No Laughing Matter: Incontinence and Pelvic Organ Prolapse
Seem like it was “yesterday” we skulked down the market’s feminine hygiene aisle tucking tampons under cereal boxes so “no one would know.” Soon we became comfortable and didn’t give a hoot who saw our whopping pack of pads. “The darn thing has wings” became part of our joke-bank. For 19 million Americans though, (80% of whom are women), the new joke is: Have you ever laughed so hard tears ran down your legs? Now we’re skulking around the market buying incontinence supplies.
Nineteen million Americans suffer from incontinence – medical speak for “wetting your pants.” That’s roughly the same as the entire population of New York. Why does it happen? Frequently it’s due to lack of structural support to pelvic organs, including the bladder. Under normal conditions pelvic tissues support the uterus, bladder, urethra, intestines, rectum, and vagina. With age, childbirth or injury, these tissues may weaken and fail to do their job. When that happens, pelvic organs slip down and press against the vagina (and sometimes even out of it).
Countless women suffer from pelvic organ prolapse (POP). According to the National Institutes of Health (NIH), with advanced POP, vaginal protrusion may block the flow of urine, prevent the bladder from emptying completely and lead to urinary tract infections. In other cases, POP causes stress incontinence (urine leakage with coughing or sneezing), difficulty with bowel movements and sexual activity. Oscar Polo, an OB/GYN at Women’s Health Today says, “I’m surprised how many women think it’s a normal part of having children or aging even when it affects their quality of life. Women don’t have to live with this.
Incontinence is one of the most frequent complaints women bring to their gynecologist. There are many different types of incontinence. The most common being stress incontinence which occurs with coughing, sneezing, laughing, and lifting. There is also urge incontinence which is from an overactive bladder. With an overactive bladder you get the “got to go” syndrome, where you feel like you’ve sprung a leak on the way to the bathroom.
With POP and incontinence, complications can be multiple depending on what organ is prolapsing. Some of these symptoms include feeling a protrusion through the vaginal opening or difficulty emptying the bladder or rectum and pelvic pressure.
That’s where an office consultation comes in; to tease apart what organs are prolapsing and what type of incontinence the patient is experiencing. According to studies at the Mayo Clinic, one in 11 women requires surgery for POP in her lifetime. One third of these will need additional surgeries to correct recurrent prolapses. Surgery is done under general anesthesia; typically requires a 2-4 day hospital stay and six weeks recovery. It’s not uncommon that patients require treatment for more than one type of prolapse at a time. A serious talk with your physician will map out a surgical treatment plan.
Today there are a multitude of treatment options for prolapse and incontinence, including physical therapy, medication, and surgical reconstruction. Therefore finding the right treatment with the skill, trust and confidence of an experienced physician is very important. Making the right diagnosis and finding the correct treatment is essential for a good outcome. Incontinence and POP are no laughing matter when if affects your daily life. Here at Women’s Health Today, we have physicians with a lot of knowledge and experience. We can make it better so you can safely laugh (sneeze or cough) again.