Hygiene for women and slight dribbles? (Slight TMI)

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Title says it all but I wanted to ask opinions, already visited urologist-Some nights I will get cleaned up (like pee, wipe) and then stand up, only to find more came out and down my pajamas which is frustrating. During the day with pads I don't have this issue nearly as much. I also was wondering if you have a bigger bladder leak in a pullup if you should change after say 8 hours or if an all day sort of thing is ok? My concern is UTIs and prevention.
 
I would say for all day use with no changes, id consider using a diaper thats made for that. Ive found that the higher quality diapers keep the wetness away from skin much better/longer than any pull ups i tried
 
Hello Koigal,

of course it's not the best idea to marinate yourself.... From my experience, it's better to use a lighter protection and change more often for that - but that's ultimately also an economic question. As a rule of thumb for me, the protection should work for 4 hours - longer I would not necessarily wear in if it got wet. Personally, I try to change it as soon as possible - but I'm also lucky that it usually only goes wrong once or twice a day when there's a toilet nearby.

For the night I handle it a little differently, because I need my sleep and don't like to change at night. To answer your question about infections: I think Usually that is not a risk to wear an aid a little longer - unless you also have bowel problems.

The bigger risk with this is skin irritation - so it might be a good idea to use better protection at night that can absorb enough to keep your skin dry.
 
Seen several places - including a doctor - who said 8 hours max. That's for the pads. I have wondered if that info came from the maker of the products, but it's logical. If you know it will be longer, maybe use a barrier cream - like used for babies. Was one named Desenex? Been 25 years since I changed a baby. My granddaughter is negligent.
 
I'm curious if you have seen a pelvic floor physical therapist for your bladder. Bladder leakage is treatable and many times it is easier to fix than you think. If nighttime is your biggest issue, that tells me your bladder has probably shrunk to some extent. Peeing too often in the daytime (to potentially prevent leaks - which does not work) will shrink the bladder and then you are unable to hold your urine for an 8-hour night. Pelvic floor PTs can make a huge difference.
 
I have visited a pelvic floor therapist twice, two separate therapists, and they weren't able to help personally. In this case the person doing the bladder surgery might not have had the right touch so to speak. Its possible that my bladder has shrunk honestly. I have both daytime and night time issues. Daytime is more light to heavy leaks/urge and stress incontinence. Night time is good up until going to the bathroom.
 
Sadly Doctor did not seem to know issue, he said "bladder looked fine" but also "bladder has high pressure in it" and "the bladder fills rapidly". After this it became clear he didn't really want to get a good answer,he would rather say I have a bladder "disorder" and give up. (Sorry for the rant). From what I recall the capacity was fine but it also fluctuates. Thank you for your post and I will check that article out.
 
Hi Koigal,
I think you most likely received an ultrasound exam and maybe a CT/MRI. This is not uncommon because in women, a UD is not the standard exam. With ultrasound (depending on the machine) you can calculate bladder volume and see if there are urinary obstructions kidney problems or ureteral anomalies Unfortunately, you can't see the dynamic behavior of the bladder with it. Now, if you want to know more about the dynamic behavior of the bladder, urodynamics (UD) or also called cystometry (not cystoscopy) comes into play.

During a urodynamic exam, a catheter is inserted into your bladder and your bladder is filled with a saline solution under computer control. Basically, two sensors measure bladder pressure and abdominal pressure during the filling process. The doctor will then ask you when you feel the first urge to urinate, when a strong urge to urinate sets in, and when they almost can't hold it in. Depending on the bladder pressure, uncontrolled emptying may also occur (which is intentional). In addition, bladder capacity, voiding speed/volume, and muscle contractions are measured.

With these data you get a very good insight into the dynamic behavior of your bladder and can include or exclude causes. This method is very suitable for the diagnosis of bladder / sphincter anomalies, pelvic floor problems and urinary retention and gives indications of neorological problems. It basically provides information about the interaction of the bladder and sphincter, bladder pressure and bladder capacity, and bladder sensitivity.
However, it does not provide information about the condition of the bladder wall and the GAG layer itself - which is important for the analysis of a possible interstitial cystis. For this, a cystoscopy is necessary. A cystoscopy is an examination in which a catheter is also inserted into the bladder and a camera is used to examine the inside of the bladder.

Both of these exams are necessary - in combination with an extensive lab - to get a better diagnosis in the case of IC. In some cases, a neurological exam is also necessary - especially if nerve damage is suspected.

So to be honest - I would not trust any doctor to make a "general" diagnosis or a very specific (like) IC without these exams.

I was foolish enough to trust my first doctor here and learned the hard way that not everything doctors tell you is the complete story. Unfortunately, it seems that you have to take care of a lot of things yourself - otherwise you waste a lot of time that you might need to treat the root cause.

I think that's what a forum like this can be helpful for. Therefore, I can only recommend everyone to ask exactly and to have everything explained to you. Many things seem simple and logical at first - but unfortunately it is often not. Especially with topics like IC or chronic UTI, many people suffer for many years before the cause is found - and that doesn't have to be the case.
 
Sorry, I should clarify-I did have a Urodynamic study. What is ironic is that I can't even look up the results of the test I paid for. I was thinking a neurological issue is also possible but they gave up before looking into things deeper. The higher pressure on the bladder makes me wonder if a prolapse is possible but at this point, I am going to new hospitals.
 
Oh, I have no problem ranting, I know exactly what you are talking about.... These docs are really good at finding excuses why they can't give you the results out... the best way to get them is to go to another doc and ask them to get them for you - sometimes that's the only way it works.

Also, the really bad thing is that the exams are being done more often for no reason (other than for the reason of funding the doc's new Porsche.... - sorry for my rant...).

But - to answer your question - I don't know why the doc would come up with increased pressure in the bladder without a UD or a measurement - but anyway - that may or may not have an impact on a prolabs - if there even is one.

Usually two things can cause prolapse - child birth or estrogen deficiency. The latter can be caused by menopause.

So if you suspect such a thing, it might be an idea to have your hormone status checked. Also, with an ultrasound, somethings should be at least partially visible.

If you want more details, a micturition cysto-urethrography can also be done. However, since this is an X-ray examination, caution is advised at first and it is not least the question how much new information one actually gains from this examination.
 
During teenage years I had a pretty severe tailbone hit, but as for recently not that I know of. Everything exclusively came after the bladder neck surgery, and to this date they have said my bladder neck is "slightly coapeted" as well if I remember correctly. I will be looking into other medical help here in my state. Its possible for it to be both OAB or IC, but my vote is PFD or IC,..though all 3 are possible. With bladder pain that would somewhat rule out OAB.
 
Hello Koigal,

do you know what exactly happened to your bladder neck? If it was a bladder neck obstruction, it is possible that it was caused by a bladder prolapse. Bladder neck obstruction is - as far as I know - rather uncommon in women, but it can happen naturally.

I think your idea with the PFD can lead in the right direction. In addition, it is also possible that the surgery went wrong and the sphincter was injured. The pain can also come from an overstretched pelvic floor - beyond that that would be an explanation for the stress incontinence. If this is the case, find out how well the sphincter is preserved and what exactly is going on with the pelvic floor. As far as OAB is concerned - I would not exclude it with the above mentioned, because such a pelvic floor problem can also lead to an increased urge to urinate.

If it has not already been done, I would have an MRI or CT scan. You need a three-dimensional image to be able to assess it better. Ultrasound can only do so to a limited extent. Depending on the resolution, you can also detect anomalies of the bladder neck and the urethra. Often this already saves the cystoscopy.
 
Thank you for the input and tips. Unfortunately no, the doctor said it wasn't common but can happen. The sphincter being injured is what I would also bet money on, and I would be curious to see if my voiding output has changed while I wait for my new insurance. The good news is where I moved, I should be able to get better answers when the waiting game is over. Its clearly somewhat IC/PFD related, but I also know they had to cut into the urethra and they did cut a bit out of the bladder neck too. Fingers crossed for better answers and thank you for the tip. Doing further research all I can say is they screwed up big time not explaining things to me, but I am also lucky I usually have lighter leaks, and feel lucky. Full bladder leaks are rare. I also kept up with the pelvic floor excersizes at one point in time but she said it seems like the issues stemmed from surgery if I recall correctly. She also said it was weak and tight from what I recall. I am thankful for a new chapter to begin figuring this out, but I have also accepted I am incontinent and it isn't a huge deal.
 
An injury to vertebrae L3-L4 or L4-L5 (both close to the tailbone, which is S1-S5) can definitely lead to incontinence; it’s what caused mine. I suggest mentioning your tailbone injury next time you see a doctor.
 
years ago broke the tailbone. They said "only thing you can do is let it heal". Said nothing about incontinence, of course.
 
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