Dr. Romanzi, Dr. DeLancey, and Gynecology’s Refusal of Transparency

Submitted by Christine on August 19, 2009 - 2:08pm

Hello Readers!

Inaccurate Pelvic Orientation
Another Inaccurate Pelvic Orientation
More gynecologists are starting to blog these days. A quick read through one doctor’s blog revealed it was filled with the gross inaccuracies that have characterized the field from its inception. Seeing the sort of propaganda that filled the page, I wrote a respectful response that actually began with the words “With all due respect...”

I told her that if she rotated all her pelvic illustrations approximately 90 degrees, she would have a much more reasonable idea of the pelvic interior in the standing woman.

I also stated that the hysteropexy she is enthusiastically selling is an age-old concept with proven risks because the very weak uterosacral “ligaments” actually carry nerves from the spinal cord to the sides of the uterus. I asked whether amputating and wrapping them around the cervix might not result in loss of feeling with orgasm. The constant tension of pulling the vagina toward the spine results in new-onset or worsening of cystocele. Reconstructive surgeons have always known this.

Finally I asked her to look at her diagram of the Colpexin Sphere. I reminded her that the vagina is a flat, closed, airless, virtual space and it is this design that protects it from the forces of intraabdominal pressure. By holding it open with such a device, the vagina becomes much more vulnerable to pressure from surrounding organs.

Alas, she has been moderating my comments for the past 24 hours and still they have not been posted.
The Accurate Pelvic Orientation
Colpexin Sphere
Louise wrote in as well. “Superb Womanhood” is the last illustration in her article, which is a circa 1850 photograph of a woman in perfect WW posture. Here is Louise’s post:

“ I couldn't help comparing the anatomical diagrams (based on cadaver orientation) that appear through the paper with the last illustration, Superb Womanhood. If Ms S Womanhood had POP I doubt that she would notice it much, because her bladder and uterus would flop forward and be supported by her pubic bone, right out of the way of her vagina. However, if she spent much of her evenings slumped in a lounge chair in front of a TV and her days driving around in a semi-recumbent car seat designed for a man, then she certainly would feel her symptoms, just like your diagrams. Perhaps posture has a crucial role in preventing symptoms from affecting a woman's life?”

Louise’s comments have not been posted either.

In the days before the internet gynecologists had power over all women’s health information. It was sealed in libraries, universities, medical conferences and in the frameworks of reference of practitioners throughout the developed world. There was little worry that conceptual framework would ever be challenged in any significant way.

We now live in a world where the walls have come down. But gynecology continues to operate as if their protected world still exists!

Nowhere is this more apparent than in a new video presented for the purposes of “educating” fellow reconstructive surgeons. Be forewarned that there is a standing female cadaver of just the pelvis and thighs that is quite disturbing. Yes, some educational value exists there, which could just as easily be obtained through imaging technology. Click here to watch the video.

Please understand that the moving upright images of intraabdominal pressure and prolapse are completely contrived. These have to be MRI still shots with the woman lying flat on her back, strung together and rotated. The most nimble contortionist could not possibly stand with her pubic bone in that position. There is also the possibility the image is that of a cadaver with artificial thoracic pressure being applied. It is an unethical, deceitful fake that illustrates the extremes these people will venture to preserve their flawed and crumbling framework.

Christine

(Inaccurate Anatomy and Colpexin Sphere illustrations are from Dr. Romanzi's blog)

Comments

louiseds

August 19, 2009 - 8:11pm

Hi Christine

The illustration at top left is probably accurate for the woman who slouches or has modern Pilates-style posture. It illustrates perfectly what does happen to the uterus in the absence of significant cystocele and rectocele, if indeed that is possible.

Like so many things in modern medicine, doctors are now trained in abnormality, not normality. I had a discussion about this at a Photoshop course I was doing. One of the other participants was a technician who prepared online materials for lecturers in medicine. He was learning about enhancing medical images of diseased tissue electronically, for purposes of illustration. He told me that, eg students do not learn about normal skin. They only learn about diseases of skin. I guess this follows through to other parts of the body. And I guess that if your skin is normal you don't need to see a doctor about it, so why learn about it. Wha???

Likewise, maybe doctors' attention is never drawn to normal pelvic anatomy. Perhaps they don't study it for its normal function, only for the things that can go wrong with it. Following on from that, probably most of the women who visit them with POP have very poor posture, so of course they have POP. If I went to a doctor to show them my WW posture, they would scratch their heads and wonder what I was doing there, and charge me all the same! Perhaps gynos looking at POP wouldn't know normal pelvic anatomy if they fell over it!!! LOL!

That makes a doctor's waiting room a bad place to be if you have POP and want help for it. It is like expecting KFC to fix your indigestion!

Louise

Oceanblue

August 19, 2009 - 8:34pm

I am thankful that you stand up to and speak out against gynecologists for what you feel should be rectified.

You are the best, as you do go to all of the effort of being thorough with your tremendous amount of in depth research, something that most gynecologists either do not care to do, or have the time to do.

Mega Hugs for you!

Oceanblue

Christine

August 20, 2009 - 7:58am

Thank you for your kindness and appreciation, Oceanblue! This information is far more important than it looks at first glance. Louise, I appreciate your comments - but the first one is especially important for what I am trying to elucidate.

Precisely my point is that the pubic bones are Never in that four o’clock position and Always in the six o’clock position. The difference between a completely raised tailbone and a completely tucked under tailbone is that the pubic bones and perineum slide ever so slightly forward - but never UP into that four or five o’clock position.

Women can feel this themselves by placing two fingers just inside their vagina and hooking them over their pubic bones. Bend over at the waist, then slowly come back up to see that the horizontal pubic bones, which are underneath you like straps of a saddle, never move from that position! The human pelvis is horizontal - just like the butt of a horse - and only through our pronounced lumbar curve do we stand up. This means all that business about forward and backward pelvic “tilt” is nonsense. The pelvis is Always tilted all the way forward. Therefore, the motion of the ilia must be more in-and-out like an accordion than forward and back. In this way they lock and unlock the sacrum.

When women are given these sorts of inaccurate illustrations it subtly programs them to believe they have crazy anatomy perched over a soft tissue hammock with a hole at the bottom. Trying to explain natural posture and the futility of kegels to women who have the wrong impression of their anatomy is very difficult. To them (and all of gynecology and PT), it makes the most sense to suck up and in as strongly as possible in hopes of strengthening the “floor”. In reality there is no floor but only a thin, sinewy wall of muscle at the back.

Correcting women’s perception of their internal anatomy is of urgent importance so they can see their body for what it truly is: an ingenious design where the organs are held naturally forward and well away from the pelvic outlet. The only effort required is to pull into our natural shape.