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Help! Leaking! Help! Leaking!

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Unread 12-29-2002, 07:53 PM
Help! Leaking!

I will be 7 weeks tomorrow post op from a total LAVH and bladder sling for stress incontinence. About two weeks after my surgery I started to leak again when sneezing or cough. Not bad but still. I told my Dr. about it at my three week checkup and he seemed kinda surprised and said that he did not see any reason as to why and everything looked ok, he did take a peek vaginally. I was told to chart everytime it happened on this chart for the next month. I go back on Jan. 7th. Anyway I am not taking any HRT and have had no problems as of yet I think, was wondering because Ive read that this can happen when all the estrogen is depleted which can take some time after surgery which might explain it not happening untill 2 weeks after. I do not want to take HRT with all the controversy and would like to take natural things if I have to take anything but is there anything that would help with this? Heard about vaginal estrogen and that it helps with this but again worry about risks. I don't know! Im worried and do not even know if it is hormonal or if the bladder repair just did not work. Dr. seems to think it was a success though. Do not want surgery again!
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Unread 12-29-2002, 09:14 PM
I hear what you are saying here but...

Topical vaginal estrogen does not act systemically like the pills and patches, so the girls on the hormone jungle tell me. Just acts on the tissues it is applied to, not the whole body.

The contraversial study needs a closer look too. First, it studied women who went thru natural menopause, not surgical menopause. Second, these women were prescribed estrogens PLUS synthetic progestins, which surgical menopausal women usually do not take. Third, these women kept their ovaries and uteri. That isn't us. I am sure someone will comment about studies that use surgically menopausal women as a sample group, I don't know that much about them but I do have some ideas on the WHI study I think you are referring to.

See what your urologist has to say. I had bladder repairs via the tension free vaginal tape method and that repair isn't healing well in the vaginal area. I am doing systemic estrogen patches but apparently, my vaginal tissues need the topical stuff to heal, at least short-term. Doing bio-identical everything. Opposing the estrogens with natural progesterone and also taking testosterone transdermally for other symptoms. I too do not want to have surgery again, wetting my pants before was quite enough, thank you! Worth doing estrogen vaginally temporarily for me to avoid further surgery. Of course, I can't make that choice for another woman. I also can't comment on the limited use of topical estrogen, say like a few months, and whether that has any long-term health consequences. Maybe someone has done this research and will comment.

The bone health question is why I am taking HRT. First year without ovaries, rapid bone loss. HRT will protect me in addition to good diet and exercise. Plan is five years of HRT and then weaning off. I am exploring naturopathic ways to help myself too and hired a naturopath since the herbal literature can be conflicting and confusing. Worth the money to get someone to guide me that has the degree and education on the subject matter. If this ND has an alternative to the topical estrogen, I will post about it later. Actually, he seems pretty cool about doing bio-identical hormones and is encouraging me to pursue that.
Unread 12-29-2002, 10:49 PM
Help! Leaking!

Hi Patricia sweetie, please don't panic about the leaking just yet OK? Many sisters have experienced some stress incontinence when the estrogen in their urethral tissues becomes depleted. This leads to a condition called urethral atrophy... the tissues aren't well toned enough to be able to hold the flow of urine under stress. Often we don't realize that's what is happening until we start feeling a burning sensation in the vagina, maybe some discomfort or even spotting from sex... symptoms of vaginal dryness and vaginal atrophy, which go right along with urethral atrophy.

Fortunately the condition can be reversed and many women go on to live dry, happy lives! Here is a link to a discussion about vaginal dryness, and all the hormonal solutions discussed in it are also helpful for urethral atrophy:

vaginal dryness

Maybe you could ask your DR if, since you're not using estrogen, you might be experiencing urethral atrophy? The topical estrogens are not appreciably transferred beyond the vaginal tissues and work wonders for most women. Transdermal testosterone can also help, especially combined with kegels, as testosterone helps build muscle mass. If you aren't familiar with kegels yet, here is a link to a description of how to do them:

All About Kegels

I highly recommend kegels as a way to eliminate incontinence; they are most effective if the tissues in the area are kept elastic and healthy. I understand that you are worried about estrogen being transferred into other areas of your body but perhaps if you discuss it with your DR he will put you at ease there.

I hope this helps. Please keep posting and let us know how you are doing. I really think you can avoid having to have another surgery. I'm keeping my fingers crossed for you!

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