Health Update: Health Update: They had postpartum bladder leakage. This device finally helped. – What Experts Say– What Experts Say.
How to Stretch and Strengthen Your Pelvic Floor
A third of women and 16% of men will experience some kind of pelvic floor disorder in their lifetime, statistics show
Amanda McKinney was a lifelong runner ‒ 5Ks, half-marathons and marathons.
She had her first child at 30, and running continued to be an emotional release for her during the excitement and stress of motherhood. But after the birth of her second child, she started experiencing bladder leakage.
McKinney tried to get back to her exercise routine, but to no avail. She was spending nearly all her time caring for two little kids, and even a single jumping jack would lead to urinary incontinence. Not only did her physical health suffer, but she began struggling with her mental health as well.
McKinney opened up to her sister, but her sister wasn’t affected that way when she gave birth, and McKinney felt a lack of peer support.
“I didn’t know if it was just me. I didn’t know if I was ever going to get over it,” she says. “I was already embarrassed that I couldn’t do a jumping jack without peeing myself.”
But despite the culture of silence around urinary incontinence, it’s common, especially among new mothers.
During and following pregnancy, as many as 4 in 10 women experience urinary incontinence, or the involuntary loss of urine. Some women also experience bowel incontinence. The lack of dialogue around incontinence leads women to assume that it is difficult to get care, but an array of treatments and devices can alleviate postpartum urine leakage.
Now, McKinney says she’ll “talk to anybody about it.” In part, that’s due to her success using a vaginal pessary, a device that provides mechanical support to areas affected by pelvic organ prolapse.
How do vaginal pessaries work, and who should use one?
Pessaries are typically made of medical-grade silicone; when inserted, they support the pelvic organs and stop bladder leakage, particularly for women with stress urinary incontinence, or SUI. SUI is urine leakage caused by sudden pressure on the bladder, triggered by activities such as coughing, sneezing, laughing, exercising, or lifting due to weakened pelvic floor muscles.
Less than 15% of women in the United States undergo surgery for incontinence, leaving 85% to seek alternative treatments, according to Dr. Scott Farrell, Canadian urogynecologist and the inventor of Uresta, a reusable, over-the-counter pessary. Vaginal pessaries are recommended for women who want to avoid surgery or are not good candidates for surgical interventions.
McKinney uses the Uresta device, which can be purchased over the counter and does not require a fitting from a doctor. 97% of women reported a reduction in leaks while using Uresta, according to company data and several third-party studies.
“Most pessaries cannot be managed by the patient themselves, so they have to go back and forth to the doctor periodically,” Farrell explains. During those visits, the doctor would have to remove the pessary, perform an examination, and reinsert the device. “That’s always been a barrier with pessaries,” he continues, “and was one of the big reasons for the design of the Uresta.”
However, pessaries, including the Uresta, do not cure the underlying muscle dysfunction causing stress urinary incontinence; they provide relief from symptoms while in use.
“It’s nonsurgical and reversible… [but] benefits only last while it’s in place, and it requires ongoing maintenance and follow-up,” according to Kathy Kates, nurse practitioner and pelvic floor specialist. She says pelvic floor therapy is considered first-line treatment in most guidelines.
“Pelvic floor therapy is a rehabilitative approach that strengthens and retrains the pelvic floor muscles that support continence,” she explains. “It takes more time and participation, but it addresses the root cause and can lead to more durable improvement.”
Many patients use a combination of treatment methods, Kates says, like a pessary for short-term relief and physical therapy for long-term benefits. McKinney has continued with her pelvic floor exercises and uses electrode treatment to prevent leakage from coughing and sneezing.
But awareness of these devices still helps to bring attention to this underdiscussed health issue.
“I think the whole field of conservative management deserves to be recognized and has a great deal to offer to this whole problem of urinary incontinence,” Farrell says.
‘It increases your mental health so much’
Hiromi Okuyama had her second child in her 40s during a planned home birth in Canada. During labor, her midwife noticed she was heavily leaking urine and suggested she see a pelvic specialist. But as a new mom, she kept pushing off appointments.
Progressively, her incontinence got worse. Okuyama lived an active lifestyle ‒ teaching karate and running around with her child, who she says is on the autism spectrum and is often hyperactive. She bought every brand of “incontinence pads”; even at nighttime, she wore a diaper.
Okuyama became embarrassed to go out in public. Even on nights out with friends, she felt uncomfortable getting dressed up with a “bulky pad underneath a nice dress.”
“It’s so erratic. You don’t know when it’s going to happen, which makes it even worse. Should I wear a heavier one today? Should I wear a light one today?” she recounts. “It’s just really difficult living like that.”
Having had a child at a later age, she didn’t think any of the younger moms would be able to relate. So, she suffered in silence. That is, until years later, when she discovered the Uresta online community, which keeps an active Facebook group.
The device helped ease her symptoms immediately.
“It felt like this freedom. It’s total freedom,” she says.
It’s comforting for her to know that she’s not alone. “The Facebook group has been so lovely,” she shares. “It’s so amazing to see all these women speaking about it. It’s such a vulnerable topic, but we feel so supportive in this community and talking about it.”
McKinney has gone back to running half marathons. While wearing the device during a race, she breezed by all the porta-potties. She didn’t have to stop once.
“I know it’s used for physical,” she says. “But it increases your mental health so much.”