Hi ((((chicklet)))) So sorry you're dealing with incontinence issues
I know just how that feels, since that's been a problem I've been dealing with since 1 year after my TVH.
First, a bit of background: I had a TVH with Rectocele repair in December 2000. The stress incontinence I'd been dealing with was mostly resolved with the Rectocele repair: would only have a few problems with leakage when I dashed or jumped, something I don't do too often.
Then, in November 2001, I started having increasing problems. No longer was I only dealing with stress incontinence, I would now find myself leaking when walking or hearing running water... annoying when you live in Canada, where it tends to rain most Fall or Spring days... or Summer days, for that matter.
It got so bad that, in the Summer of 2002, I finally consulted a doctor, thinking it was my hormones acting up. However, I was confronted with doctors who didn't seem to think that incontinence was something that needed to be delt with. Finally, in May, I got a GP to take me seriously, and got a referral to a Urologyst.
I went to the Urologyst, sure that I would be facing another repair surgery and really, really not looking forward to it. Much to my surprise, she noticed that most of my problems stemmed from muscle weakness in the perineal area and she opted to send me for Perineal therapy
I had my first therapy session last Tuesday, and here's what I found out:
First off, I couldn't believe it, but I found out some more things my doctor, who I know is a very, very good doctor (excellent has been used to describe him, by one of his colleague):
1) the therapist said that if I'd been sent for a consultation, right after the hyst and rectocele repair, the problems with incontinence could have been totally avoided!!!
2) at first, especially in cases like mine, where the perineal muscles are very, very weak, kegels should be done lying down. She equated doing kegels in a seated or a standing position when your muscles are too weak to having the efficacity of trying to lift 100 lbs weights when you can only lift 20 lbs: you won't be able to do it, you'll use the wrong methods and have the potential of hurting yourself.
Other tips I found out:
1) when having a bm, instead of sitting with legs spread, in the position of giving birth, we should sit with our thighs together: not only does this protect the perineum (sitting with thighs opened, opens up the perineal area, leaving it in a vulnerable position), it also favors evacuating towards the rectum, reducing the straining efforts. I tried it and found a difference immediately: much more effective!!!
2) when you have a huge urge and feel like you're not going to make it, stand against a wall, legs together but not crossed, and bring your pelvis in. Hold the position until you feel ready to go (ie, the bathroom is free again). This is the most effective position to help you keep it in.
Now, the way the therapy worked:
She uses a bell-shaped sounding device that is linked to a computer. You purchase the device, so it's yours to keep... and no risk of contamination
The device emits electric waves, they felt like tickles, and, at the same time, it forces your muscles to contract. As I got used to it, she had me contract the muscles along with the device. This lasted only 15 minutes, but, let me tell you, I was very exhausted at the end of the session!!!
When I left, she gave me some exercises to do: I have to 10 repititions of contracting the muscles, rest, then repeat for 3 times. The objective is to do 10 repititions, 10 times a day. The aim is to them right: lying down, ensuring that's it's the perineum muscles working, not the bum, not the tummy and not the thighs. As with most exercises, it's more important to do them right, than to do too many.
In my case, since pain is not an issue, I didn't feel any pain... just tired... and realized just how little I've been working those muscles.
I hope that this information is helpful to you. While this type of therapy might not be the right way to go for everyone, and it is expensive (my sessions cost $80.00 and the device cost $30.00), this might be a viable alternative to surgery.
Wishing you the best of luck with your uro appointment. Please keep us posted.