I have mixed incontinence and had pelvic floor surgery, which helped a lot. Unfortunately I also struggle with constipation, which my doctor told me after surgery it was imperative to avoid. I did well for an extended period of time until I got ill and suffered an extremely bad episode of constipation. Since then, incontinence has gotten progressively worse again. I use pads daily, but have never been offered or discussed medication for the urge incontinence, which is the most bothersome. My concern would be if constipation is a side effect, it could end up causing more damage, couldn't it? I don't know if a second surgery is even an option.
At the age of 50, I was ‘lucky’ to be diagnosed with bladder cancer. Lucky because I had no symptoms, nor did I fit any of the demographics- male, older, smoker, overweight . While having an ultrasound to screen for ovarian abnormalities, my tech noticed a growth attached to the top of my bladder and recommended I see a urologist. Fortunately the growth, which was cancerous, was small, had not spread too far into the bladder wall and was easily removed surgically. I’m lucky because by the time you notice the symptoms of a bladder tumor it can be much more difficult and invasive to treat. Nearly 20 years have passed cancer free and it’s all a distant memory. Except one thing. My urologist told me to Stop holding my pee for so long. Whether I felt like I needed to or not, he suggested that I set a timer and urinate every two hours, gradually increasing to three hour intervals. Among many other pieces of advice, all of which you covered here, this is the one that had the most impact. Thank you for opening a conversation about incontinence. Sorry for rambling on for so long!
Thank you for the timer idea. After a groin catheter to insert a Stent in my heart, I has a large blood cloth in the vein where the catheter was inserted. I had much better bladder control for about 5 months until the blood clod finally dissolved with the aid of arnica oil applied several times a day. 1.5+ years later, my bladder control is worse! Has your bladder control improved since you cancer surgery during the past 20 years?
I dont think you should say you were rambling,i for one am greatful to you for sharing what you went through and now i will go to docs about myself to check i am ok ...Thankyou 🙏👍
You didn't ramble...you were GREAT and lm sending you blessings and continued good health. I'm being told l need an operation for a cyctosele IDK ,have lil trust in docs,sadly!
I had stress incontinence from my 4 pregnancies. I'd pee when sneezing and sometimes when coughing. Went to a pelvic floor specialist for therapy; she taught me how to do kegels. Now I very rarely pee when sneezing or coughing. It improved my quality of live immeasurably!
Another thing that they did not mention was that you can have incontinence if your muscles are too tight as well. I have scoliosis which leads to my piriformis muscles being too tight which causes my pelvic floor muscles to be extremely tight. I urinate about every half hour at night. It is extremely horrible and keeps me up at night. I went to therapy and it helped for about a year and a half. Now, I’m back in therapy to help with this issue. it is very frustrating and exhausting. And I was told that I will live with this for the rest of my life. 😫 it’s really interesting how the body works and how all muscles can affect other things in your body.
I'd like to mention that the video of the 2 healthcare professionals with the person on the exam table, were very weirdly smiling during an example of an exam. This was a VERY poor example and poor choice!
Could you do another video on this topic for women who've had hysterectomies? There are various scenarios with this as well. Also, a historical perspective about the difference between vaginal hysterectomy vs. Laparoscopic hysterectomy, oophorectomy, etc., and how this impacts a woman's ability to void or not. We need this knowledge! Ty.
The change in anatomy from a hysterectomy is important to cover especially in regard to incontinence and leaking . They should be covering this in this video . Surprised they missed this .
You left a BIGGIE OUT… Sacral Neuromodulation. I have an Interstim device for fecal urgency but most people get the identical thing for bladder incontinence. It’s a pacemaker that sits near the sacral nerve. The sacral nerve controls bladder and bowel function. Some people’s sacral nerve misfires, and that is what the device is for. Mine was surgically implanted by a Urogynecologyst, just like the doctor in this video. This has been the most wonderful thing for me. It’s been life changing and there are thousands of women who have gotten help from this technology and able to have a normal life again. It helps women who have been “messed up” during a difficult vaginal birth as well as other reasons. I am so sorry they did not discuss this minimally invasive procedure as an option.
Had surgery 2 weeks ago to implant Medtronic. What a relief after 40 years of searching for relief from continuing bladder leakage. Am so enraged that my primary doctor didn’t recommend this. Years of using drying pills that left me dry eyed and mouth dry, but little relief from my bladder problem.
I just started a somewhat similar, but less invasive therapy. Once a week I go and they do nerve sacral nerve stimulation through my ankle. I was waiting for her to discuss those options as well.🙁
@relsba Your primary md isn't a specialist. "Enraged"? That's a pretty angry & off the wall stance to take. Your primary has enough to worry about. It's impossible for the primary to know every alternative out there. You should have gone to a urologist for an examination & options. This surgery is a newer procedure so stop being so judgemental. I have had incontinence for years, too, & have used every prescription available. My urologist recommended this surgery about a year ago. I asked my neurologist his opinion on it & he was not crazy about the idea at all. Now that I have seen a few responses here about it, I may look into it again. But, back to my point.....stop being Enraged & just be thankful you finally got relief. Don't be a Karen.
I am 60 years old. And I have a neurotransmitter implanted. Commonly called Interstem therapy. It has helped so much with my mixed incontinence. I would recommend this to anyone suffering with incontinence.
I have POTS so mine is due to an autonomic nervous system disorder. Essentially my brain doesn’t give me the signal soon enough. Setting an alarm and going every two hours regardless of whether I have to or not doesn’t always work, especially when I’m at work and get busy. How does a neurotransmitter work?
I have 2 stims. One on the sacral nerve for bladder issues and pudendal nerve one for bowel. I got on a trial for the pudendal one in 2009. I have spinal damage following botched surgery which "tore" the nerves apart. I love my stims
@@jaeshasway it is a small chip implanted just under your skin on your backside. There's a lead that connects to your sacral nerve. It gives a small electric charge to the nerve, which reminds your pelvic floor muscles to behave properly. At least, that's how I understand it. It involves a surgery for placement and a couple small incisions. I had it done as an outpatient. Then you have a controller that you use. Once it's set, you set it and forget it. Remember it's normal to go every 2-3 hours anyway. Your Urogynecologist would probably try something less invasive first. Good luck! ❤️
I belong to an all-women support group at work and plan to share this video and/or the topic with them in our next meeting because, as you say, it's time to start talking about this and end the suffering when there are medical and non-medical alternatives to help alleviate the symptoms. Thank you for posting. Love you guys!
Great video thank you. I had a brain tumour and my incontinence is really bad. My brain does not send a signal that I need to wee until a minute or so before I need to go. I wet myself almost every time. I'm fortunate to live in England and my pads are provided free via the NHS. It's made such a difference, I feel I can go out safely now without wetting my friends couch or the chair at church and so on. Thank you for the help you're giving to so many. Blessings
I had incontinence issues for a long time am 61 yrs old. What I find to eliminate it completely , was doing squats really it eliminated my Incontinence problem just simple squats . I'm a naturalist and I always find natural approach to do everything all you have to do is spread your legs and do 50 squats only nothing else, that's what eliminated my Incontinence and strengthened my pelvis muscle and I don't have to take pills, I don't need to do any surgeries . Try it ladies you have nothing to lose. P.S. keegel exercise makes it worse so don't do them !!! 😮
Squats require you to bend your knees , I can’t do that anymore, replacement on right and left is bone on bone, I take a pill that don’t work very well. Dr.suggested Botox shots. Leary that it will freeze the bladder and I won’t be able to go
I would like her to come back and talk a little more about the surgery for stress incontinence. What it looks like, what it entails, the real nitty gritty. 🙌🏻
My aunt had a mesh placed to hold up her bladder around 12 years ago and started having problems with it and it was falling with it hanging inside and her obgyn that performed the surgery was no where to be seen. She finds there is a lawsuit for the mesh I believe they were wire she files and about 8 years ago got a settlement. She suffered and nobody would fix it but after the settlement she got it taken out.
I underwent the surgery. it helped immensely my urgent incontinence, but not the stress incontinence. My Urologist also gave me a patch to put on your stomach, to help me relax the bladder. It really helps with long car and plane trips. Thank you for outstanding & informative presentation.
I tried Hypopressive exercises after having babies because I was experiencing those issues and they are amazing life changing. They help to lift the pelvic organs besides strengthening the PF muscles. Now I became a trainer.
@@Warmfireandtea Hypopressives lower the intra abdominal pressure by performing a stomach vacuum. So you strengthen your core muscles and PF muscles without increasing the pressures on your pelvic organs. I don’t have a channel but you can look up my master trainer Trista Zinn.
@@bludaizee24 Hypopressives lower the intra abdominal pressure by performing a stomach vacuum. So you strengthen your core muscles and PF muscles without increasing the pressures on your pelvic organs. I don’t have a channel but you can look up my master trainer Trista Zinn.
74 yr old woman, had to use panty liners beginning at about 62 for some leakage. Now, I use poise pads due to having to void every couple hrs and some leakage. Avoiding the bladder thing with Docs, I have 2x shoulders to have cuffs repaired. I in 3 weeks :). Very good info here as always and ty.
I‘m 54 now, since I was in my end 30ies I‘ve got more and more problems with urinary infections. Later, in my end 40ies I started with lifting my legs every morning to strengthen my muscle in my belly, because I could‘nt hold it back very well 😮. With 52 I started with female hormone replacements because I forgot each and everything.. ..and a most welcomed side effect was that my problems with urinary infections and little incontinences went away!!! My God! I am so happy that I started with these Hormone Replacements!!!!! For many reasons! Greetings from Switzerland, Europe!
I suggest consulting with an experienced and knowledgeable chiropractor. They deal with neural pathways and understand how spinal injury in one area can affect another area. You can get a consultation, which should include x-rays, before you commit to treatment. Courses of treatment will take place over a number of visits. The manipulations are essentially retraining your musculoskeletal system to hold you in the correct position, the way it used to do pre-injury, and it takes visits over time. Depending on the long term weakness left by the injury, it may take quite a long time, but the intervals between visits may well lengthen once the area completely heals. I no longer have to visit mine, haven’t been in years, but I’d go if I experienced another injury. Oh, btw, your medical doctors will never recommend or approve of seeing a chiropractor. It is like a lot of ancient medicine - something our modern Western medical networks refuse to acknowledge the value of.
Im glad you talked about overactive bladder some as that's what I have. Eliminating soda and certain foods has helped. I had to cut back on the amount of water i was drinking and stop at 500pm. I was stopping eating at 700pm but I have found that I have to stop at 600pm. I have also found that processed foods irritate my bladder. The urogynecologist that I went to says my OAB is due to menopause. The doctor has had me use a tens unit placing the electrodes on my ankle. I think it has helped. It's all been trial and error and a number of not so good night's sleep over the past year. I still hate and its frustrating at times.
Have you tried Gemtesa yet? I was on it for a couple of years until my insurance decided it no longer covered it. The only med that didn't make me swell or screw with my blood pressure.
@@rainbowzebraunicornpegasus2962 I'm on Gemtesa; been on it for 2+ years. I've had limited success, and only with frequency, NOT urgency or ability to stop flow. It's better than Oxybutynin (anticholinergic), which I was on for 2+ years; that gave me horrible dry mouth and eyes, and led to dental problems. Myrbetriq (2nd drug of choice) is contra-indicated due to hypertension treated with beta blocker and an ARB. Had to do Gemtesa; insurance be damned. Special authorization was needed; retail value of 30 day of Gemtesa is $500. Insurance pays 100%. I have a great Uro-gynecologist; presence and position of a small rectocele means P.T exercises don't work. Uro gyn. is now awaiting general & cardio clearance from my primary care to schedule installation of nerve stimulation implant. Also tried 10 weekly in-office sessions with stimulation of pelvic nerve via electrode at ankle; negligible results before a minor brain bleed caused by a bad bonk on the head forced the end of this therapy. It took 9+ months and severe Rx adjustments to get Neurology ok after the brain bleed. I'm hoping the implanted device, with a constant stimulation pattern, will finally fix this. Good luck to you!
At age 37, after two damaging vaginal deliveries of 9+ pound babies, I had surgery for stress incontinence (and vaginal repair). It worked exceptionally well. I am now almost 76 and have started having urgency incontinence. Thank you for the overview. I learned a lot and will check out urogynecologists in my area.
I temporarily lost bladder control due to a spinal injury. I had surgery for the spine. Since then I never regained full bladder control. I get the urgency incontinence as well as the dribbling incontinence. The urgency one, one minute I don't feel like I have to go at all, then suddenly the next minute I suddenly have to go bad, and I have zero control over it then.
Same here 😢 horrible. Was never told that this could be a side effect of spinal surgery. L-4&5, S-1. Watched a chiropractor video and found out. I regret having the surgery, still have severe back pain.
@@marymiles9922 oh mine was from the injury itself, not the surgery. I had the surgery because of the injury. The first surgery just fixed the immediate issue and bought me some time. I will eventually have to have a second surgery yet to fully fix the whole issue.
A very informative video Docs! This is like the videos you've previously done for the male viewers who might be too embarrassed or insecure about talking to anyone about their issue. The sad part is when women are dismissed by their male doctors.🧐 Don't get me wrong, I've met some very good, patient and compassionate male gynecologists who are great at explaining things to patients without being condescending or dismissive. But reading through the comments, many women have faced this very problem. We're very fortunate to have doctors like you who want to educate patients and point them in the right direction! If only we all had doctors like you!👍 You spend a lot of time and effort making these videos for us! We can tell you love what you do! And we love it too! Thanks for your patience and all the work you do in helping so many!👍
I have a vesico-urethral sling that was done 28 years ago after serious damage after one of my children. It is still working great all this time later.
I have had Botox injections which helped for 3 years. I have an appointment in March to get it done again. During the process, the doctor let me watch it on the screen. I found it very interesting.
Having experienced mixed incontinence related to pelvic organ prolapse I had a mid urethral sling placed at the time I had surgery for the prolapse and it has worked perfectly. I tried a pessary first and it actually made the stress incontinence much worse. The urge incontinence continued and since I couldn’t tolerate the medications I have just had bladder Botox which seems already to be having a positive effect. Your presentation was very interesting though I was hoping you would get to these two options to treat mixed incontinence. I am so grateful for being referred to a urogynecologist who has helped me so much with these issues.
I just went through the same thing. The pessary was a nightmare. And the bladder prolapse 1:51 just kept increasing. Found an amazing uro- gynecologist near me. Went through the whole eval process. Had a repair and bladder sling. And it has been amazing.
Pelvic floor physical therapy is an amazing experience. I have found that the specialists in that field are some of the best physical therapists because they listen in a way other therapists do not.
I have urgency incontinence and am on my second sacral neurneuromodulator. I am happy to report that the sacral stimulator has helped me tremendously. I started with a Medtronic InterStim II and it and the patient support was sub par. I now have an Axiom stimulator and both the patient support and my incontinence have been greatly improved.
No it’s implanted in the muscles of your lower back in a minor outpatient surgery. You then have a small device that is attached to one of the nerves controlling your bladder. You will be given a remote control to the neural stimulator that you will be taught to use to control the strength of the electrical pulses to your bladder.
The doctor didn’t mention a neurotransmitter or Botox in the bladder. I have been having Botox injections in my bladder for four years every six months. From the first set of injections I have not worn a pad once. My incontinence started in the 3rd grade and I am now 78 and couldn’t be happier with this decision.
Years ago my dr tried all the meds, but I didn't do well with them, and they didn't help. I had a historectomy and at that time they did surgery to support the bladder, and the rectum. It helped some, as I had had a couple babies, and the 2nd one was quite large. She is now 61. Now many years later, I'm plagued with the urge incontinence, and fecal incontinence is becoming a problem. I am a normal weight, but am old, and work on strength, balance, and yes, I do the keagels when I think of them. This was a very informative video. I learned a lot.
I have mixed incontinence and I don’t empty my bladder fully. I had bladder sling surgery and the surgery changed my life. It improved so much but as the doctor said, it did not cure or solve all the issues. Keeping my weight in check is the biggest help of all.
Great video. Dr. Best did a very thorough job explaining and Dr. Z and Dr. P asked really helpful questions to draw out the information. Really informative video - thanks docs!
I had several falls in the last few years, which pinched some critical nerves. I can no longer sleep thru the nite, due to "potty breaks". Incontenence/piddle pads are now part of my wardrobe.
I would have liked to hear you talk about the bladder lift and what material is used since there has been controversy about using a mesh or has that changed.
I don't know where to begin but have a history of urgency. I went years ago to a urinalysis. He had a pessery put in me. It was horrible! I ran a high temperature & got gloves( I worked in medical field) & took it out but did go see my OBGYN very next day to see if I was alright. I've also seen my neurologist & I learned I wasn't to have it in. I've got spinal issues which it's better for me to drink fluids & stop at a certain time of day. If I don't drink pain goes in my kidney. So painful! I recently gone to my primary having my urine checked. I would listen to this video closely as it's very educational ladies. Another thumbs 👍 up video!
I have plastic mesh in my abdomen and a bladder sling (which had to be cut because it was too tight) so there is a bunch of plastic in my abdomen and I have a prolapsed bladder (after a hysterectomy) and now I do not go out because of incontinence. A surgeon injured my pancreas while trying to take out my gall bladder with a laparoscope and now I am diabetic as well. A surgeon also accidentally deflated both my lungs with CO2 he pumped into my abdomen while attempting to repair a hernia in my diaphragm. While I was being anesthetized for childbirth related surgery, I heard one doctor complaining about how inconvenient it was because he had a golf game scheduled. I have heard of doctors suffering from burnout, but what about their patients?.....I honestly believe I would be healthier, richer, and better off if I never went to any doctor at all.
Could it be the state you sought medical attention? I live near NY and made my medical appointments there because I worked in NY and it was convenient. Nowadays it's become a dangerous place making medical appointments unwise.
Like others here, I was interested to see this topic come up for female incontinence and especially with Dr. Best (my Dr.) I'm using a pessary due to a bladder prolapse but experiencing leakage/dribbling. Switching to a pessary designed to help curb the leaking. Looking forward to Wednesday aka Pessary Day which makes me laugh and tinkle. I have found Dr. Best works with you when something doesn't work out, no shaming or being annoyed. She's very kind and wants to make you comfortable. I would like to see a video on surgical options.
Great presentation, lovely Doctor in every way, I really wish to say that I wish she had warned that anticholinergic drugs have been proven in several reliable studies to cause dementia. I will not discuss my personal history, but let’s just say, I’m so pleased I found this out 3 months ago. No more of these meds for me. Love ❤️ you Docs!
Crazy timing. Going through incontinence post urethral diverticulectomy and not sure what the journey to resolve the issues is going to look like except I am taking the Mirabegron, about to start PFPT, and have an MRI coming up to rule out fistula. Your videos are so helpful!
This was a very relevant topic doctors. Thank you! I have severe urgency incontinence and a prolapsed bladder that I currently use a pessary for. Using a pessary has created other problems due to post menopausal vaginal wall atrophy. There is nothing fun about this.😢
This is an important topic and I appreciated very much that you had a female doctor with experience in this field to do the presentation. What I really didn't appreciate was the giggling, teenage boy humor from the two men. I suppose it must seem very humorous to men who don't experience childbirth or cope with the lifelong aftereffects.
After I had a Total Hysterectomy & Bladder lift I started to experience bladder issues!! My life was terrible for 2 years with this contentious!! I had surgery 2 weeks ago and I got a “sling” and it’s Amazing how better I am doing!! NO more Leakage. I have my Life back!!
I wear a pessary. I started having trouble holding my urine on my way to the bathroom. My bladder would give out and urine would run down my legs. It came on quite suddenly when I reached the age of 78. It was fitted by a uro-gynecologist. I see him every 3 months for removal and cleaning. It is made of silicone. I am so happy to wear it. It has helped me a lot. Barbara.
Tyose 🎉hings pinch. I am not going to get it removed ev 3 mo.s. Get hubbs to do it . I am not sure wether those cause uti's or just bladder dropsy ;Probly both but I sure hate those . They are dangerous,can travel up to the kidneys!
I have never had children but noticed stress incontinence since I was an older teenager. At first it happened occasionally with jumping. Not long after I started leaking during orgasm. Now it happens when I sneeze, cough, lift heavy things. I didn’t really drink a lot of caffeine until my late 20s and I rarely drink alcohol. When I turned 24 I started to have trouble emptying my bladder when I wanted to. I was able to get the stream started, but had to bear down to empty my bladder. I went to several doctors and when I explained my symptoms they all looked at me like I had three heads. I also get UTIs every time I have sex regardless of following all the rules you are supposed to follow (wiping front to back after using the toilet, voiding immediately after sex, not taking baths, wearing cotton underwear, etc.) and every time I went to the doctor for a UTI they gave me this same list of “don’ts” and acted like if I was getting UTIs I obviously wasn’t maintaining proper hygiene, which I found not only frustrating but very insulting. They did an ultrasound and they did find that I was not emptying my bladder fully. They prescribed Flomax for that which as far as I could tell did nothing. It didn’t seem like medical professionals had any answers for me and I pretty much gave up. I’m 41 now. I got so frustrated with all of this that I pretty much don’t even go to the doctor anymore because it seems like all they do is gaslight me and accuse me of being gross or stupid or both. I wish there were more doctors like you guys.
Try a detachable shower head to clean up after sex with soap and water. Wiping front to back does nothing for after sex UTIs. I am not sure baths are harmful unless the water is contaminated.
I had the bladder mesh done in 2008, wasn’t successful. 😢. I’m now 70 years young. My urologist explained that I have mixed control issues. I drink water, go to bathroom at least 3 times just from 1 glass of water. Can be exhausting. Don’t drink anything an hour or so before going to bed,up at least twice per night going pee. I participated in a study, tried meds, but they were short lived. I give up. Also was explained to me with having Ulcerative Colitis, can sometimes create pain in trying to empty out. I’ve found most GPs don’t understand nor take time to explore symptoms or send to a specialist.
@@TalkingWithDocs yes this has, thank you. I think in these years since I had the mesh done, a lot more information has been brought forward from various studies and the experience of Urologists. I’m going to see about pelvic floor physiotherapy to see if I can help improve things myself with proper training. Thank that nice Dr for spending time explaining things. Please have her back to explain even more and tell Paul to quit getting so excited that he pees his pants! 🤣🤣🤣. Can you also ask her about frequent UTIs? I go through stages where I get many infections and some are harder to clear up, especially the K-pneumonia bacteria. That one does me in.
I've had UTIs from your friend Klebsiella (2 different species in that genus), as well as E. coli. Several times. Can't tolerate the Dr's. favorite fluoroquinolone antibiotics which cause crippling and severe tendinitis in my lower legs, and I'm allergic to penicillin, so I've had to take extended runs of sulfa drugs, mostly a horse-sized monster called Bactrim. Also Macrobid. So I know about waiting. I was prescribed Methenamine in hopes of acidifying the lining of my bladder so no bad guy bacteria want to take up residence there, but the very first dose made my urine smell like formaldehyde and I had a purely coincidental brain bleed after the second dose, so no more of that vile substance. I also know about C. diff; contracted TWICE because of too many antibiotics. I'd say I empathize with you. My plumbing - both systems - is a sad joke.
I was incontinent for many months wearing nappies. Finally after a visit to the doctor and a course of strong antibiotics then a course of medium strength antibiotics my inconvenience cleared up. I am now back to wearing nickers again. Yeay!!!!! Incontinence no more.
I noticed that you used a shot of a woman engaging in an exercise that is a yoga pose - she's doing the bridge. There are studies on performing various yoga poses for incontinence. I sometimes experience urge incontinence. Since I already practice yoga regularly, I'm going to incorporate more of these poses to see if I can benefit.
Had my hips replaced 12 months ago and since then don’t have complete control of my bladder have to wear pads 24/7 as don’t know when will have accident. Great talk will go to Doc and have a chat haven’t spoken to anyone about this as embarrassed I’m 64 and haven’t had children so was horrified when this started happening.
Hi, same for me - I had no problems until I broke my hip at age 58 and had a hip replacement. Now have mixed incontinence, wear pads when I go certain places or somewhere new. Not what I envisaged for my 60s going forwards. It seems to be one of the few remaining taboos so it's good that it's talked about openly. I'm going to be a bit braver and more open myself. Good Luck.
Excellent video! I have urge incontinence. Hubby and I recently started Pilates and I found out that our instructor does “pelvic floor strengthening” therapy (Kegals). When I first learned that, I kinda joked about “Oh, I need that!” but think I will talk to her about this option.
Just fyi: if you have too much tension in your pelvic floor muscles and/or weak glutes kegels may make the problem worse. An actual pelvic floor specialist will tell you this and assess where you're at, but a pilates instructor that hasn't gone through pelvic floor training probably doesn't know that kegels aren't appropriate for everyone.
Thank you for this great video about a topic that is so common. I was wondering if you could do a talk about Lichen Sclerosis with Dr. Best. It is a condition that is more common than you think. Even as a nurse myself, I had never heard of it until I was diagnosed, as well as a friend who is also a nurse. By joining a support group on Facebook, I see how common it is and how underdiagnosed it is and how few doctors know much about it. It is another topic that we are embarrassed to talk about. Love all your videos. So informative!
I am 62 and I never really had any incontinence issues. Then one day a few years ago, I had an awful accident where I fell down my stairs at home and managed to slam down hard on my tail bone for about 8 steps. Besides breaking my tibia and fibula on my rt ankle and the fear of losing my foot, I found out after I got home from the hospital I was now incontinent. I went to a urologist who said the nerves between my bladder and brain had been damaged. He ran some tests and we discussed a neurotransmitter which I decided to go for. I had the procedure done with the implant on my left back hip. It was wonderful for about the first 8 mos., then things started to go back to the way they were before. The power is adjustable but I find it too uncomfortable to increase it much, so now I’m back in adult underwear. Before I go for my yearly check up with my urologist 4:50 , do you have any advice or suggestions?
Great discussion that I hope will bring this topic to many. Perhaps you'll branch off into POPs and the other 'life-saving' uses of the pessary. Paul, I almost developed some stress incontinence of my own, when your comment about passing long-lasting pessaries down through generations caused me to burst out laughing. Always a good time to be had with you guys, as you dispense valuable information. Good job, Dr. Best!
Great explanations. I have the stress problem. After twins and another birth I had no real problems but after a hysterectomy at 50 the stress incontinence has been issue. I noticed it with every kind of coughs/sneeze and exercise. I appreciate all the expert advice! I am going to buy a pessary and do kegle exercises correctly
After being treated for a kidney stone, I addressed my overactive bladder issue with my urologist. I participated in bladder training which helped significantly. I let up on the daily exercises and overactive happened more often... I'm back on the training program and will just have to be judicious.
EMDR can help with physical stimuli with urgency incontinence. I couldn't go to the basement to check laundry or hear the garage door go down without needing to go urgently. But if I got distracted, wow, no problem. EMDR definitely helps. This is done by psychologists and therapists trained in it.
I had a bladder sling surgically implanted about 20 years ago. It was 100% effective for about 10 years, then gradually became less so. Now it has no effect.
I’m a 75 year old woman. I’ve had incontinence for about a year. Why did I wait so long - my son died unexpectedly last January 2023. I really didn’t want to think about anything but him. So now I went for a Urodynamic test today. My issue is I have the feeling I have to urinate but once I stand up, I have seconds to make it to the bathroom. I’m using heavy incontinence pads but I do not feel secure that I could go out. Other issue, I’m constipated. I have had 1 bowel movement this week. I’m using Miralax and my urologist said to try Smooth Move Tea. I had a cup this evening. Other possible issue is I have two Spinal Cord Stimulators implanted for back pain and neuropathy in my foot. The doctor mentioned it is a possibility that the stimulator can possibly be interfering. After the Urodynamic test I was unable to void. It was only after I stood up and got to the bathroom and I urinated. My doctor said there is nothing she can do to help me. No medication nor Botox. She said to try and correct the constipation and it might improve on its own. Needless to say I was very disappointed. I hope someone can suggest something. I’ll finally start taking care of myself. I’m also overweight mainly to inactivity and pain from psoriatic arthritis. I’m on quite a bit of medication. Any help would be very much appreciated. Karen S.
Thank you for another excellent session. I have developed urinary incontinence in the past 4 or 5 years. I had a sub total hysterectomy at 40 (am 70 now) but had little problems after that. The gallbladder came out 8 years ago and since it has been a balancing act between the amount of bile flowing vs what I eat and how long between meals. Bile is rather like castor oil or some other laxative but if the type/amounts of certain fats is too much at some point then constipation results. I like intermittent fasting but too much bile and too little food in the gut = abrupt voiding. With both types of incontinence, it can be interesting. I am now practicing kegels, drinking reasonable amounts of fluids, and making pre-emptive trips to the bathroom on more of a schedule. Weight loss and more exercise are in the works but both knees were due for replacement when the pandemic started so on hold. It is helping although I still use pads/pull ups but I expect to see more improvement in managing. My family doctor had nothing to say on the matter so your videos are very helpful.
@TaKy gyno just gave ke another pessary that pinchs I can't get at to remove. Why don't they tell us about all these bladder leak helpers? There are like 33 things for it I just learned here in comments . Botox? Shots? Yikes. No wayyy.
The doctor I went to gave me two choices : botox shots or a battery in my behind with a set up to work like a pacemaker and was pushing for the battery. None of these other methods were mentioned. Thank you for this information.
Thank you for your information .You are right when you state to empty your bladder every 2 to three hrs,I prefer every 2hrs it works better.Also drinking 4 8oZ of water is sufficient, if I drink more than that ,then I am going more frequently. I believe we are overloading our bladder with too much water and maybe damaging the bladder with excessive water,but that can be answered by a nephrologist.
I have had four children and am an avid gardener, which is quite physical and have had a hysterectomy and several other surgeries!! I have had my bladder suspended two times and I still have incontinence! I wear pads but I don’t really like to, it does bother me! I really don’t know what else to do! I don’t understand what a pessary is, it sounds like that would really bother me, you didn’t really go into that too much! Thank you for this video, I’am sure it helped a lot of people, and I appreciate each of you sharing your knowledge with us!!
I use washable flannel pads. When I go out and about...I pull disposable underware over my everyday protection....just in case! I am searching for a washable alternative but haven't found an affordable product yet.
I have talked to my Dr. only to be shrugged off, and he wrote an Rx, which i didn't take because side effects were memory issues. Granted, that was 10 years ago or so. I've succumbed to wearing mattress pads 24/7! Ugh!
I have mixed incontinence with the worst being stress incontinence. I am a runner and cannot get through a run without at least a partial bladder release and sometimes the entire bladder. I was given both types of drugs you mentioned for the overactive bladder. The first relaxed my esophagus so much I couldn't swallow. The Mirabegron was OK, but not a huge improvement and since I have IBS, there were issues there. I was advised that my pelvic floor and vagina in general was very week and that, at the moment a pessary might cause me pain. I did go to 6 months of pelvic floor therapy, with only a slight improvement. I think they are recommending surgery, but since I have had 7 abdominal surgeries over the years, I am not really leaning that way. I will probably push to try a pessary, for at least my runs. I do leak many other times a day too just standing around, but nothing like when I run. Anyway, thank you for doing this segment and btw, I am one of those women who overshare with her other post-menopausal friends about what is going on with my body. 😆
Look up Uresta device. It works for me as I walk everyday for at least an hour. Was releasing urine in my walks. Now with Uresta device that has stopped and I have piece of mind.
My specialist dr. put ten injections of Botox in my bladder in her office. It helped eliminate the urge and constant leaking within three days and was great for seven months. It was super painful for me so I am being scheduled on my 8th month since having the procedure in the office, another round of botox under general anesthesia in the hospital. It has been a life saver. NO more depends.... and the irritation they cause being wet down there.I am 70 years old. I did try first, acupuncture on my ankle to send electrical up my leg to the bladder. It hurt with zero help after four months of that.
Thanks for sharing your story. I avoided going to a specialist for years because I figured I wouldn't want to do any of the serious interventions they had in mind. Finally I went and she wanted to do the Botox injections. I was going to try it once then decide if I wanted to continue since it took going every six months first for a urine test then 3 days later for the procedure. Covid popped up about then so appointments were cancelled and I haven't tried to go back. For you, even with the pain and now needing to have the procedure under general anesthesia, you seem to feel Botox treatment is worth it.
Do we know how much caffeine would be considered as generally acceptable? 1 to 2 cups of coffee per day, for example? Or are we aiming to cut it out completely? Thanks for making this topic more accessible. I will be sharing this video with a few people.
1 to cups in the morning hours. If you can eliminate caffeine, that is best. Follow it with drinking water in order to decrease the spasms caused by the caffeine effects on the bladder.
Diagnosed with „Mixed Incontinence“ Uro-GYN able to administer Botox injections to bladder under anesthesia)once general, once local) ~ both of which helped immensely for nearly a year. This was covered by health insurance. Risk of loss of ability to urinate & need to self-catheterize. Pandemic disrupted my treatment schedule. Really want to resume. Currently having private Pilates lessons for this symptom. Thank you for wonderful & informative video clip
Awesome info and presentation. Invaluable to me since I’ve had incontinence since my mid-forties. Do most uro-gyn understand pessaries? I’m 78 and no doctor has mentioned it. Again, thank you. ❤❤❤
I wish more doctors would explain this instead of just brushing it off as post baby issues….thanks for sharing DOCS x
Our pleasure!
😊😊😊😊😊😊
I’ve never had a baby and have had this problem since I was in my 30’s.
I have mixed incontinence and had pelvic floor surgery, which helped a lot. Unfortunately I also struggle with constipation, which my doctor told me after surgery it was imperative to avoid. I did well for an extended period of time until I got ill and suffered an extremely bad episode of constipation. Since then, incontinence has gotten progressively worse again. I use pads daily, but have never been offered or discussed medication for the urge incontinence, which is the most bothersome. My concern would be if constipation is a side effect, it could end up causing more damage, couldn't it? I don't know if a second surgery is even an option.
I wish more doctors would explain this instead of just brushing it off and being insensitive saying it's age related issues.
Live, Love, Laugh, Leak
😂😂
😊😊9
Awesome❤❤😊😊
I like this ...a lot😄
Sneeze.
At the age of 50, I was ‘lucky’ to be diagnosed with bladder cancer. Lucky because I had no symptoms, nor did I fit any of the demographics- male, older, smoker, overweight . While having an ultrasound to screen for ovarian abnormalities, my tech noticed a growth attached to the top of my bladder and recommended I see a urologist. Fortunately the growth, which was cancerous, was small, had not spread too far into the bladder wall and was easily removed surgically. I’m lucky because by the time you notice the symptoms of a bladder tumor it can be much more difficult and invasive to treat.
Nearly 20 years have passed cancer free and it’s all a distant memory. Except one thing. My urologist told me to Stop holding my pee for so long. Whether I felt like I needed to or not, he suggested that I set a timer and urinate every two hours, gradually increasing to three hour intervals. Among many other pieces of advice, all of which you covered here, this is the one that had the most impact. Thank you for opening a conversation about incontinence.
Sorry for rambling on for so long!
Thank you for the timer idea. After a groin catheter to insert a Stent in my heart, I has a large blood cloth in the vein where the catheter was inserted. I had much better bladder control for about 5 months until the blood clod finally dissolved with the aid of arnica oil applied several times a day. 1.5+ years later, my bladder control is worse!
Has your bladder control improved since you cancer surgery during the past 20 years?
I dont think you should say you were rambling,i for one am greatful to you for sharing what you went through and now i will go to docs about myself to check i am ok ...Thankyou 🙏👍
I agree, she can ramble anytime. What she expressed is important to know! 😊
You didn't ramble...you were GREAT and lm sending you blessings and continued good health. I'm being told l need an operation for a cyctosele IDK ,have lil trust in docs,sadly!
Thank you for sharing your experience. This is beneficial.
I had stress incontinence from my 4 pregnancies. I'd pee when sneezing and sometimes when coughing. Went to a pelvic floor specialist for therapy; she taught me how to do kegels. Now I very rarely pee when sneezing or coughing. It improved my quality of live immeasurably!
That’s awesome!❤
Thank you for talking about this issue with care and compassion and not with a bunch of jokes.
Absolutely our pleasure
Amen!
Another thing that they did not mention was that you can have incontinence if your muscles are too tight as well. I have scoliosis which leads to my piriformis muscles being too tight which causes my pelvic floor muscles to be extremely tight. I urinate about every half hour at night. It is extremely horrible and keeps me up at night. I went to therapy and it helped for about a year and a half. Now, I’m back in therapy to help with this issue. it is very frustrating and exhausting. And I was told that I will live with this for the rest of my life. 😫 it’s really interesting how the body works and how all muscles can affect other things in your body.
I'd like to mention that the video of the 2 healthcare professionals with the person on the exam table, were very weirdly smiling during an example of an exam. This was a VERY poor example and poor choice!
@@sheilasmith1109 the one on right always laughs 😮
Thank you so much. I have had bladder problem for over 10 years and received more knowledge in this video than ever. Thanks again
I agree, thank you for the information. I had the sling and still have problems
Could you do another video on this topic for women who've had hysterectomies? There are various scenarios with this as well. Also, a historical perspective about the difference between vaginal hysterectomy vs. Laparoscopic hysterectomy, oophorectomy, etc., and how this impacts a woman's ability to void or not. We need this knowledge! Ty.
Yes, I second this idea!
Yes this needs to be discussed
The change in anatomy from a hysterectomy is important to cover especially in regard to incontinence and leaking . They should be covering this in this video . Surprised they missed this .
Yes!!
This lady doctor should start her own RUclips channel. It would be a BIG hit. This is a topic that is an epidemic & women are suffering silently.
We agree she is awesome
She is so articulate!
You left a BIGGIE OUT…
Sacral Neuromodulation. I have an Interstim device for fecal urgency but most people get the identical thing for bladder incontinence. It’s a pacemaker that sits near the sacral nerve. The sacral nerve controls bladder and bowel function. Some people’s sacral nerve misfires, and that is what the device is for. Mine was surgically implanted by a Urogynecologyst, just like the doctor in this video. This has been the most wonderful thing for me. It’s been life changing and there are thousands of women who have gotten help from this technology and able to have a normal life again. It helps women who have been “messed up” during a difficult vaginal birth as well as other reasons. I am so sorry they did not discuss this minimally invasive procedure as an option.
Never heard of this before. SIRI did the research for me 😊 so interesting. Thx
Had surgery 2 weeks ago to implant Medtronic. What a relief after 40 years of searching for relief from continuing bladder leakage. Am so enraged that my primary doctor didn’t recommend this. Years of using drying pills that left me dry eyed and mouth dry, but little relief from my bladder problem.
I just started a somewhat similar, but less invasive therapy.
Once a week I go and they do nerve sacral nerve stimulation through my ankle. I was waiting for her to discuss those options as well.🙁
I have one too! It's fantastic!
@relsba Your primary md isn't a specialist. "Enraged"? That's a pretty angry & off the wall stance to take. Your primary has enough to worry about. It's impossible for the primary to know every alternative out there. You should have gone to a urologist for an examination & options. This surgery is a newer procedure so stop being so judgemental. I have had incontinence for years, too, & have used every prescription available. My urologist recommended this surgery about a year ago. I asked my neurologist his opinion on it & he was not crazy about the idea at all. Now that I have seen a few responses here about it, I may look into it again. But, back to my point.....stop being Enraged & just be thankful you finally got relief. Don't be a Karen.
A very clear summary of the condition(s). Could you do a 'part two', discussing related surgical procedures, (such as bladder lift) and also prolapse?
Sling after cancer total hysterectomy made incontinence worse. Need help.
I am 60 years old. And I have a neurotransmitter implanted. Commonly called Interstem therapy. It has helped so much with my mixed incontinence. I would recommend this to anyone suffering with incontinence.
unfortunately didn't work for me
I have an interstim too! Love it. Totally worth it.
I have POTS so mine is due to an autonomic nervous system disorder. Essentially my brain doesn’t give me the signal soon enough. Setting an alarm and going every two hours regardless of whether I have to or not doesn’t always work, especially when I’m at work and get busy. How does a neurotransmitter work?
I have 2 stims. One on the sacral nerve for bladder issues and pudendal nerve one for bowel. I got on a trial for the pudendal one in 2009. I have spinal damage following botched surgery which "tore" the nerves apart. I love my stims
@@jaeshasway it is a small chip implanted just under your skin on your backside. There's a lead that connects to your sacral nerve. It gives a small electric charge to the nerve, which reminds your pelvic floor muscles to behave properly. At least, that's how I understand it. It involves a surgery for placement and a couple small incisions. I had it done as an outpatient. Then you have a controller that you use. Once it's set, you set it and forget it. Remember it's normal to go every 2-3 hours anyway. Your Urogynecologist would probably try something less invasive first. Good luck! ❤️
I belong to an all-women support group at work and plan to share this video and/or the topic with them in our next meeting because, as you say, it's time to start talking about this and end the suffering when there are medical and non-medical alternatives to help alleviate the symptoms. Thank you for posting. Love you guys!
Great video thank you. I had a brain tumour and my incontinence is really bad. My brain does not send a signal that I need to wee until a minute or so before I need to go. I wet myself almost every time. I'm fortunate to live in England and my pads are provided free via the NHS. It's made such a difference, I feel I can go out safely now without wetting my friends couch or the chair at church and so on. Thank you for the help you're giving to so many. Blessings
I had incontinence issues for a long time am 61 yrs old. What I find to eliminate it completely , was doing squats really it eliminated my Incontinence problem just simple squats . I'm a naturalist and I always find natural approach to do everything all you have to do is spread your legs and do 50 squats only nothing else, that's what eliminated my Incontinence and strengthened my pelvis muscle and I don't have to take pills, I don't need to do any surgeries . Try it ladies you have nothing to lose. P.S. keegel exercise makes it worse so don't do them !!! 😮
Squats require you to bend your knees , I can’t do that anymore, replacement on right and left is bone on bone, I take a pill that don’t work very well. Dr.suggested Botox shots. Leary that it will freeze the bladder and I won’t be able to go
I’m going to try
U can't do that when you're old and creeky.... Back too worn out.
What works for you don't work for everyone. So telling someone kegel doesn't work abd you are not a doctor is bad advice. Do what works for you
I would like her to come back and talk a little more about the surgery for stress incontinence. What it looks like, what it entails, the real nitty gritty. 🙌🏻
Everyone I've talked to that have had had these surgeries regret it on every level.
@@AlbesiLentuh, oh. This needs to be explained.
@@AlbesiLentI don't regret it at all.
10:08 😅😅😅
My aunt had a mesh placed to hold up her bladder around 12 years ago and started having problems with it and it was falling with it hanging inside and her obgyn that performed the surgery was no where to be seen. She finds there is a lawsuit for the mesh I believe they were wire she files and about 8 years ago got a settlement. She suffered and nobody would fix it but after the settlement she got it taken out.
I underwent the surgery. it helped immensely my urgent incontinence, but not the stress incontinence. My Urologist also gave me a patch to put on your stomach, to help me relax the bladder. It really helps with long car and plane trips. Thank you for outstanding & informative presentation.
My problems disappeared when I started squating to pee ..huge difference.no more peeing every 10 minutes
Thanks for this info.
May I asked the name of the patch please
11:03
Is the patch otc or rx? Whats it called
I tried Hypopressive exercises after having babies because I was experiencing those issues and they are amazing life changing. They help to lift the pelvic organs besides strengthening the PF muscles. Now I became a trainer.
Excellent.
Do you make videos on RUclips? If you do I'll totally subscribe!
What is that? Not isolating the pelvic muscles?
@@Warmfireandtea Hypopressives lower the intra abdominal pressure by performing a stomach vacuum. So you strengthen your core muscles and PF muscles without increasing the pressures on your pelvic organs. I don’t have a channel but you can look up my master trainer Trista Zinn.
@@bludaizee24 Hypopressives lower the intra abdominal pressure by performing a stomach vacuum. So you strengthen your core muscles and PF muscles without increasing the pressures on your pelvic organs. I don’t have a channel but you can look up my master trainer Trista Zinn.
Been waiting for doctors to explain this issue Thank You 🙏🏼 all so much for this information ❤!
You are so welcome!
THANK YOU so much. I am going to a urologist for the first time on Monday for incontinence.
74 yr old woman, had to use panty liners beginning at about 62 for some leakage. Now, I use poise pads due to having to void every couple hrs and some leakage. Avoiding the bladder thing with Docs, I have 2x shoulders to have cuffs repaired. I in 3 weeks :). Very good info here as always and ty.
Welcome. Maybe some of the non-operative treatments can be of assistance.
I‘m 54 now, since I was in my end 30ies I‘ve got more and more problems with urinary infections. Later, in my end 40ies I started with lifting my legs every morning to strengthen my muscle in my belly, because I could‘nt hold it back very well 😮. With 52 I started with female hormone replacements because I forgot each and everything.. ..and a most welcomed side effect was that my problems with urinary infections and little incontinences went away!!! My God! I am so happy that I started with these Hormone Replacements!!!!! For many reasons! Greetings from Switzerland, Europe!
Wow that's awesome. Thanks for sharing
Me too!
I suggest consulting with an experienced and knowledgeable chiropractor. They deal with neural pathways and understand how spinal injury in one area can affect another area. You can get a consultation, which should include x-rays, before you commit to treatment. Courses of treatment will take place over a number of visits. The manipulations are essentially retraining your musculoskeletal system to hold you in the correct position, the way it used to do pre-injury, and it takes visits over time. Depending on the long term weakness left by the injury, it may take quite a long time, but the intervals between visits may well lengthen once the area completely heals. I no longer have to visit mine, haven’t been in years, but I’d go if I experienced another injury. Oh, btw, your medical doctors will never recommend or approve of seeing a chiropractor. It is like a lot of ancient medicine - something our modern Western medical networks refuse to acknowledge the value of.
😮
Im glad you talked about overactive bladder some as that's what I have. Eliminating soda and certain foods has helped. I had to cut back on the amount of water i was drinking and stop at 500pm. I was stopping eating at 700pm but I have found that I have to stop at 600pm. I have also found that processed foods irritate my bladder. The urogynecologist that I went to says my OAB is due to menopause. The doctor has had me use a tens unit placing the electrodes on my ankle. I think it has helped. It's all been trial and error and a number of not so good night's sleep over the past year. I still hate and its frustrating at times.
Have you tried Gemtesa yet? I was on it for a couple of years until my insurance decided it no longer covered it. The only med that didn't make me swell or screw with my blood pressure.
@@rainbowzebraunicornpegasus2962 I'm on Gemtesa; been on it for 2+ years. I've had limited success, and only with frequency, NOT urgency or ability to stop flow. It's better than Oxybutynin (anticholinergic), which I was on for 2+ years; that gave me horrible dry mouth and eyes, and led to dental problems. Myrbetriq (2nd drug of choice) is contra-indicated due to hypertension treated with beta blocker and an ARB. Had to do Gemtesa; insurance be damned. Special authorization was needed; retail value of 30 day of Gemtesa is $500. Insurance pays 100%. I have a great Uro-gynecologist; presence and position of a small rectocele means P.T exercises don't work. Uro gyn. is now awaiting general & cardio clearance from my primary care to schedule installation of nerve stimulation implant. Also tried 10 weekly in-office sessions with stimulation of pelvic nerve via electrode at ankle; negligible results before a minor brain bleed caused by a bad bonk on the head forced the end of this therapy. It took 9+ months and severe Rx adjustments to get Neurology ok after the brain bleed. I'm hoping the implanted device, with a constant stimulation pattern, will finally fix this. Good luck to you!
At age 37, after two damaging vaginal deliveries of 9+ pound babies, I had surgery for stress incontinence (and vaginal repair). It worked exceptionally well. I am now almost 76 and have started having urgency incontinence. Thank you for the overview. I learned a lot and will check out urogynecologists in my area.
So glad we could help.
I temporarily lost bladder control due to a spinal injury.
I had surgery for the spine.
Since then I never regained full bladder control.
I get the urgency incontinence as well as the dribbling incontinence.
The urgency one, one minute I don't feel like I have to go at all, then suddenly the next minute I suddenly have to go bad, and I have zero control over it then.
Same here 😢 horrible. Was never told that this could be a side effect of spinal surgery. L-4&5, S-1. Watched a chiropractor video and found out. I regret having the surgery, still have severe back pain.
@@marymiles9922 oh mine was from the injury itself, not the surgery.
I had the surgery because of the injury.
The first surgery just fixed the immediate issue and bought me some time.
I will eventually have to have a second surgery yet to fully fix the whole issue.
@@carriehollyland3596 I hope your next surgery works!
I had the exact same procedure and the same problem with incontinence 😢@@marymiles9922
I'm wondering, based on your comment, if you had / have Cauda Equina Syndrome?
A very informative video Docs!
This is like the videos you've previously done for the male viewers who might be too embarrassed or insecure about talking to anyone about their issue.
The sad part is when women are dismissed by their male doctors.🧐
Don't get me wrong, I've met some very good, patient and compassionate male gynecologists who are great at explaining things to patients without being condescending or dismissive. But reading through the comments, many women have faced this very problem.
We're very fortunate to have doctors like you who want to educate patients and point them in the right direction! If only we all had doctors like you!👍
You spend a lot of time and effort making these videos for us! We can tell you love what you do! And we love it too!
Thanks for your patience and all the work you do in helping so many!👍
I have a vesico-urethral sling that was done 28 years ago after serious damage after one of my children. It is still working great all this time later.
What is that?
I have had Botox injections which helped for 3 years. I have an appointment in March to get it done again. During the process, the doctor let me watch it on the screen. I found it very interesting.
Thank you for sharing. I am having the same procedure next month
Botox didn’t work well for me. I couldn’t go so I ended up with a lot of UTI’s.
@@DeeDee4always Baking soda in water-hold your nose, and unsweetened cranberry help. The acidity causes pain. I found baking soda helps right away.
Having experienced mixed incontinence related to pelvic organ prolapse I had a mid urethral sling placed at the time I had surgery for the prolapse and it has worked perfectly. I tried a pessary first and it actually made the stress incontinence much worse. The urge incontinence continued and since I couldn’t tolerate the medications I have just had bladder Botox which seems already to be having a positive effect. Your presentation was very interesting though I was hoping you would get to these two options to treat mixed incontinence. I am so grateful for being referred to a urogynecologist who has helped me so much with these issues.
I just went through the same thing. The pessary was a nightmare. And the bladder prolapse 1:51 just kept increasing.
Found an amazing uro- gynecologist near me.
Went through the whole eval process.
Had a repair and bladder sling. And it has been amazing.
Pelvic floor physical therapy is an amazing experience. I have found that the specialists in that field are some of the best physical therapists because they listen in a way other therapists do not.
Occupational Therapist also teach pelvic floor exercises. I was trained to teach, "Beyond Kegels." Works great!
I have urgency incontinence and am on my second sacral neurneuromodulator. I am happy to report that the sacral stimulator has helped me tremendously. I started with a Medtronic InterStim II and it and the patient support was sub par. I now have an Axiom stimulator and both the patient support and my incontinence have been greatly improved.
How does it work? Is it in the v jj?
No it’s implanted in the muscles of your lower back in a minor outpatient surgery. You then have a small device that is attached to one of the nerves controlling your bladder. You will be given a remote control to the neural stimulator that you will be taught to use to control the strength of the electrical pulses to your bladder.
The doctor didn’t mention a neurotransmitter or Botox in the bladder. I have been having Botox injections in my bladder for four years every six months. From the first set of injections I have not worn a pad once. My incontinence started in the 3rd grade and I am now 78 and couldn’t be happier with this decision.
Very nice
How often do you have to get injections? Why not mesh sling?
Years ago my dr tried all the meds, but I didn't do well with them, and they didn't help. I had a historectomy and at that time they did surgery to support the bladder, and the rectum. It helped some, as I had had a couple babies, and the 2nd one was quite large. She is now 61. Now many years later, I'm plagued with the urge incontinence, and fecal incontinence is becoming a problem. I am a normal weight, but am old, and work on strength, balance, and yes, I do the keagels when I think of them. This was a very informative video. I learned a lot.
You boys are wonderful, thank you for bringing this subject up, thank you to Dr. Best for sharing her expertise
I have mixed incontinence and I don’t empty my bladder fully. I had bladder sling surgery and the surgery changed my life. It improved so much but as the doctor said, it did not cure or solve all the issues. Keeping my weight in check is the biggest help of all.
This is a wonderful topic to discuss. I have never got such great information. Thanks to all of you.
Our pleasure! Hope it helps lots of people !
From the female
Great video. Dr. Best did a very thorough job explaining and Dr. Z and Dr. P asked really helpful questions to draw out the information. Really informative video - thanks docs!
GREAT TOPIC TALK MORE ABOUT THIS ISSUE
I had several falls in the last few years, which pinched some critical nerves. I can no longer sleep thru the nite, due to "potty breaks". Incontenence/piddle pads are now part of my wardrobe.
I would have liked to hear you talk about the bladder lift and what material is used since there has been controversy about using a mesh or has that changed.
I pee when I stand , I pee when I walk , I pee when I sneeze , I pee when I cough , I'm pee g when I'm trying to sit down to pee
Very informative! Thanks for covering this problem!!
Thank you so much for addressing this important issue. You are the greatest!
I don't know where to begin but have a history of urgency. I went years ago to a urinalysis. He had a pessery put in me. It was horrible! I ran a high temperature & got gloves( I worked in medical field) & took it out but did go see my OBGYN very next day to see if I was alright. I've also seen my neurologist & I learned I wasn't to have it in. I've got spinal issues which it's better for me to drink fluids & stop at a certain time of day. If I don't drink pain goes in my kidney. So painful! I recently gone to my primary having my urine checked. I would listen to this video closely as it's very educational ladies. Another thumbs 👍 up video!
This channel
I have plastic mesh in my abdomen and a bladder sling (which had to be cut because it was too tight) so there is a bunch of plastic in my abdomen and I have a prolapsed bladder (after a hysterectomy) and now I do not go out because of incontinence. A surgeon injured my pancreas while trying to take out my gall bladder with a laparoscope and now I am diabetic as well. A surgeon also accidentally deflated both my lungs with CO2 he pumped into my abdomen while attempting to repair a hernia in my diaphragm. While I was being anesthetized for childbirth related surgery, I heard one doctor complaining about how inconvenient it was because he had a golf game scheduled. I have heard of doctors suffering from burnout, but what about their patients?.....I honestly believe I would be healthier, richer, and better off if I never went to any doctor at all.
We are so sorry to hear of the litany of difficulty you have had. All doctors are not like that and we hope you find the help you need and deserve
Could it be the state you sought medical attention? I live near NY and made my medical appointments there because I worked in NY and it was convenient. Nowadays it's become a dangerous place making medical appointments unwise.
Very informative! I need to be more consistent in my exercises! This video helps. Thankyou ... all 3 docs!
This was awesome. Why don't docs ask you as part of every health exam if you have this issue? Thank you!!!
You need to speak up re: any issues.
It's on rhe list they have u ck.
Thank you so much for all your videos, they are so helpful!
Glad you like them!
Like others here, I was interested to see this topic come up for female incontinence and especially with Dr. Best (my Dr.) I'm using a pessary due to a bladder prolapse but experiencing leakage/dribbling. Switching to a pessary designed to help curb the leaking. Looking forward to Wednesday aka Pessary Day which makes me laugh and tinkle. I have found Dr. Best works with you when something doesn't work out, no shaming or being annoyed. She's very kind and wants to make you comfortable. I would like to see a video on surgical options.
Great presentation, lovely Doctor in every way, I really wish to say that I wish she had warned that anticholinergic drugs have been proven in several reliable studies to cause dementia. I will not discuss my personal history, but let’s just say, I’m so pleased I found this out 3 months ago. No more of these meds for me.
Love ❤️ you Docs!
i hope she would come back to talk about the bladder sling and bladder mesh surgery for stress incontinence. thx.
I have had 2 both failed in 6 months. So sad. Was great well it lasted
Mesh did not work for me!
Mesh is scary. It gets into the tissue ,cuts it.
I thought they stopped using it.
Crazy timing. Going through incontinence post urethral diverticulectomy and not sure what the journey to resolve the issues is going to look like except I am taking the Mirabegron, about to start PFPT, and have an MRI coming up to rule out fistula. Your videos are so helpful!
My urologist explains everything. Shout out to Dr. Salva in USA.
This was a very relevant topic doctors. Thank you! I have severe urgency incontinence and a prolapsed bladder that I currently use a pessary for. Using a pessary has created other problems due to post menopausal vaginal wall atrophy. There is nothing fun about this.😢
Another reason to take hrt.
I always have a good laugh with you guys 😂😂 . Always very good info , we need more Drs like you . God 🙏
Doing our best to be informative, but also lighthearted. We never intend to make fun of anything, but rather just show the lighter side.
@@TalkingWithDocs- you Docs are doing a great job. Thank you so much for all your info🇬🇧👏🙏🙋🏻♀️👍🏻
this female dr is awesome
This is an important topic and I appreciated very much that you had a female doctor with experience in this field to do the presentation. What I really didn't appreciate was the giggling, teenage boy humor from the two men. I suppose it must seem very humorous to men who don't experience childbirth or cope with the lifelong aftereffects.
Iagree
After I had a Total Hysterectomy & Bladder lift I started to experience bladder issues!!
My life was terrible for 2 years with this contentious!!
I had surgery 2 weeks ago and I got a “sling” and it’s Amazing how better I am
doing!!
NO more Leakage. I have my Life back!!
I wear a pessary. I started having trouble holding my urine on my way to the bathroom. My bladder would give out and urine would run down my legs. It came on quite suddenly when I reached the age of 78. It was fitted by a uro-gynecologist. I see him every 3 months for removal and cleaning. It is made of silicone. I am so happy to wear it. It has helped me a lot. Barbara.
Tyose 🎉hings pinch. I am not going to get it removed ev 3 mo.s. Get hubbs to do it . I am not sure wether those cause uti's or just bladder dropsy ;Probly both but I sure hate those . They are dangerous,can travel up to the kidneys!
I have never had children but noticed stress incontinence since I was an older teenager. At first it happened occasionally with jumping. Not long after I started leaking during orgasm. Now it happens when I sneeze, cough, lift heavy things. I didn’t really drink a lot of caffeine until my late 20s and I rarely drink alcohol. When I turned 24 I started to have trouble emptying my bladder when I wanted to. I was able to get the stream started, but had to bear down to empty my bladder. I went to several doctors and when I explained my symptoms they all looked at me like I had three heads. I also get UTIs every time I have sex regardless of following all the rules you are supposed to follow (wiping front to back after using the toilet, voiding immediately after sex, not taking baths, wearing cotton underwear, etc.) and every time I went to the doctor for a UTI they gave me this same list of “don’ts” and acted like if I was getting UTIs I obviously wasn’t maintaining proper hygiene, which I found not only frustrating but very insulting. They did an ultrasound and they did find that I was not emptying my bladder fully. They prescribed Flomax for that which as far as I could tell did nothing. It didn’t seem like medical professionals had any answers for me and I pretty much gave up. I’m 41 now. I got so frustrated with all of this that I pretty much don’t even go to the doctor anymore because it seems like all they do is gaslight me and accuse me of being gross or stupid or both. I wish there were more doctors like you guys.
So sorry to hear this. Hope some of this content can be of use. You are not alone!
Try a detachable shower head to clean up after sex with soap and water. Wiping front to back does nothing for after sex UTIs. I am not sure baths are harmful unless the water is contaminated.
I had the bladder mesh done in 2008, wasn’t successful. 😢. I’m now 70 years young. My urologist explained that I have mixed control issues. I drink water, go to bathroom at least 3 times just from 1 glass of water. Can be exhausting. Don’t drink anything an hour or so before going to bed,up at least twice per night going pee. I participated in a study, tried meds, but they were short lived. I give up. Also was explained to me with having Ulcerative Colitis, can sometimes create pain in trying to empty out. I’ve found most GPs don’t understand nor take time to explore symptoms or send to a specialist.
Sorry to hear that. Hopefully this was helpful
@@TalkingWithDocs yes this has, thank you. I think in these years since I had the mesh done, a lot more information has been brought forward from various studies and the experience of Urologists. I’m going to see about pelvic floor physiotherapy to see if I can help improve things myself with proper training. Thank that nice Dr for spending time explaining things. Please have her back to explain even more and tell Paul to quit getting so excited that he pees his pants! 🤣🤣🤣. Can you also ask her about frequent UTIs? I go through stages where I get many infections and some are harder to clear up, especially the K-pneumonia bacteria. That one does me in.
I've had UTIs from your friend Klebsiella (2 different species in that genus), as well as E. coli. Several times. Can't tolerate the Dr's. favorite fluoroquinolone antibiotics which cause crippling and severe tendinitis in my lower legs, and I'm allergic to penicillin, so I've had to take extended runs of sulfa drugs, mostly a horse-sized monster called Bactrim. Also Macrobid. So I know about waiting. I was prescribed Methenamine in hopes of acidifying the lining of my bladder so no bad guy bacteria want to take up residence there, but the very first dose made my urine smell like formaldehyde and I had a purely coincidental brain bleed after the second dose, so no more of that vile substance. I also know about C. diff; contracted TWICE because of too many antibiotics. I'd say I empathize with you. My plumbing - both systems - is a sad joke.
Dr Best is excellent, great explanation & information! Thanks for bringing her on!
This was a great video, and I thank you for it. Can you please do a video on interstitial cystitis?
Great suggestion! Will add it to the list for sure
@@TalkingWithDocs Thank you!
I was incontinent for many months wearing nappies. Finally after a visit to the doctor and a course of strong antibiotics then a course of medium strength antibiotics my inconvenience cleared up. I am now back to wearing nickers again. Yeay!!!!! Incontinence no more.
Makes no sense. It is not caused by an infection .
I noticed that you used a shot of a woman engaging in an exercise that is a yoga pose - she's doing the bridge. There are studies on performing various yoga poses for incontinence.
I sometimes experience urge incontinence. Since I already practice yoga regularly, I'm going to incorporate more of these poses to see if I can benefit.
Had my hips replaced 12 months ago and since then don’t have complete control of my bladder have to wear pads 24/7 as don’t know when will have accident. Great talk will go to Doc and have a chat haven’t spoken to anyone about this as embarrassed I’m 64 and haven’t had children so was horrified when this started happening.
Hi, same for me - I had no problems until I broke my hip at age 58 and had a hip replacement. Now have mixed incontinence, wear pads when I go certain places or somewhere new. Not what I envisaged for my 60s going forwards. It seems to be one of the few remaining taboos so it's good that it's talked about openly. I'm going to be a bit braver and more open myself. Good Luck.
Don't be embarrassed dear heart! Just talk with your doctor! Or if needed get a 2nd opinion!🌹
Excellent video! I have urge incontinence. Hubby and I recently started Pilates and I found out that our instructor does “pelvic floor strengthening” therapy (Kegals). When I first learned that, I kinda joked about “Oh, I need that!” but think I will talk to her about this option.
Just fyi: if you have too much tension in your pelvic floor muscles and/or weak glutes kegels may make the problem worse. An actual pelvic floor specialist will tell you this and assess where you're at, but a pilates instructor that hasn't gone through pelvic floor training probably doesn't know that kegels aren't appropriate for everyone.
Some women those muscles are so damaged they only contract a little when they sqeeze. So nothing. No help at all
Thank you for this great video about a topic that is so common. I was wondering if you could do a talk about Lichen Sclerosis with Dr. Best. It is a condition that is more common than you think. Even as a nurse myself, I had never heard of it until I was diagnosed, as well as a friend who is also a nurse. By joining a support group on Facebook, I see how common it is and how underdiagnosed it is and how few doctors know much about it. It is another topic that we are embarrassed to talk about.
Love all your videos. So informative!
My sister has that. My gyno said it's important to treat it to slow or stop it from worsening. Sorry you're dealing with this.
I had this problem and started to do Pilate and with this exercise I have solve my problem
I am 62 and I never really had any incontinence issues. Then one day a few years ago, I had an awful accident where I fell down my stairs at home and managed to slam down hard on my tail bone for about 8 steps. Besides breaking my tibia and fibula on my rt ankle and the fear of losing my foot, I found out after I got home from the hospital I was now incontinent. I went to a urologist who said the nerves between my bladder and brain had been damaged. He ran some tests and we discussed a neurotransmitter which I decided to go for. I had the procedure done with the implant on my left back hip. It was wonderful for about the first 8 mos., then things started to go back to the way they were before. The power is adjustable but I find it too uncomfortable to increase it much, so now I’m back in adult underwear. Before I go for my yearly check up with my urologist 4:50 , do you have any advice or suggestions?
How aWful for u
Great discussion that I hope will bring this topic to many. Perhaps you'll branch off into POPs and the other 'life-saving' uses of the pessary. Paul, I almost developed some stress incontinence of my own, when your comment about passing long-lasting pessaries down through generations caused me to burst out laughing. Always a good time to be had with you guys, as you dispense valuable information. Good job, Dr. Best!
Great explanations. I have the stress problem. After twins and another birth I had no real problems but after a hysterectomy at 50 the stress incontinence has been issue. I noticed it with every kind of coughs/sneeze and exercise. I appreciate all the expert advice! I am going to buy a pessary and do kegle exercises correctly
After being treated for a kidney stone, I addressed my overactive bladder issue with my urologist. I participated in bladder training which helped significantly. I let up on the daily exercises and overactive happened more often... I'm back on the training program and will just have to be judicious.
Another great info session, Docs.
EMDR can help with physical stimuli with urgency incontinence. I couldn't go to the basement to check laundry or hear the garage door go down without needing to go urgently. But if I got distracted, wow, no problem. EMDR definitely helps. This is done by psychologists and therapists trained in it.
It would help with the psychological component but not the mechanical portion
EMDR is brilliant for PTSD. I know veterans that have been helped with it.
Putting my key in the front door always triggers my urgency.😂
I had a bladder sling surgically implanted about 20 years ago. It was 100% effective for about 10 years, then gradually became less so. Now it has no effect.
I’m a 75 year old woman. I’ve had incontinence for about a year. Why did I wait so long - my son died unexpectedly last January 2023. I really didn’t want to think about anything but him. So now I went for a Urodynamic test today. My issue is I have the feeling I have to urinate but once I stand up, I have seconds to make it to the bathroom. I’m using heavy incontinence pads but I do not feel secure that I could go out. Other issue, I’m constipated. I have had 1 bowel movement this week. I’m using Miralax and my urologist said to try Smooth Move Tea. I had a cup this evening. Other possible issue is I have two Spinal Cord Stimulators implanted for back pain and neuropathy in my foot. The doctor mentioned it is a possibility that the stimulator can possibly be interfering. After the Urodynamic test I was unable to void. It was only after I stood up and got to the bathroom and I urinated. My doctor said there is nothing she can do to help me. No medication nor Botox. She said to try and correct the constipation and it might improve on its own. Needless to say I was very disappointed. I hope someone can suggest something. I’ll finally start taking care of myself. I’m also overweight mainly to inactivity and pain from psoriatic arthritis. I’m on quite a bit of medication. Any help would be very much appreciated. Karen S.
Try mineral oil for the constipation. 1 tbsp twice a day
If you are constipated, take magnesium. It will help.
@@RG-hf4et.
So do prunes and they help bones too!
Thanks Docs. I have had urgency for years and have taken Mybectric which really helps me.
Thank you for your explanations about urinary incontinence! This is a fascinating discussion with options to help reduce incontinence.
Hope it helps a lot of women
This doctor is very knowledgeable.
Thank you for another excellent session. I have developed urinary incontinence in the past 4 or 5 years. I had a sub total hysterectomy at 40 (am 70 now) but had little problems after that. The gallbladder came out 8 years ago and since it has been a balancing act between the amount of bile flowing vs what I eat and how long between meals. Bile is rather like castor oil or some other laxative but if the type/amounts of certain fats is too much at some point then constipation results. I like intermittent fasting but too much bile and too little food in the gut = abrupt voiding. With both types of incontinence, it can be interesting.
I am now practicing kegels, drinking reasonable amounts of fluids, and making pre-emptive trips to the bathroom on more of a schedule. Weight loss and more exercise are in the works but both knees were due for replacement when the pandemic started so on hold. It is helping although I still use pads/pull ups but I expect to see more improvement in managing.
My family doctor had nothing to say on the matter so your videos are very helpful.
Please cover pelvic prolapse, thanks!
That is on the list for sure
@TaKy gyno just gave ke another pessary that pinchs I can't get at to remove. Why don't they tell us about all these bladder leak helpers? There are like 33 things for it I just learned here in comments . Botox? Shots? Yikes. No wayyy.
The doctor I went to gave me two choices : botox shots or a battery in my behind with a set up to work like a pacemaker and was pushing for the battery. None of these other methods were mentioned. Thank you for this information.
Thanks for sharing!
@@TalkingWithDocsThat was a good explanation of rhe hardware approach. Ug
Thank you for your information .You are right when you state to empty your bladder every 2 to three hrs,I prefer every 2hrs it works better.Also drinking 4 8oZ of water is sufficient, if I drink more than that ,then I am going more frequently. I believe we are overloading our bladder with too much water and maybe damaging the bladder with excessive water,but that can be answered by a nephrologist.
Thank you. I am 68 and have urgency incontinence. I have bladder spasms which are worse if I drink a carbonated drink.
Sorry to hear that but now you know to avoid that!
Thank YOu for this vital imformation !!
Thank you this video very helpful
You're welcome!
GREAT explanation!
So helpful and informative. Thank you.
Glad it was helpful!
Thank you for the great information!
Glad it was helpful!
I have had four children and am an avid gardener, which is quite physical and have had a hysterectomy and several other surgeries!! I have had my bladder suspended two times and I still have incontinence! I wear pads but I don’t really like to, it does bother me! I really don’t know what else to do! I don’t understand what a pessary is, it sounds like that would really bother me, you didn’t really go into that too much!
Thank you for this video, I’am sure it helped a lot of people, and I appreciate each of you sharing your knowledge with us!!
I use washable flannel pads. When I go out and about...I pull disposable underware over my everyday protection....just in case! I am searching for a washable alternative but haven't found an affordable product yet.
Thank you, Docs! Very helpful information. And congratulations on your milestone views!
I have talked to my Dr. only to be shrugged off, and he wrote an Rx, which i didn't take because side effects were memory issues. Granted, that was 10 years ago or so. I've succumbed to wearing mattress pads 24/7! Ugh!
Well, now you know the options Sally
Heds wear mattress pads. U mean sanitary napkin monsters? Those irritate me. Even tiny ones give me blisters.
I have mixed incontinence with the worst being stress incontinence. I am a runner and cannot get through a run without at least a partial bladder release and sometimes the entire bladder. I was given both types of drugs you mentioned for the overactive bladder. The first relaxed my esophagus so much I couldn't swallow. The Mirabegron was OK, but not a huge improvement and since I have IBS, there were issues there. I was advised that my pelvic floor and vagina in general was very week and that, at the moment a pessary might cause me pain. I did go to 6 months of pelvic floor therapy, with only a slight improvement. I think they are recommending surgery, but since I have had 7 abdominal surgeries over the years, I am not really leaning that way. I will probably push to try a pessary, for at least my runs. I do leak many other times a day too just standing around, but nothing like when I run. Anyway, thank you for doing this segment and btw, I am one of those women who overshare with her other post-menopausal friends about what is going on with my body. 😆
Look up Uresta device. It works for me as I walk everyday for at least an hour. Was releasing urine in my walks. Now with Uresta device that has stopped and I have piece of mind.
My specialist dr. put ten injections of Botox in my bladder in her office. It helped eliminate the urge and constant leaking within three days and was great for seven months. It was super painful for me so I am being scheduled on my 8th month since having the procedure in the office, another round of botox under general anesthesia in the hospital. It has been a life saver. NO more depends.... and the irritation they cause being wet down there.I am 70 years old. I did try first, acupuncture on my ankle to send electrical up my leg to the bladder. It hurt with zero help after four months of that.
Thanks for sharing your story. I avoided going to a specialist for years because I figured I wouldn't want to do any of the serious interventions they had in mind. Finally I went and she wanted to do the Botox injections. I was going to try it once then decide if I wanted to continue since it took going every six months first for a urine test then 3 days later for the procedure. Covid popped up about then so appointments were cancelled and I haven't tried to go back.
For you, even with the pain and now needing to have the procedure under general anesthesia, you seem to feel Botox treatment is worth it.
Electrical. Ha!
Do we know how much caffeine would be considered as generally acceptable? 1 to 2 cups of coffee per day, for example? Or are we aiming to cut it out completely?
Thanks for making this topic more accessible. I will be sharing this video with a few people.
1 to cups in the morning hours. If you can eliminate caffeine, that is best. Follow it with drinking water in order to decrease the spasms caused by the caffeine effects on the bladder.
Try decaf. Or 1 cup regular & cup 2, use decaf.
Omg!! I love how funny you doctors are and the way in which you explain things!! It's making my life easier for sure!! Thanks.
Diagnosed with „Mixed Incontinence“ Uro-GYN able to administer Botox injections to bladder under anesthesia)once general, once local) ~ both of which helped immensely for nearly a year. This was covered by health insurance. Risk of loss of ability to urinate & need to self-catheterize. Pandemic disrupted my treatment schedule. Really want to resume. Currently having private Pilates lessons for this symptom. Thank you for wonderful & informative video clip
I had the Botox. Never again. I had UTI so much because I couldn’t go.
@DeeDee4always omg 😲 so how did you get help goung to bathroom if you couldn't? Did you get rid of the UTI?
Gen.knock out for a pee leak procedure?
Yikes! Too dangerous for us olders.
@@Warmfireandtea if you read the full comment I also had it under
Local. Best bet is still behavioral timing & exercises (kegels. Squats). Good luck
Awesome info and presentation. Invaluable to me since I’ve had incontinence since my mid-forties. Do most uro-gyn understand pessaries? I’m 78 and no doctor has mentioned it. Again, thank you. ❤❤❤
I went to a Urologist for urgency and incontinence. I was diagnosed with IC (interstitial cystitis). I had never heard of it until then.
Me either. I've never heard of a lot of things in these comments 😂. Man,this is a big problem. And it looks like nothing really stops it for long .