Having a weak pelvic floor – and related, erm, bladder leakage – is a universal problem for many post-partum mums in Singapore. It’s got us thinking: Why is it that so many of us suffer from incontinence but we don’t talk about it? It’s one of the inexplicably taboo topics like life after maternity leave and feminism for girls (and don’t even start on having the sex talk with your kids). Jessie Steffen Rausch is an active American mum of four who’s been living in Singapore for three years. She decided to share her successful pelvic floor surgery story online. Her post went viral, hitting a nerve with women all over Singapore. Thanks to the bravery of Jessie, we’ve decided it’s time to start talking about real issues that affect women every day.
We sat down with this trailblazing mum, to hear all about her journey to pelvic floor surgery. She’s given us all the crucial information you’ll need to decide it this is the incontinence fix for you!
We found your post about your successful pelvic floor surgery selfless and inspiring! What made you go public with your experience?
I knew I was really putting myself out there, but thought that if my story helps ONE person, then it’s worth it. I think a lot of women struggle with bladder leakage but no one talks about it. Having “accidents” all the time is depressing and embarrassing, but life doesn’t have to be like that forever, you can do something about it. I was so excited about the success of my surgery, I wanted to share with others who might be struggling with similar conditions and offer them some hope.
Tell us a bit about your life before surgery
I’ve been running races since high school and have always enjoyed working out and being active. We started our family when I was in my late twenties and now have three boys and one girl, all roughly two years apart. All my kids were born naturally, and were large babies – the biggest weighing in at 4.3kg! After each pregnancy it became harder and harder to workout, at first due to time constraints, but later because I was struggling with incontinence. I couldn’t sneeze, cough, jump, or jog without wearing protection. When my youngest was three we knew we weren’t having any more kids, so I decided to do something about it.
Did you try Kegel exercises and other non-invasive methods first?
I’ve done Kegels for years, and still do them now. Following my second, third, and fourth pregnancies physiotherapists used instruments such as electrodes and ultrasound equipment to measure the effectiveness of my efforts. My last physio informed me that while I should do Kegels for the rest of my life, incontinence would only worsen with age. After having so many big babies so close together, she recommended (thank goodness) that I’d need surgery to fix the issue.
How did you find out about the procedure?
I’ve been aware surgery was an option for years as my mother had a different procedure done for the same problem. I hadn’t heard about Tension-Free Vaginal Tape (TVT) until I went for my first consultation with a doctor.
Where did you have your surgery? Did you consider travelling overseas?
I’d heard some unsuccessful incontinence surgery stories – including my mother’s – so I interviewed several doctors. Dr. Christopher Chong Yew Luen at Gleneagles Hospital studied and practiced TVT exclusively for an entire year in Australia and has performed it successfully for many years here in Singapore. After seeing him I didn’t consider going abroad to have surgery, as the best possible treatment is available right here! I was very confident in my choice, as Dr. Chong is truly an expert in his field. (By the way, I have no affiliation with Dr. Chong.)
How much does it all cost?
Let me preface this by saying we have excellent insurance. I paid S$4000 for the initial and follow-up visits and procedures (which was quickly reimbursed by insurance). I obtained a letter of guarantee from my insurers before being admitted to hospital to completely cover the costs of my surgery and stay (totalling S$26,000).
What does the procedure involve from diagnosis, to hospital time, and recovery?
My initial consultation included vaginal and bladder ultrasounds and an urodynamic study which were all relatively quick, and while uncomfortable, not painful. Once I’d decided on TVT surgery and got the go-ahead from insurers, a pre-surgery consultation was scheduled to provide more detailed information. The surgery was fast – about an hour (including additional stitching for vaginal prolapse).
Following the surgery, I had minute scars on the insides of my upper inner thighs where the TVT was inserted (which I couldn’t see until Dr. Chong showed me) and stitches in my perineum. The discomfort was similar to post vaginal delivery, but was easily managed with medication and didn’t last more than a day or two. My body was sore and achy for a few days and as I was told to do very, very little I and spent most of the first week in bed or on the couch.
I don’t have live-in-help and my close-knit neighbourhood was amazing – creating an online signup to bring us meals for a few weeks. I’m so lucky! I could do more the second week and by the end of the month, I felt completely normal. I had to be careful not to do too much, too soon (jogging and lifting my kids had to wait). I had multiple post-op visits including ultrasounds and an urodynamic study to ensure the tape was in the right place and functioning properly.
Amazingly, just six weeks after surgery I was able to run! Ten weeks after surgery I went to BOUNCE (pictured). I am now 12 weeks post-op and have been cleared to lift weights, kids, you name it! It is an absolute miracle.
What is your prognosis now?
According to my doctor my prognosis is very good. The tiny barbs on the tape adhere to your organs, helping to lift your pelvic floor, and the long-term fix comes from the scar tissue that surrounds the tape, holding everything in place. With the use of ultrasound Dr. Chong demonstrated that I am able to fully void my bladder, and that the tape is in the correct position. It’s not expected to fail, and with regular Kegels, I should remain leakage-free long-term.
How has your life changed for the better?
I can’t say enough positive things about this surgery. I feel like a kid again. I can run, skip, hop and jump. I can join a boot camp class without wearing protection and the fear of embarrassment is a thing of the past. Most importantly, I can keep up with my kids, which is worth everything to me.
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