Preventing Pelvic Organ Prolapse Guest Blog Written by: Elizabeth Carrollton
It is likely that pelvic organ prolapse (POP) will become a problem for half of all women who have given birth and in some who haven’t. In most women, this common pelvic support disorder will show up during or after menopause, but some women will experience POP symptoms at an earlier age. However, taking good care of your pelvic health can significantly reduce your risk of developing POP, and if prevention fails, there are many treatments that can help, ranging from conservative options to surgery.
What is Pelvic Organ Prolapse?
Pelvic organs, such as the uterus, bladder, small intestine and bladder, are kept in place primarily by support provided by the pelvic floor, which often becomes stretched and weakened over a woman’s lifetime. In pelvic organ prolapse, that pelvic floor damage has progressed to the point that the organs are no longer adequately supported, allowing one or more of them to drop out of normal position. Symptoms of POP can include urinary or bowel dysfunction, pelvic pain or pressure, bulging in the vagina or protrusion of tissues through the vaginal opening.
Pregnancy and childbirth are the primary risk factors for POP. Women who have difficult deliveries or large babies may develop pelvic organ prolapse after childbirth and are at increased risk of being affected later in life than women who have uncomplicated deliveries. Women who are overweight, work in occupations that require heavy lifting and those who participate in high-impact sports are also at greater risk.
Protecting pelvic health can help prevent pelvic organ prolapse. Physiotherapy during and after pregnancy that focuses on enhancing pelvic floor strength and tone can significantly reduce prolapse risk. Regular Kegel exercise is important for prevention, especially during pregnancy, after delivery and during the years leading up to menopause.
If you’re overweight, you’re placing undue stress on the pelvic floor, especially if the excess weight has settled around your waistline. Maintaining a healthy body weight can lower risk. Frequent straining with constipation is a risk factor, so increase fiber in your diet to prevent it. Good nutrition is important, ensuring that the body has the nutrients necessary for proper muscle maintenance and function.
If you’re already showing the signs of pelvic organ prolapse, many of those prevention methods are also used in conservative POP treatment. Physiotherapy has been shown to enhance pelvic floor function, improving symptoms in many women. Weight loss can reduce symptoms, as can treating or preventing constipation. Avoiding caffeine and spicy foods can reduce incontinence, and using a support device in the vagina, called a pessary, can reduce pelvic pressure and pain.
Surgery has helped many women with severe symptoms. However, it is an option that must be approached with caution, since there are risks. Transvaginal mesh procedures merit particular concern, since they have been labeled risky by the FDA and have caused serious complications in thousands of women. Most common is mesh erosion, which can lead to organ perforation, mesh protrusion through pelvic tissues and infection. There have been several recalls for transvaginal mesh products, including implants made by Boston Scientific, C.R. Bard and Johnson & Johnson, and hundreds of lawsuits have been filed by injured women. Please be sure to always discuss all treatment options and the risks associated with each with your doctor.
Elizabeth Carrollton writes to inform the public about defective medical devices and dangerous drugs for Drugwatch.com.
Harvard Medical School: What to do About Pelvic Organ Prolapse: http://www.health.harvard.edu/fhg/updates/update0805c.shtml
Prevention of pelvic organ prolapse: a summary of the evidence: Dr K. K. O’Dell: http://www.ihe-online.com/index.php?id=2448
A randomized controlled trial of pelvic floor muscle training for stages I and II pelvic organ prolapse: http://www.ncbi.nlm.nih.gov/pubmed/18806910
Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women: http://www.ncbi.nlm.nih.gov/pubmed/18843750
FDA Safety Communication: UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm262435.htm
FDA: Medical Devices: Implants and Prosthetics: Pelvic Organ Prolapse: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/UroGynSurgicalMesh/ucm262299.htm