I Pee When I Run

I read a great article from Triathlete Magazine the other day entitled, The Surprising Health Issue Plaguing Females Triathletes. It was remarkably interesting as it was about something I have been dealing with since my hysterectomy—pelvic floor disorder and stress urinary incontinence.

Now, much like my post about jock itch (see Fungus Amongus), I had been reluctant to blog about this, because, well, it’s a lot of TMI (too much information). However, also like the jock itch story, I’m realizing talking about this might be helpful. And if it encourages only one female triathlete or runner or, heck, female to seek help about a topic we don’t bring up due to embarrassment, well, I call that a win.

Last year when I finally got my thyroid under control and had energy back to start running and training for triathlons again, I started noticing that I peed when I ran. Now, I’d always had a little dribble, and talking to others, that seemed to be kinda normal. But this was new, it wasn’t only a dribble, it was a stream that would run down my legs, and it was awful! It didn’t matter if I’d gone to the bathroom seconds before running, it was like I had a full bladder. I stopped running altogether after one race where it happened at the start of a race, in the crowd, and I could see pee splashing as I ran–it was horrifying, I worried that people around me could see, and worse, what if I splashed someone?!?!

I was super embarrassed about it. I felt like a little kid who peed her pants (note, I did this as a little kid, so I was extra sensitive about it). So I didn’t tell anyone, not even Alan. I tried running with menstrual pads, which was uncomfortable. Finally, Poise came out with a product that helped called Impressa®, which is an insertable device that helps stop leaking by putting pressure on the urethra from inside the vagina, like an umbrella tampon.

The Impressa® helped with running and I had freedom for a while. But after a while, the stress urinary incontinence got worse with non-running activities. Sneezing, coughing, lifting objects, laughing, dancing, Zumba, getting startled, and even tripping over my feet while walking through a parking lot caused leakage. One day I started walking up to a neighbors house and completely wet my pants halfway up the block and had to turn around and clean up and change. So the Impressa® went from a use-while-running device to daily use. This was frustrating because no one wants to use a tampon every day (which is essentially what Impressa® is), it’s expensive, and creates a lot of waste!

So at my next physical I finally talked to my provider, who referred me to a urogynocologist. I didn’t even know this specialty exists, but they do and they deal with stress incontinence and prolapse issues. She determined that I had severe urinary stress incontinence and first sent me to physical therapy to try to strengthen my pelvic floor, however, she also put me on the schedule for surgical intervention as she was concerned that PT wasn’t going to be enough in my case.

PT focused on building strength in my pelvic floor with specific Kegel exercises—yes, those, the better sex exercises you read about in Cosmo magazine! Oftentimes focused PT is all that is needed to correct stress urinary incontinence. I was coached through three different exercises that I am sharing, with my PT’s blessing (click here to download instructions shown below):

 

 

In the first one, you imagine your va-jay-jay is an elevator shaft and you need to lift the elevator to the top floor (that’s what the instructions refer to when it says to think of the elevator analogy). You first imagine closing the doors, squeezing from the bottom, and then squeezing your muscles upward, lifting the elevator up to the top and then relaxing.

The second one is pretty easy to understand, it’s just simply contracting and releasing.

The third one is not as difficult as the instructions and illustration make it out to be. And you don’t need any specialized equipment, like the physio-band, like it shows. You simply sit, turn your toes outward, put a hand on the outside of each knee, press your knees into your hands and hold for 5 seconds.  Then you turn your toes in, make a fist and put it between your knees (top of your hand facing up), and squeeze your knees into your fist while you kegel down and hold for 5 seconds. Then rest for 5 seconds and repeat.

In the end, PT alone wasn’t enough for my case and I ended up having a TVT mid-urethral sling procedure. It basically is a tape that attaches to muscles in your pelvic cavity, slinging underneath your urethra, that contracts and pulls the urethra up during activities that cause stress incontinence (sneezing, coughing, lifting, running, etc.) (see information here). It was an out-patient day surgery and waaaayyyy easier than having a hysterectomy. I was only on pain medication for two days and even started daily walking outside two days after surgery.

The only caveat to having this procedure is that you cannot, and I mean CANNOT lift more than 10 pounds for two months. This rule is imperative, as you can rip the sutures holding the tape ends out of the pelvic muscles if you don’t comply and have to have the procedure redone. I was able to start swimming two weeks after my procedure and cleared for Zumba a month after surgery. All told, I exercised (walked, swam, or Zumba) every day for the two months (minus the first two days after surgery) and never had any problem.

Two days ago was my release date and I ran! I did have a little leakage, but it was really back to the normal pre-hysterectomy days and a mere fraction of what I had before. I sneeze, cough, jump, work out in the yard, laugh, dance, all without peeing myself. What freedom this is! And I wear the same pants all day long again–really how sad is that expectation!?! And now that I’m past the two month mark, I can start up with the PT exercises again and perhaps get that last drip stopped completely.

So my advice is this…if you are suffering from stress urinary incontinence, don’t wait, talk to your healthcare professional because there is help. It can happen naturally, not necessarily due to a hysterectomy. Please don’t be embarrassed about it. As the nurse said unprovoked during my pre-op visit, “What a great Christmas present you are getting yourself!” And it’s true, this has been a huge gift to myself and I have regained my life!

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