"Parents are like shuttles on a loom. They join the threads of the past with threads of the future and leave their own bright patterns as they go."
-Fred Rogers

Thursday, August 16, 2012

Spreading the Word About Pelvic Organ Prolapse Treatment

I recently received the following email:

Hi Tricia,
I am contacting you on behalf of the Public Outreach Department at DrugWatch.com. I saw that you had some great posts and was wondering if you would be interested in a guest blog post from our writers to help raise awareness about a serious women’s issue involved with pelvic organ prolapse.

This condition, which typically affects women after childbirth, a hysterectomy or menopause, has a rocky history when it comes to its popular means of treatment. Since the 1990’s a product called transvaginal mesh has led to a series of complications the most serious of which includes organ puncture, infection and in extreme cases loss of life. Being a doula site I thought that this topic would be a good way to get this important information out women to keep them informed about the condition should it come up later down the road.
f this is something you would be interested in or if you have any questions please let me know. I look forward to hearing back from you. Thanks so much for your time.
Best Regards,
Jeff Jocoy
Public Outreach

I did a bit of research and agreed that this was a topic my readers would find relevant and interesting, so I'd like to welcome Elizabeth Carrollton, who writes about defective medical devices and medication safety for Drugwatch.com. I hope you enjoy this guest blog piece.

Pelvic organ prolapse, or POP, is a condition that affects approximately half of all women at some point in their lives. It occurs when a weakened or stretched pelvic floor allows pelvic organs, such as the bladder, uterus and rectum, to drop lower than they should be in the pelvis, placing pressure on the vagina.

Most frequently, POP becomes evident in the years leading up to menopause or after a woman has gone through the change of life. While severe cases may require surgical repair, if caught in its early stages, POP can usually be treated successfully with non-invasive therapies. Unfortunately, many women are unaware of POP risk, and since the symptoms of POP can be embarrassing, many women who have them suffer in silence rather than seeking diagnosis and treatment.

How it Happens

In most cases, POP is a condition that has developed over many years, as damage to the pelvic floor — due to childbirth, heavy lifting, excess body weight and other factors — gradually weakens its muscles and ligaments. Then, when menopause approaches, the changes in hormone levels and body chemistry that occur cause those tissues to lose elasticity, becoming even weaker, leading to more prominent symptoms.

Symptoms of Pelvic Organ Prolapse

POP can involve the prolapse of one pelvic organ or several. Women with mild cases may show no symptoms, while those with moderate to severe POP can experience symptoms that include pressure or pain in the lower abdomen or back, and pain during sex. In women with severe POP, organs may begin to protrude through the vaginal opening, and constipation can become a problem as prolapsed organs obstruct bowel function.


Mild to moderate POP is often treated with physical therapy, which consists mainly of pelvic floor exercises to strengthen the weakened pelvic floor muscles. Kegel exercises, Pilates and yoga are often recommended, and can reduce or even eliminate POP symptoms. Maintaining a healthy body weight can help, as can avoiding tobacco products and eating well. All of these treatments are also excellent for POP prevention.


Severe POP that does not respond to lesser treatments can usually be corrected with surgery. However, women who are considering this option or have already had surgery should know about the risks involved with procedures that use transvaginal mesh implants for POP repair. These implants are inserted through the vagina (transvaginally) to support the pelvic organs.

The Food and Drug Administration (FDA) has advised that procedures using transvaginal mesh have not been proven any more effective than those that don't. The agency has issued alerts on transvaginal mesh products, citing concerns over disturbing rates of serious complications. Among the most frequently reported problems are erosion of mesh through the vaginal walls, mesh shrinkage, organ perforation and infection all of which have led some woman to begin filing a vaginal mesh lawsuit.

Women should ask their surgeon whether he intends to use transvaginal mesh, and if so, why he feels it is necessary. If a woman is not satisfied with his explanation, she should get a second opinion. For women who already have a mesh implant, they need to make sure their doctor is on the lookout for these complications.

Author Bio: Elizabeth Carrollton writes about defective medical devices and medication safety for Drugwatch.com.


  1. thanks for this tricia! i realized i had a POP about 2 weeks after the birth of my second child. I felt a bulge in my vagina which for the first day I thought was a post-partum clot that I couldn't shake out, then realized was a part of my body! As I'm only 22 years old, my doctors were very surprised I was already having symptoms of prolapse. However, the birth of my first child required forceps assistance, where I endured a 4th degree tear (front to back). While I never felt I completely healed from the birth, all my health care providers told me I was normal down there. I believe my second pregnancy and delivery put too much of a strain on my already very weak pelvic floor, which caused the bulging post-partum. I ended up going for pelvic floor therapy for 6 weeks, which improved my symptoms a lot. My provider said that pelvic therapy is very new, which is probably why it was never suggested to me after my first birth 8 years ago (when I should have received help). However, in order to maintain strength just like any other muscle, you constantly have to practice your exercises, and being a busy working single mom to two kids, I find myself not keeping up and will likely have to return to therapy soon (1.5 years pp). I fear that my next pregnancy/birth will only further deteriorate my pelvic floor :(
    I really wish that at my first birth my doctor would have suggested changing positions to push in so we could avoid using the forceps, so all of this would never have happened. I was only 14--the doctor ruined my vagina before I had much of a chance to even use it.

    When I was diagnosed with POP, I approached my pp doula to seek knowledge from her, as I was both self-conscious about it and concerned for my health and ability to birth naturally with subsequent children. Unfortunately, she was unable to provide much support in that realm (which I do not hold her liable for anyway). However, I think it would be very helpful to clients for doulas to possess at least a working knowledge of the condition, considering how common it is.

  2. I like this post as I'm trying to learn more about pelvic organ prolapse. Just recently, mom was diagnosed with POP, surgery was one of the options but we're not considering that as of the moment. I'm quite surprised how common POP is.