POP SURGERY: DAMNED IF WE DO, DAMNED IF WE DON’T
By Sherrie Palm
Each time the media posts negative information about pelvic organ prolapse, it send’s pro-active women’s health backwards in time. POP is difficult to navigate once we finally get a definitive diagnosis to explain our chronic constipation, our incontinence, our vaginal or rectal pressure, or our tissues bulging from our vaginas. POP is certainly difficult to navigate when we’re told we have to go through several uncomfortable (and awkward) tests to determine which of the five types of pelvic organ prolapse we have. But we do what we must do and move forward. And then the media smacks us right in the face with articles that inflame the worst case scenario, creating doubt that we are making the right decision to move forward with surgery or creating fear that the surgery we’ve already had is going to fail.
It’s important that we recognize that every health condition since the beginning of modern medicine has experienced a growth curve-a recognition phase, a treatment solution phase, and a modification of treatment phase. The nature of medicine is continual growth, continual research, continual improvement.
I have little doubt that the urogynecologist who surgically treated my cystocele, rectocele, and enterocele may be utilizing a different technique now than she did when I had surgery. It doesn’t make me any less happy with my outcome. As the POP arena moves forward, techniques and tools will continue to evolve.
The recent release of research data related to long term outcomes of POP surgery documented surgical
failure over time. The media had a field day similar to coverage of transvaginal mesh; multiple articles were broadcast on POP surgical failure and mesh complications. But what about the rest of the story?
What about the fact that these surgeries took place 7-10 years ago and like all developing fields, a considerable amount of change in technique and tooling has taken place in recent years?
What about the fact that the learning curve for mesh placement in the pelvic floor is significant, I wonder how many years of sacrocolpopexy experience each physician who took part in the study had?
What about the fact that little dialogue occurs with patients about the value of post-surgical maintenance such as weight lifting restrictions and continuing pelvic floor exercises?
It’s important that we continue to view pelvic organ prolapse procedures for what they truly are-a path to improve our quality of life. Will we ever be 25 again-not going to happen. But we women must move forward living our lives to the fullest, recognizing that we actively participated in the decision making process to treat our prolapse concerns. There is significant value in POP research and truly is a need, no matter what the study outcomes reveal. It is up to each of us to move the ball forward, and not falter or freak out every time the media is trying to capture headlines.