C-section for second baby then surgery on bladder following severe incontinence from 1st birth

[2ndtimeround]

I am having to have a c-section for my second baby due later this year after a very long and brutal delivery of my first baby by 2 failed ventouse, manual rotation and forceps rotation. I have severe urinary stress incontinence as a result (faecal incontinence now resolved-ish)and have tried all treatments, am under a specialist unit and require a TVT (tape surgery to fix constant leaking) to my bladder post baby no.2. I will not be able to have further children after this procedure.
Has anyone else been though this or able to tell me about c-sections....do you have to have a catheter...my enemy!! I am v anxious re: incontinence being even worse post c-section (although better than it would be post vaginal birth! and rectal problems would be permanent...so a definate no-go. Has anyone had a TVT procedure?
Would love to hear.

[Beauregard]

My mom had the tape thing done a few years ago,it has really helped her.

[2ndtimeround]

Thanks, yes usually it is post menopausal women that have this surgery as everything starts to give way later on in life I understand! As my symptoms are so bad they will do it now for me in early 30's, which they don't normally advise. I am pleased to hear it has worked for your mum, can she now run/walk fast/do exercise? I am a bit like an old woman at the moment but work hard and am v busy so it is pretty tough. Can't do any exercise. Thanks

[spudballoo]

I'm so sorry to hear of your difficult first birth and subsequent problems. Congratulations on your pregnancy!

I had a tricky first birth too, 17 months ago, which resulted in me having a colostomy bag. I am hoping to get rid of this when I stop breastfeeding my 2nd child, born by section 3 weeks ago.

Yes, you do have to have a catheter for a section. My son was born at 7pm, the catheter came out about 11am the next day.

I was advised, if not ordered to have a section for medical reasons by my colorectal consultant. He told me that the weight of pregnancy may do further damage to my pudendal nerves, but a section would protect my pelvic floor.


so, Im not exactly in your position but yes a section is your best option but is no guarantee that your problems wont be worse post birth. I had decided not to have more children to protect my pelvic floor, but got pregnant by mistake when my first child was 8 months.

Good Luck! x

[pregnabrain]

Sorry to hear about your problems 2ndtimeround. I haven't had the TVT op (yet!) but have heard very good things about it. The success rate is very high, particularly if you have it when you're younger. So it sounds like it could be really great for you.

Am interested that you've been recommended a c-section this time round (you too Spudballoo). I am thinking about a second baby now but am terrified of worsening the damage to my pelvic floor. I thought that my consultant would recommend a c-s but he says 'the damage is done now so there is no point'. Do you think this is weird? I feel like I should trust him as he's a uro-gynae expert but i'm so scared...

[2ndtimeround]

Thanks for the messages. Funny you should write that pregnabrain as I saw my consultant yesterday, also a uro-gynae and obstetrician who said the same thing to me from a urinary incontinence perspecitve...that I might want to consider a normal birth (is he MAD????). The damage is done and won't get worse from that angle, but from a faecal incontinence issue and also how traumatised I was by the hideous birth last time he will consider a c-section. Faecal incontinence could get much worse from a delivery. He also said that I will be as badly incontinent as I was just after my baby's birth again with or without a c-section, which I didn't know. I assumed a vaginal birth would make it worse. Are you having to have TVT then pregnabrain? And spidballoo I am so sorry to hear your difficulties. The whole just sucks doesn't it?! But congrats on new no.2.

[2ndtimeround]

God sorry just read it, v bad spelling and words missing, sorry have a toddler trying to draw on a lovely new sofa with a green felt tip ++++crying!!!

[pregnabrain]

Wow. Wonder if we have the same consultant! Those words really could have come out of his mouth! Are you in London?
It's just reminded me, actually, that even my physio kept repeating that a second delivery wouldn't do any further damage. It seems so unbelievable when I think what my body went through last time!

I can totally see why they're recommending a c-section in your case. The faecal incontinence is obviously the bit that's concerning them with a second delivery. And I can absolutely sympathise with your fear after what sounds like a really traumatic experience the first time.

I just keep turning it round and round in my mind - it's driving me mad. The scared part of me wants to opt for a c-section but I also have a really strong urge to go for a second vaginal birth. I keep thinking that a straightforward second birth would help put all the demons to rest from my first, horrible one. Aargh!

I wish someone would make the decision for me.

[pregnabrain]

Sorry, forgot to answer the bit about the TVT. I had really bad stress incontinence straight after dd's birth but lots of hard work (and luck) has improved things dramatically. I had the urodynamics tests recently and the results were virtually normal. They have said that they definitely won't consider me for TVT with this level of problem.
Obviously, I'm thrilled that they think I'm in good shape. But it makes the second baby decision even harder. The delivery might not affect my pelvic floor strength, but a second pregnancy will probably have a negative effect. The best decision I could make for my pelvic floor would be not to have another child at all but I can't bear that thought.

[Katymac]

I've had TVT

I was referred to a specialist for physio and spent months on a machine (in Liverpool) which helped but wore off if I stopped the machine for more than a day

I moved to Norfolk & was referrel to a specialist for physio - who said OK go see Gynae

Saw Gynea who wrote a report saying it wasn't too bad

GP wrote back saying "get this mad woman off my back & do the damn tests)

I lay on the bad and the inserted a catheter and filled y bladder with water - I said "Umm that's all leaking out"
Cheif nurse said "don't be silly dear" & consultant tutted
Junior nurse pout hand on bed & said "it's all wet here"
Consulatant said "Oppps maybe your problem is a bit worse than we thought"

SO they started the test again with a different type of catheter (with a ballon to stop the water leaking out)

They did various tests and then asked me to stand up

I did & peed the floor

I then coughed & peed the floor

& I stretched & peed the floor

Then she said - well there isn't much point asking you to do star jumps is there

4 months later I had TVT

I leak everso slightly when I sneeze standing up

I feel vunerable when I have a bad cough - but I don't generally leak

hth

[2ndtimeround]

Hi Katymac, sounds very like one of my urodynamics appointments. I too went from pillar to post and have a VERY big complaint going through in the nhs currently due to mismanagement both at the birth and after. I am interetsed to hear you had TVT and it helped somewhat though. I have very severe urinary stress inconinence currently, leak on any exertion (walking, picking things up, standing from sitting), and sometimes doing nothing too. I have told my consultant I have no desire to be a trampolinelist in the future (!!) so would be happy with minimal leaking. Just want to get rid of the bloody incontinence pads 24/7.
And Pregnabrain....go for it and get pregnant. Urinary incontinence will be worse during pregnancy, but they have offered me a drug, but I said no at this stage. And it will also be worse when breastfeeding, so am only feeding for a little while this time. But hopefully if PF exercises did it last time it would work this time too. Chances are we will all be incontinent when we hit menopause anyway !!....and there is always surgery and many other drugs to trial if you do still have problems. I am based in S London so perhaps same team? They have been great though, excellant and sooooooooooo professional.

[pregnabrain]

Hello again

Am in south London - bet you're seeing the same bloke! I have been really impressed by the care as well.

How's the second preg been? Has it got much worse or has it been bearable? You sound really positive - much more so than me!

I hope it all goes well for you.

[2ndtimeround]

Hi Pregnabrain
2nd time not so bad, so damn tired though! Am a bit more leaky but am so used to it now. If you think you can manage it... go for it, don't let your bladder decide how many children you will have (ALTHOUGH mine has! Only 2 would've liked 3, but maybe adopt??). Hopefully your bladder would be OK this time after some work again, and if not there are so many options. If I can do it with my terrible incontinence you will manage just fine. And if you had a bad birth the uro-gynae consultant I see is also an obstetrician and v understanding regarding birth trauma and not wanting another horrid birth....so is open to c-sections. It will be getting a lot worse but I am at least prepared this time, instead of doctors saying "just do a few pelvic floor exercises and it will be fine"....er no.....!

[morningpaper]

oh Kaytmac

I'm so sorry but I did laugh at the "well there isn't much point asking you to do star jumps is there"

Many sympathies to you ladies though Hope you make the right choices and get some good consultant care xx

[2ndtimeround]

Ooh my goodness me....you will definately want a pram....babies are heavy and unless you are a Pilates fanatic now and have been for some time your back will be terrible!! Also I had a difficult first birth so couldn't use a sling for a long time due to knackered pelvic floor, pain, rectal tearing, piles, urinary incontinence.... not good for your pelvic floor constant carrying of heavy babies.
Useful but a good buggy will see you through this baby and the next. Good luck!

[2ndtimeround]

oooh sorry went on the wrong thread.....

[pregnabrain]

Thanks for your response, 2ndtimeround. You've given me hope! I think I just need to go for it and worry about it once i'm on that path... Not much point worrying about it endlessly beforehand.

Best of luck with everything.