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Monday, March 9, 2015

Why I Decided to Have Surgery for Stress Urinary Incontinence

It's been four years since I had surgery to repair stress urinary incontinence that I lived with from 2005-2010. And while I've written before about how it was one of the best decisions I ever made and how my life changed for the better after having the surgery, I haven't actually shared some of the details that informed my decision to go through with the surgery. 

If you have stress urinary incontinence and you're reading this, I hope you seriously consider getting the surgery. My specific surgery was the midurethral sling.

There are many commercials and advertisements that warn women against getting this surgery. Most commercials refer to the surgery vaguely as "mesh implants" and highlight the pain or discomfort they (may) cause. I realize I'm only one person, but I truthfully haven't had a single problem. Life has only gotten better for me since the surgery. At my most recent visit to my OB I emphasized how happy I was. 

She then confided in me how frustrated she was with other patients who would be good candidates but believed commercials on television more than they trusted her. I had a frank talk about how many of her patients choose to believe lawyers on television who warn about the dangers of the surgery as opposed to listening to her informed medical opinion. 

My stress urinary incontinence developed after the birth of my first son in 2005 who was 9 lbs 2 oz. A big kid! While I had a very healthy pregnancy and basically normal vaginal delivery, I wasn't prepared for a lot of the post-pregnancy side effects. 

I knew diastasis rectis was a possibility, and stretch marks. I knew about hemorrhoids in theory but I don't really remember getting any info on how painful they actually were. I remember crying to my mom "I know these never truly go away but how to people walk around like this?" Eventually, with treatment, they can return to a manageable state and now don't affect me at all.

And I really don't remember anyone telling me about stress urinary incontinence. Many people encouraged me to perform Kegels before and after pregnancy, which I did. I love working out, and doing Kegels was easy for me to do anywhere. 

When my son was four months old, I remember heading out in the warm spring air to try out a jump rope workout. It would be good cardio while my lovely little guy slept in his baby seat. But I found I couldn't stop wetting myself. I ran into the bathroom, emptied my bladder, came back out, tried again. I kept wetting myself! I finished every run with soaked underwear and shorts. And then it started happening when I coughed, laughed, sneezed, or lifted things at work and at home. 

I did those Kegels. You bet I did. I was Kegeling all day. And they did nothing. Then I had another son in 2007, this time 8 lbs, 10 oz. And a third son arrived in 2010 at 9 lbs 5 oz, the biggest yet! I noticed one key thing - after a certain point in each subsequent pregnancy, my incontinence went away. ( It turns out that when they got to a certain size, they helped keep my urethra in the right position.) After giving birth though, the incontinence returned with a vengeance. 

During the five years when I was having kids and dealing with stress urinary incontinence, I learned I could run as long as I wore a giant pad. I also needed a pad to get through the ordinary day.

I wanted to change things. I wanted to fix things. I read about the surgery online. But I was nervous. 

Finally, it was a conversation with another woman who had had the surgery that helped me have my first conversation with my OB. My OB was all for it and encouraged me to meet with a urologist who had performed this surgery on many women.

That first meeting didn't go well. The urologist felt I would be a good candidate but he stated he would not perform the surgery on me unless my husband also got a vasectomy.

In 2010, I was only 35. It was definitely possible for me to have more children, even though I didn't want to have more children. I didn't want to use an IUD or birth control pills and I didn't see how a procedure on my husband should be a prerequisite for a surgery I wanted and needed. That felt like an outdated and unfair condition to me. (Rereading this in 2021 enrages me. That doctor was way wrong.) 

So I got a second opinion from a different urologist who said current research showed that while pregnancy could weaken the repair, it was no longer viewed as serious problem. More importantly, he said he would perform the surgery because it was what I wanted and had nothing to do with any procedures my husband did or didn't want to have. Exactly.

In December of 2010, I checked into West Penn Hospital and by that afternoon I was home. It was a simple outpatient procedure. I think the worst part for me was getting the anesthesia out of my system. I believe it made me really grumpy and affected my mood. But once that wore off, my life changed for the better. Much, much better! 

2021 Update - It's been 10 years since I've had the surgery, and every day I am so, so grateful I did. 

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