My Incontinence - Part 1

There are 4 major types of urinary incontinence (a few other types), but non is the cause of my incontinence.

The first teeny leak probably started some time in 2015, if my memory serves me well.  

As a women’s fitness coach, my immediate instinct was to find out why.

Once you know the cause, you can work to solve the problem. 

That year, I had plans to travel to Canada to attend class and learn from a top women’s physiotherapist and teacher, Diane Lee. I promised myself I would go learn and also find out what was wrong. I graduated from the class, and Diane checked me. Based on movement assessments and finding out imbalances, we identified the rehabilitative work I should be doing and continue to observe if it would help the symptoms. 

The symptoms improved a little. But never did go away. 

In 2016, I attended another women’s fitness class with another top physiotherapist and teacher in California. I deduced that I could have a hypertonic pelvic floor that is causing the involuntary leaks. So I generally worked on rehabilitative pelvic floor exercises to manage the symptoms over time. 

Unusual Symptoms

The thing is, my symptoms and the conditions it presented with, became very glaringly odd by 2018.

A hypertonic pelvic floor (overly tight pelvic floor muscles) typically presents itself with symptoms similar to stress incontinence. For example, you will tend to leak when you jump rope, hop or manage a heavy load (whether carrying your child or coming up from a barbell squat).

But those were not my experiences at all. 

My incontinence typically happened when I was in a relaxed position. 

When I sat down comfortably to do work, I felt the leak.

When I leaned back comfortably in bed, ready to enjoy a book, I felt the leak.

When I got comfortable on the floor in a cross-legged position, I felt the leak.

 It was so absurd!

I decided to go visit my friend, Monica Donaldson from Physiodownunder Singapore, and have her help me unravel this mystery. But the timing was not great. By the time I decided to reach out to her, I found out I was pregnant again. And honestly every observation or data you collect once you are pregnant, can be skewed and an inaccurate representation of normal daily occurrences.  

So we only really got to start work in 2020 after about 5 months postpartum. 

Monica was really the first person to point out an abnormality. Based on my observations of the occurrences, plus her assessments of my Pelvic floor muscles, vaginal palpations, pelvis and abdominals checks, we ruled out the typical causes of incontinence. 

She picked up on a shadow-like area on the image of her ultrasound and referred me to her trusted OBGYN for further checks, just to be sure. 

At Dr Christine’s, she was thorough and very patient in explaining the checks she was running through. Her main concern was to be sure that the C section stitches were not causing the leaks. And she said I needed to see another doctor who could “think out of the box” to help me find the root cause. 

So I ended up at another doctor’s clinic. I met Dr Michael Wong at Mt Elizabeth Medical Centre. 

He had me go through an MRI and a cystoscopy (GA, day surgery procedure) and very proudly announced to me that he solved my mystery!

“It’s a urethra diverticulum!”

The good news is, it can be removed and the problem is resolved. 

The bad news?

We need to make a cut via the vagina to reach the diverticulum at the urethrea to excise it. You need to be on a catheter for 2 weeks, to let the urethra heal properly. 😩

At that point in time, my brains just couldn’t register another surgery.

I just had a second C section which was traumatic enough for me. I refused to go into an OT again, if given the option. I was emotionally not ready to put myself through surgery and any bodily discomfort/ trauma at that point in time.

So I said no. 

Let’s KIV.

>> Read on next for Part II - What is urethra diverticulum?