I Pee When I Laugh - Incontinence After Childbirth

There, I said it. I’m out of the proverbial closet, the water closet, that is. I pee when I laugh, or I used to anyway. To be clear, I peed when I laughed, or sneezed, or coughed, or danced, or stumbled, or jogged, or climbed a hill while riding a bike, and the list goes on. Here’s my humble story, and what I did to overcome this nightmare. Read on, there is hope.

When I signed up to become a Mom, no one told me I'd be wearing Depends by the time I hit age 32! Apparently, hours and hours of solid grunting, pushing and straining to get a watermelon-sized thing out through a walnut-sized tunnel was a little more than my pelvic floor could handle. With a rip, tear, and a snip, ahhhh, relief, sweet Jesus, that baby was finally out!

The next day, when I was allowed to walk down the hall and shower, I learned that things...you know, down there...were different. The startling realization hit me when a slight lean forward, and a bend at the waist caused all the urine in my bladder to drain out without so much as a warning. I didn't feel a thing, except for the warm pee running down my leg. It was mortifying!

“Oh God, just kill me now!”

Kegels, Kegels, and more Kegels

At the follow-up appointment with my doctor, I was told that Kegels were the answer. Kegels are kind of an odd little exercise. You know you are doing them correctly when you sit down to pee and after the pee starts to flow, you contract the muscles around your urethra and are able to stop the pee stream from coming out. Once you know you're doing them right, you do them any time you can (i.e. in the checkout line, while you're driving, etc.)

So I did my Kegels, and things did get a little better. I no longer leaked when I bent forward, but I still couldn’t do many of the other activities I had done in my formerly active life. At this point, I was diagnosed with Stress Incontinence (meaning any time the muscles of my pelvic floor were exerted or fatigued, urine would leak out). My next step toward a leak-free life lead me to a physical therapy clinic where I would engage in exercises to strengthen my pelvic floor. I had no idea what I was in for.

Physical Therapy for my Bladder?

A young gal, probably in her 20’s, who didn’t even have children, who wasn’t even wearing a white lab coat, escorted me into a private exam room. She asked me to disrobe from the waist down and get up onto the exam table. I wasn’t really prepared to have a pelvic exam. I started to feel flushed as I lie there waiting for her to return to the room. Beads of nervous sweat began to form on my upper lip. The room was suddenly unbearably hot. She came back in, apologized for her cold hands, and slipped on a rubber glove. And then the familiar dialogue began.

“Scoot your bottom down....a little more...a little more...c'mon, all the way to the end of the table”.

As I tried to raise up and move my bottom down the infinitely long chasm of space between where I was, and the end of the table, I felt something sticking to my backside, and it tore as I scooted. That sanitary paper covering the exam table had grabbed on and it wasn't letting go! Thoughts raced through my head, “My God, it’s not bad enough that I have to get my nether-regions probed by some young, childless non-doctor, but now I’ve got damp paper bits sticking to my bottom?”

“Humiliating”.

“Relax and let your knees fall open,” she said. “Relax. You’re going to have to relax and open up those knees so I can do this exam," she ordered in a more assertive tone.

Next, she inserts her fingers and asks me to do a whole barrage of Kegel exercises while she’s feeling around in there. First, some quick ones, then I had to contract and hold for 10 seconds. All while she was saying things like, “Mmm hmmm, yes, very good,” as if she was making some huge discovery in there that would cure my condition.

I was relieved when the exam was over and she came back into the room with my treatment plan. May I have a drum roll please? You guessed it, more Kegels! Oh, and one more thing...vaginal weights.

Mommy, what just fell out of your JY-NAH?

I did the Kegels the way she had instructed. The vaginal weights were another matter. My baby was now a very bright, very vocal, very inquisitive 2-year-old. I rarely had a moment of privacy. I was supposed to take the little tampon-shaped vessel apart and put the lightest weight inside it, screw it back together and stick it up my hoo-ha, keeping it in there for 10 minutes. I casually disappeared into the bathroom when I saw my son was engaged in a cartoon playing on the television. During my first attempt, I found that keeping the vaginal weight in was easier said than done. The little sucker kept slipping out and falling onto the floor. I heard footsteps coming toward the bathroom. As the door opened, I grabbed the weight off the floor and tucked it away in my pocket. I just wasn’t ready to explain why Mommy has some strange thing that keeps falling out of her JY- NAH onto the bathroom floor. Finding the right time to deal with the vaginal weights became a problem, so I gave up on them.

Progress! Or so I thought.

Still, I felt I had made progress. I wasn’t leaking as often. So, when the handsome new trainer at the gym asked me if I’d like him do a fitness evaluation on me, I said, “Sure!” The first part involved 10 minutes on the treadmill. I chose to do a fast walk, because I knew I’d leak if I jogged. Uh-oh, a few minutes in, I felt a trickle. I couldn’t believe it! I had just gone to the bathroom before getting on the treadmill! The trickle grew to a river. The urine had overtaken my pantyliner and was flowing down the inseam of my sweat pants. I managed to finish my 10 minutes on the treadmill, thinking that was the end of my fitness evaluation. Next, the trainer instructed me to lie down on my back and do sit-ups while he held my feet down.

“Oh God,” I thought, “I hope he doesn’t notice the wetness of my pants”. I squeezed my knees together. “Do I smell like pee? If I smell like pee, I’ll never be able to show my face in this gym ever again!” I couldn’t stop these thoughts from swirling around in my head.

“Mortifying!”

It was over, and I was out of there! At this point, I didn’t care about the results of my fitness evaluation. I made an excuse and hurried home.

I could go on about all the embarrassment my little problem had caused me, but I’ll spare you the details. By this point, my husband and I had decided that we weren’t going to have any more children. That meant, I could pursue a surgical remedy for my condition.

The Cure!

My doctor referred me to a Urogynecology specialist. She was an expert in all things related to the pelvic floor. After a quick pelvic exam and a urine flow test, my new doctor recommended the TVT procedure. This was a 30-minute outpatient surgery that had a very good chance of solving my problem. She explained that a little mesh hammock would be placed under the urethra to stabilize it during coughing, laughing, sneezing and similar activities. She would make a small incision in the top part of the vaginal wall, place the permanent mesh tape under the urethra, then thread it up through to 2 small punctures just above the pubic bone. Studies had shown the TVT procedure to be an effective cure for stress incontinence in 80% of patients, with another 10% of patients showing great improvement.

I had the surgery, rested for a few days, and have not leaked a drop since! I am now able to do any activity I choose to do, without worrying about peeing my pants. No one ever talks about this issue, and I wonder how many women are out there, giving up the things they enjoy doing because they fear the nickname, Susie Wha Wha Pee Pee Pants. Well I’m here to say, it doesn’t have to be you!