This goes beyond just peeing yourself.
Rose Smeiman always radiated positivity and a lust for life, so it was difficult to believe that before she underwent a life-changing procedure that halted her incontinence, she was ready to end her life.
“I was housebound for about a year because I wouldn’t go anywhere.” Rose was afraid to sit on someone’s couch in case she left a wet patch. “I didn’t go shopping in case urine ended up running down my legs. I wouldn’t even let my partner touch me… It’s no life for anyone”, she says, recalling the deep shame, frustration and humiliation.
Smeiman, who lives in Port Nolloth with her partner, Leon Coetzee, is emotional as she recalls those dark days, but is adamant that she wants to tell her story. “I want to tell every women out there suffering like I was that there is life out there, that they shouldn’t give up,” she says.
Her hope came when she and Coetzee found themselves listening to Cape Town urogynaecologist Dr Pieter Kruger on the radio, she at home, and him at work. “Leon phoned me and told me to turn on the radio. I told him I was listening.”
It was the start of a life-altering process that Kruger and his partner Dr Steven Jeffery know too well as they operate, train and treat in the public and private health sector. Specialists in the field of gynaecology and minimally invasive or keyhole surgery, they address a range of conditions common in women older than 50, including vaginal prolapse, incontinence and benign gynaecological conditions.
The statistics for South Africa aren’t conclusive, but the prevalence of urinary incontinence in European countries of as high as 40 percent, and in the US up to 37 percent, points to the scale of the problem here, especially with urogynaecologists in short supply.
The South African Urgynaecology Association points out that while incontinence and urinary dysfunction is lower in black and Asian women globally, in the Western Cape the opposite is true – at more than 17 percent for black women, nearly 13 percent for coloured women, and 13 percent for white women.
It’s no surprise then that Kruger says urogynaecology is very, very valuable, and that it changes lives. Smieman’s problems began after she underwent surgery for a prolapsed bladder six years ago, at age 62. About two or three years later the leakage began, and from November 2015 she was literally housebound by her condition, going through nine to 10 packets of protective pads every month.
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But more than that, her life was in shambles. Her doctor, who performed the bladder operation, said he could do nothing more for her. Countless patients like Smeiman have passed through the doors of Kruger and Jeffery, who share an academic position at UCT, and private practices at both Vincent Pallotti and Chris Barnard Memorial hospitals.
“Part of the reason for this is that women are living longer and longer, well into their 80s and 90s. And they are otherwise well, but problems with prolapse are preventing them from living any kind of a full life,” Kruger explains.
Smeiman learnt from the doctors that she had nerve damage related to giving birth, combined with an overactive bladder, and shortly after her evaluation with Kruger, she underwent her first operation in September to connect tiny electrodes to her spine.
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Two weeks later the battery that had been outside her body since the procedure was transferred inside her body, where it will stay until it needs replacing in about four to five years.
“The morning after the operation I woke up and I was dry, dry, dry. Two weeks later I could go home to Port Nolloth, and I am still dry today.”
Effectively, her therapy involved the implanting of a tiny neurostimulator which sends mild electrical pulses to the sacral nerves, Kruger explains. They’re the nerves that contribute to urinary control, so assisting with bladder control.
“I was reborn that day. I got my life back, and I’m telling my story because I want other women suffering like I suffered to know that there is hope …. They don’t need to be ashamed,” she says.