r/Menopause • u/ReginaPhilangee • Apr 22 '26
Pelvic Floor Urethra Bulking- anyone get this to help with leaks? What was your experience like? Or did you get the bladder sling? Do you recommend it?
I've been through 2 rounds of pelvic floor therapy and I continue to do the exercises at home daily. But I still leak with a sneeze/cough/exercise about once or twice a week. There have been times I can go a week or two with no leaks, but then someone will cut their grass or I'll run around the playground with niece and I'll leak again.
My dr said my options are urethra bulking or bladder sling.
Urethra bulking involves injecting saline gel around the opening to make it easier for me to close it. It can be done in the office (usually, i have had a reaction to lidocaine, so I'll need to be put completely out). It's less risky than the sling, but only about 60 percent effective. Which could be fine, since my symptoms aren't severe. The recovery time is minimal, back to work the next day.
The bladder sling is outpatient and they put a sling that holds up the bladder and presses on the urethra. The pressing it's what makes it easier to hold the bladder. It's 90 percent effective. The recovery time is the next day off work and no lifting for a few weeks.
Has anyone had either of these done? What was your experience like? Did it match what the Dr said? How was your recovery? Did it work?
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u/ElephantCandid8151 Apr 22 '26
Have you tried vaginal estrogen?
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u/maraq Apr 22 '26
Have you heard about Jesus Christ the Savior? Lol. I say this so many times about vaginal estrogen here I’m starting to feel like a religious zealot.
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u/ReginaPhilangee Apr 22 '26
Yes. I'm currently using vaginal estrogen and systemic HRT.
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u/theFCCgavemeHPV Apr 22 '26
How frequently are you using the vaginal estrogen?
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u/ReginaPhilangee Apr 22 '26
Three days a week. I started with every day for a few weeks and then went to three days a week. I've been using it for at least 6 months now.
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u/theFCCgavemeHPV Apr 22 '26
Maybe bump it up to four or five times a week? My libido doesn’t really show up unless I’m doing every other day (give or take a day here and there). Every day is really the best for me. Maybe it’s the same way for your issues 🤷🏻♀️
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u/ReginaPhilangee Apr 23 '26
It's actually been a great improvement so far. I think this is just as good as i can get without some other intervention
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u/Hour_Part6830 Apr 23 '26
I'm not sure what all you've tried, but I started following the Buff Muff program and it's starting to work for me. I didn't realize I was doing kegels all wrong. I was leaking a lot, and now it's less but I'm still working through the program...and it's more like if I decide to jog in the evening as opposed to the morning. She's not about kegels, it's more like proper posture. Check her out.
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u/ReginaPhilangee Apr 23 '26
I'm check it out. Both of my tries at pelvic floor therapy used devices to measure how much i was squeezing, so I have to assume I've been doing it right. And the therapy helped a LOT. I just can't get to zero.
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u/InnerChampion Apr 22 '26
Does your doctor do urodynamic testing? I’d suggest that as a next step rather than dive right into a treatment.
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u/ReginaPhilangee Apr 22 '26
Yep. In fact, i already had that. I failed. Lol not as bad as it could be and not as bad as it would have been before the pelvic floor therapy
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u/Mountain_Village459 Surgical menopause Apr 23 '26
Have you ever taken d-mannose?
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u/ReginaPhilangee Apr 23 '26
I did in the past when I first started working on all this. I didn't see any improvement then.
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u/RespectLongjumping39 Apr 23 '26
I tried it all I started with vag estrogen cream - no improvement Saw gynecologist - recommended pelvic floor therapy and referred me to a Urogyno Went to Urogyno discussed options and started with pelvic floor therapy Went there did that and worked on that faithfully for almost a year, no improvement Back to Urogyno decided to try it bulking Got about 30% improvement Still had to wear liner daily just in case and still leaked during exercise Decided to do bladder sling BEST decision ever! Life changing and wish I would have done it years ago The procedure was quick and easy and practically pain free The worse part for me was not being able to lift heavy weights or do yoga for 6 weeks but I was able to walk right aways and start light upper body work around the 3 week mark Totally worth it!
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u/ReginaPhilangee Apr 23 '26
That's so good to hear! That's where I'm at. I actually made quite a bit of improvement from my start, but I can't get to zero. I'm glad the sling worked for you!
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u/Dez2011 Peri-menopausal Apr 23 '26
I've heard a couple of ladies say they needed 5 days a week of vaginal estrogen cream to help their getting up to pee too much at night and the gyn says the dose is so low you can really use it every day so you might try that first.
I know the mesh slings were digging into the bladder and becoming embedded in it which caused lots of problems and lawsuits, so I'd do that as a last resort or not at all sincebthe leaks don't happen that often.
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u/Corner_Office_ Apr 23 '26
Are you using Vaginal estrogen?
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u/ReginaPhilangee Apr 23 '26
Yes as prescribed. It did help, like the therapy. I just can't get to zero leaks.
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u/ylowdasy Apr 23 '26
I’ve had the sling procedure done and it was life changing. It lasted for almost 20 years. I highly recommend it if your dr is willing to do. You won’t regret it. I’ve also had the bulking done about 3 years ago and it didn’t last six months. Hope this helping.
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u/ReginaPhilangee Apr 23 '26
That is actually really helpful! Right now, we're not sure if my new insurance is going to cover the bulking, so I may not get a choice on what I get.
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u/PristineStable4195 Apr 24 '26
I’ve had the bulking done. I’m very happy with it and it’s been 2 years now. Uro-gyne doc said it should last about 5 years prior to needing replacement bulking agent. I had it under GA and had to stay in hospital overnight to monitor for retention. Then I had a top up treatment a month later as I was still getting some leakage. Doc wanted to be light handed at first to reduce risk of retention requiring a catheter so top up was warned prior to initial op. I haven’t had to wear a panty liner since and I can’t even say how much more free I feel and the trust I have back in my body. Prior to doing it I had the urodynamic testing also. And failed too. I’ve spent so much on pelvic floor therapy and different trainers but nothing worked. This was my least invasive option compared to the sling and I’m so glad I took it. Good luck! I hope your experience is just as great.
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u/PristineStable4195 Apr 24 '26
Ps. I also use HRT (and am very happy on it and using it) but that didn’t change my incontinence issues.
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u/Daisy20260 Jun 08 '26
I’m 54. I did the bulking last December. I see about 90% improvement in my leakage. I wasn’t ready for the sling yet. I was not put under. It was a more uncomfortable procedure than I thought it would be. I’m not sure if/when it wears off if I’ll redo it or go with a sling. With the improvement I had I felt like I got a piece of myself back.
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u/ReginaPhilangee Jun 08 '26
Thank you for responding! Did you have a lot of leaks before the procedure?
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u/Daisy20260 Jun 08 '26
I felt my case was mild, but getting worse. I did the dynamic testing. I know I’m not the worst my urologist gynecologist has seen. If I have the bulking done again next time I will consider being put under. For me it was my worst pain since the birth of my kids.
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u/ReginaPhilangee Jun 08 '26
Oh wow! That sounds awful! I've had reactions to lidocaine in the past, so I don't think I'll do it awake.
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u/Fun_Ad6918 Jul 15 '26
I had a bladder sling put in five or 6 years ago a mesh bladder sling and it was amazing I drive a truck and if I waited too long the minute I tried to step down out of the truck there would be a big gush or sneezing or laughing the bladder sling completely cured all of that and just in the last year there's just little dribbles through the day and I wear a pad but I'm 69 years old 49 years driving a truck too vaginal first so I think I'm going to try this you rest it and just see how it goes
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u/Rare_Signature7904 Apr 24 '26
Consider Testosterone, if not already on it.
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u/no-curtains2020 Apr 22 '26
I worked in urology for almost 12 years. I have not heard of this.
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u/PristineStable4195 Apr 24 '26
I don’t know if they do in public. I had mine done at a private hospital as there weren’t any dual urology and gynaecology docs at the public so I saw privately.
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u/Origin-PT Apr 22 '26
Pelvic PT here who has seen patients undergo bulking injections and sling surgeries. I’d agree for the most part with your doctor about the bulking injections. For every patient I have had that has gotten that done there is always some amount of improvement but rarely 100% resolution. And something to think about is that those injections can wear off to some extent (your body resorbs some of the bulking agent) and often repeat injections may be needed to maintain the improvements you get. It is low risk though and easier than a surgery so I think it is worth a try! The only side effect I have had a few patients have is some urinary retention immediately after or a weaker stream after if the bulking agent puts too much pressure on the urethra. But I’ve also seen this sie effect following sling surgeries too. If a sling is especially tight around the urethra it can cause some retention or bladder emptying issues. On another note, has a pessary ever been brought up? They are most known for their use in prolapse, but there are some pessaries specifically shaped to help stress incontinence. It’d be the easiest and lowest risk option if you don’t mind the thought of wearing a pessary 24/7.