

Even if you only choose to follow a couple of these steps prior to pregnancy, know this: this time is all about prevention – the steps you take now to take care of your body will pay off in folds down the road.  Don’t wait to start taking control of your health. 

Check in with us all month to learn how to stay healthy at every stage of life.