Pelvic floor....or what's left of it

[Life After Babies]

Hi Family Room

I love my kids, but after several years of pelvic floor exercises I'm depressed to find I still have problems if I try to run, or cough, or sneeze. I hate it. I'm a fit & healthy woman & I had really good birth experiences, no damage at the time just this longstanding issue ever since. I'm really shocked to still be struggling with this.

It's not a subject people tend to be open about, understandably .....but I could really do with some input from others....

Has anyone on here had surgery to 'fix' pelvic floor problems & if so did it work?

Please PM me if you can offer any advice or support.

[Monkey]

No surgery here but doing lots of squeezes and various exercises with a physio. And it's working ok. Have you actually seen a physio or someone about it?

I am very open about it. Even got my physio to give a talk at my office! Had lots of thank yous for it!

[Life After Babies]

Thanks Monkey - you're braver than me!

I exercise, do some Pilates, use a Mamasure (internal Tens machine) & all the usual stuff but several years on I'm still having problems.

I have a referral to Kings but feel rather nervous about the possibility of surgery.

But otherwise I fear I will never truly relax & do more than walk again. :-(

I just wondered if there are loads of people like me out there, as it's always suggested its a female design flaw that we all suffer post birth, or if actually I'm a freak. :-(

[Princess]

I had two kids 19 months apart and both were big! My second child is now 15 months and I am still under the care of various consultants and physios (both NHS and private) for my problems. We have all talked several times about surgery and every time it boils down to two issues 1) I'm only 95% sure I am definitely finished having kids 2) I don't have someone who can help me run around after/lift the kids whilst I recover.

I am lead to believe the surgery is very successful but it's not something they do lightly and certainly the 'scoring' system on the NHS means things have to be pretty severe for you to qualify for treatment. However, when you get through all of that, things can happen quite quickly.

I'm sorry I wasn't any specific help as I haven't had the surgery - yet. however, I just wanted to answer your post and say there are plenty of us out here in a similar situation.

Good luck.

[Monkey]

Yes, plenty of us. When I sent the meeting invitation for the physio talk at work, I had an overwhelming response rate within minutes! Women of all ages.

I am thinking of surgery too if my problems don't improve as much as I want.

Sorry, no insight to offer except there's a really good uro gyne at King's called dr Bidmead.

Best of luck. You are NOT alone.

[nymom]

I have major problems in this area. Even squatting down is an issue. Jumping, running, going down staris quickly, youname it. I have been through all of the physio at kings. Consultant urogyn said I would need surgery if I want any improvement. But I want a third child. So everything on hold until then. I find it frustrating and dont know anyone else with this issue.

[hellosailor]

Dr. Bidmead at Kings is indeed great. And no, you're not alone, there are lots of us out there!

[Trish]

Lots of us!!

[Cora]

I have an appointment in a few weeks...I have now had all the children but still find it scary thinking of having a hysterectomy to support the actual surgery having a good outcome. Also nervous about messing up other bits that thankfully still work (she says euphemistically!).

Would also really welcome any anecdotes from others who have had surgery at Kings for this.

Thanks.

[BeccaL]

Gynae physio at Kings was very good in terms of making sure exercises are correct - thankfully didn't need surgery, hope you can find someone who can reassure you about that. Think it's the unspoken thing about childbirth - I miss my pelvic floor!!

[fapl]

Talking of design flaws, since having had my children I am convinced modern western toilets were not the greatest invention. I always have my feet up on my kids stool in the bathroom so my knees are higher than my hips when doing a number 2. (also, wiping a 3 year olds bottom with dry paper makes you realise it is not the most efficient way to get things properly clean down there.

How weird would it be if I installed a squat toilet and a hose in my bathroom (kids would love the hose) :)

Back the original topic, as you can see you are not the only one, but if you have not seen a physio, PLEASE DO. I presonally would make sure I have tried everything before surgery, as from all accounts it is a fairly major operation.

There is quite a supportive (international) forum on http://prolapsehealth.com/forums/ But bear in mind you may hear more horror stories about surgery than positive results because people turn to these sorts of things for support before hand, but have no need to hang around if surgery is successful, only if the result is not as good as hoped.

You are not alone.

[Jo'sEnglish]

Agreed, I think they will proabably send you to a woman's health physio first. I had a difficult instrumental birth and a bad third degree tear and lots of problems after my son but after seeing the women's health physio at Lewisham (who is amazing), as well as various consultants and specialists, things are ok! I also do a lot of Pilates which I think really helps, so keep that up.

And you are definitely not a freak! It's just not something that comes up in conversation, is it?

[enjoy]

ok, can't help with personal experience but I've read about this one:

TVT, Tension-free Vaginal Tape

[nymom]

Hi. I think there are different surgical procedures. The one discussed with me was minor and didn't involve a hysterectomy. I was told it is minimally invasive and had a very good success rate assuming you have no further children

As if you have a second procedure the effectiveness drops dramatically. I am sure each person will have a unique situation and treatment plan, however there are options that are less invasive than others.

[Gooders79]

There are a lot of factors which predispose problems, genetics, bigger than 8 lb baby, 2 nd stage labour of more than 1 hr, episiotomy, forceps delivery, hyper mobility syndrome... You need to be able to complete repeated quick contractions (100) and slow with hold for a minute as a baseline. If you can't do this physio is likely to help, both st Thomas's and kings have excellent women's health services. You really shouldn't have to put up with this and surgical options do exist...

[Goodliz]

This is a big problem for many, many women.

As I get asked about this alot at my Powerpramming classes I did a phone round of some physios. I wanted to be able to recommend someone who really specialises in this area - rather than someone just recommending pelvic floor/ kegel exercises. Many women do these exercises on a regular basis and still have not regained the strength they would like to have - or reliability of the pelvic floor.

I had really good chat with a physio called Helen Keeble who is based in West Ferry/ Canary Wharf.

This is a link to the website:

http://www.physiotherapy-specialists.co.uk/physiotherapist_canary_wharf_team.htm

look under pelvic floor specialist sub heading.

She specialises in pelvic floor issues and sees women on a regular basis. She is very understanding of the problem of weak pelvic floor but very positive about the amount of work that can be done to help.

Her number is 07752 710637 or clinic is on 020 7093 3499 - she is private not NHS.

She will see if you are doing pelvic floor exercises properly (may involve a VERY QUICK internal indicator). If you are doing them properly this may show some kind of core abdominal weakness. She can then let you know the next steps forward.

One of the main things she says is about the importance of bracing the abdominals muscles when lifting/ coughing/ sneezing/ laughing etc. The abdominal muscles provide support to the pelvic floor so they must be used in daily activity.

Hope this is of interest. Sorry it is rushed as I am off to get the kids from school.

Liz Stuart www.powerpramming.co.uk

[Monkey]

And please be careful when exercising at the gym. I think things like the leg press and some abdominals exercises have really made things worse for me. Take advice from your physio.

[Goodliz]

Monkey Wrote:

-------------------------------------------------------

> And please be careful when exercising at the gym.

> I think things like the leg press and some

> abdominals exercises have really made things worse

> for me. Take advice from your physio.

You may well be doing all this but just incase: breathe out as you push legs forward on the press and also try and engage you abs (belly button to spine)

Not sure which ab exercises are making it worse but perhaps sit ups without breathing out as you come up.

Try and breathe out on the effort part of the ab exercise.

Apologies if you are doing this already and I am well off the mark. As you say, physio provde great advice.

[Audrey]

Do your PFE's standing up. Its really hard as your working against gravity, and therefore doing a lot of strengthening. It means you can't just do them while drooling over GBBO, but it does also mean your concentrating on doing them well.

[Princess]

I know this will sound a bit wierd but there's a free app called PFE that you can get for most smartphones. When my physio recommended it, I was a bit sceptical. But, it's great, I get an alert 3 times a day to remind me it's 'that' time and it works a bit like a very basic Wii fit for your pelvic floor. The excercises get harder as you feel you're getting stronger etc.

[vch]

Silly question, but how does one know whether or not their pelvic floor is in good shape?

[Princess]

Oops sorry mis read post above.

[Monkey]

I guess what I meant is exercise with someone who knows about post baby bodies like Goodliz for example. Goodliz, i am in dire need of exercise. Might call you soon.

VCh, symptoms are stress incontinence when you cough, sneeze, run etc...., sensation that "things" are "falling out" like something pushing down your vagina. Not nice!

[dulwichgirl2]

100 contractions.... That seems a lot, oh dear....

[Gooders79]

I know 100 seems a lot but if you think if your pelvic floor as the muscle it is,you can see how easily effected it will be by fatigue. By the time you've been up for a couple of hours squatting to do washing, tend to children etc before you've even picked one of them up (!) you can appreciate how tired it will be, once tired it just won't be effective. I think it's a really individual thing as well, for one person contracting in standing might be the best thing, for another side lying is the only way you can get a flicker of movement and then that's your starting point. Current recommendations are for no impact exercise for 6 months post partum and after that you should still proceed with caution if you are getting stress incontinence symptoms