Pelvic Organ Prolapse: The Silent Epidemic

Pelvic Organ Prolapse: The Silent Epidemic
by Sherrie Palm•More.com Member

CHAPTER ONE

PELVIC ORGAN PROLAPSE, THE BASICS

POP stands for what?? In a time of truly enlightened women, it is hard to imagine that there can be a condition that is quite widespread, yet relatively unheard of. The baby boomers of today are educated, self-reliant, pro-active answer finders; when a problem of any nature arises, they keep searching until they find those answers. It is hard to believe that there is a female condition that has been on record for centuries, is quite common, causes physical discomfort, and can be corrected, and yet an extremely large percentage of women aren’t even aware of it.

Being told at the age of 54 that I had Pelvic Organ Prolapse was a bit of a shock. It wasn’t so much that I had concerns about having a condition that needed to be addressed; I already knew that from the symptoms I was having. It was finding out that I had a condition that I’D NEVER HEARD OF that rocked me. I consider myself to be a relatively intelligent, medically self-educated person; to find out that a condition existed that I had never heard of and possibly could have prevented progression of was infuriating. Living during a time when ED (Erectile Dysfunction, a male condition where erection of the penis is difficult or sometimes impossible to achieve) is on television commercials all the time, I found it hard to believe that nothing was being discussed about Pelvic Organ Prolapse.

Pelvic Organ Prolapse has probably been around since women began having babies. Many of the factors that contribute to it occurring are factors that were as prevalent in the days of early man as they are now. The oldest documentation of Pelvic Organ Prolapse goes back to Egyptian times. The word prolapse comes from Latin origins, meaning “to fall”. Hippocrates wrote about inserting a pomegranate into the vagina as a treatment for Prolapse, (hmmm, fruit in the vagina, let me think about this….), and at least one of it’s symptoms, urinary incontinence, is commonly known.

But in general, the condition in its entirety is not discussed. This is a topic that not only needs to be brought out in the open so that women who are suffering in embarrassed silence can get treatment, but also to attempt to change the school of thought for the younger generation. If the importance of Kegel exercises was passed on at the same time as the importance of having routine pelvic and breast exams, and if it was repeated on a regular basis to young women, it would become second nature to these young women, just like having the other exams is. Since performing Kegel strengthening exercises is not visible to the naked eye, and can be performed sitting, standing, or lying down, they can be done anywhere at any time. (Standing in line at the grocery or discount store is sssoooo boring, this could give you something to focus on that would not only help keep those pelvic structures in place, but also help control urine leakage, as well as improve sensation in the lower region for more sexual sensation-see the chapter on Prevention for more info.) If women in their twenties were taught a few basic, simple exercises that they could do on a daily basis to help prevent pelvic floor complications later in life, maybe the amount or degree of pelvic organ prolapse cases would decrease. If nothing else, at least the awareness of the potential for pelvic organ prolapse would help bring it onto the front page.

POP (pelvic organ prolapse), can occur when an organ in the pelvic cavity (or organs, oftentimes there are multiple organs involved), shifts in a downward direction. This shifting can make the organ or organs, such as uterus, bladder, vagina, urethra, or rectum, bulge out of the normal position. Sometimes they bulge down into the vaginal canal or even beyond it. This downward displacement of organs and attached tissues is called pelvic organ prolapse, or POP for short.

With POP, organs can be out of their normal position, causing many of the different symptoms experienced by women. Organs are often displaced but still within the pelvic cavity, but occasionally the organs can actually push tissues down into or even outside of the vagina. Many women will have symptoms that lead to the diagnosis of other medical conditions; unless the POP has progressed to the point of bulging into the vaginal canal, the POP may go misdiagnosed or undiagnosed.

The statistics behind this condition indicate that many women are being treated for it, just not talking about it. Some of the statistics I found startling were:

·More than 40% of women suffer from some level of incontinence

·There are more than 300,000 surgeries for POP annually

·Caucasian women have the highest rate of POP

·The number of women seeking care for POP is predicted to

increase by 45% over the next few years

1 in every 9 women undergo surgery for POP

·20% of patients with POP have some loss of bowel control

damage to the anal spinchter during childbirth can lead to
loss of bowel control

· As many as 1 in 3 women suffer sphincter damage during

childbirth

·1 in 10 women suffer from anal incontinence

·30% of women with urinary leakage suffer from loss of bowel

control as well

·In 2002, the estimated annual cost of surgical treatment for

prolapse surpassed $10 Billion

·It is estimated that 50% women that have children will have

prolapse later in life

29% of women will undergo multiple surgeries for pelvic floor
disorders

Women tend to underreport POP disorders due to embarrassment; because of this, there is a distinct possibility that the true statistics may be even higher than the research data shows.

Sometimes what brings POP to the front page is a very personal dynamic. When a woman who has enjoyed sex all of her adult life suddenly starts finding sex painful, it can make her confused and frustrated. Since POP commonly starts to present itself at the time of life when a woman may be going through peri-menopause or menopause, she may assume the changes are due to that rather than something more pronounced. The change in the sexual dynamic for a woman may also create tension in her relationship with her partner. Telling your partner that it is painful to have intercourse is difficult enough, having your partner assume you just are making excuses to get out of having sex can be extremely frustrating. It is very common to experience pain with intercourse when your organs are not where they are supposed to be.

Some women also want to refrain from sex because of embarrassment about urinary or fecal leakage, either of which can occur with POP. Rather than risk it happening and have to deal with the embarrassment and then try to explain why it happened, they would rather refrain from sex altogether.

It is easy to assume that POP is a “little old lady” syndrome, but realistically, it is becoming more commonplace for women in the 30-60 age pocket to seek medical advice for symptoms that they want answers for. We are a young, active society, and are seeing more and more options for the Baby-boom generation. It is unfortunate that many women choose to live their lives putting up with symptoms that they don’t understand. Hopefully, this book will shine some light on this correctible scenario.