The problem started right after Jamie Li delivered her first child. The birth went well, but when she went to use the bathroom for the first time afterward, she noticed she had leaked urine. She didn't worry much. She figured it was probably because of the epidural or the urinary catheter she'd had during delivery. Or maybe it was a side effect of the chemotherapy she'd had after learning she had breast cancer during the pregnancy. Over time, the incontinence improved, though she continued having to wear panty liners every day.
Overcoming Incontinence Gave This Mom Her Life Back
"It's one of those things no one ever talks about, especially young moms," says Li, a 41-year-old cake maker from San Mateo, California. But when she dispensed with that social norm by mentioning what she was experiencing to other women, she discovered she was not alone. Indeed, stress incontinence – the term for when physical stress triggers the passage of urine – affects up to 35 percent of all women at some point. Pregnancy, age, obesity and smoking all can play roles in weakening pelvic muscles and ligaments, leading to the condition.
Li had two more children over the next four years, and with each pregnancy, the leaking became more of a problem. She switched to heavy-duty pads. After her last pregnancy, because she has a BRCA mutation that raises cancer risk, she opted to reduce her risk of recurrence by having her ovaries and uterus removed. That turned into her breaking point. "I don't know if it was because, when they take your organs out, things shift, but bad as things were before, they got progressively worse," she says. Every time she coughed, sneezed, ran or picked up one of her kids, urine dribbled out. She began curtailing activities. She stopped exercising, and even stopped running around with her kids. Just going out for a walk made her anxious.
She saw a specialist who suggested a pessary – a device that's inserted into the vagina to support the urethra and bladder. But it didn't fix the problem.
Finally, she had a consultation with Dr. Alex Berger at the UCSF Gynecologic Surgery and Urogynecology clinic. A specialist in female pelvic medicine and reconstructive surgery, Berger has treated thousands of women with stress incontinence. While physical therapy can sometimes resolve the problem, he told Li that no amount of physical therapy would make a real difference in a case as severe as hers. He recommended mid-urethral sling surgery, a procedure in which a synthetic mesh is placed like a supporting hammock under and around the urethra. It's a minimally invasive procedure that can be done on an outpatient basis, with minimal pain and scarring. "I decided on the spot: "Get me a surgery time," Li recalls.
Although the preparation, anesthesia and recovery took up most of a day, the procedure itself lasted only about 20 minutes. After some mild cramping and a day of rest in bed, Li was back on her feet. Two days after the surgery, she put her baby son in his stroller and went for a two-hour walk – the longest walk she'd taken in years. "There was no problem, no pain, no leaks. It was amazing."
Li revels in how the surgery has given her life back to her. "I can run. I can work out. I recently ran and flew a kite with my kids. That's such a small thing, but I had not done it for five years."