what do you make of this?

Broken ankles...yeah. Thanks so much for posting this.

I want to write about the prolapse surgical climate - it's more pervasive than ever even as the reality is being revealed through these sorts of studies. Will try in the next couple of days. Also want to answer Chester and Aza and Nikki - hopefully tonight. So much to do!

:) Christine

Thank you so much for posting this. It confirms what I have been thinking for the last 3 years or so. Every single woman I have ever talked to about prolapse has also had one. Not one that they knew of so much- but after talking with them for a bit- heard the same story over and over again-about a bulge- or frequent bladder infection or ache in the perineum or discomfort when running or what ever---

I have often dreamed of having access to an OBGYN's clients just to check for this :) even considering medical school ;)

I especially loved this portion: it really disproves and dismisses all this "thinning tissues must get surgery now or have a greater rate of failure" nonsense.

Another interesting finding was the apparent spontaneous resolution of prolapse. For example, among women with grade 1 cystocele examined 1 year later, 23% had resolved, 10% had progressed (to grade 2-3), and the remainder demonstrated no change. Spontaneous resolution of higher-grade prolapse was less common. Nevertheless, prolapse to or beyond the introitus resolved completely over 1 year of observation in 9.3% of women with cystocele and 3.3% of women with rectocele. Further studies are needed to clarify the prognosis for mild prolapse and to explain the risk factors and biologic mechanism for progression and regression.

only worries me a bit because if they start acting like this is some new phenomenon and decide to come up with some great fix for it we are all screwed.
and I am so curious as to why in the world we get this relaxation (not really WHY- but what purpose it serves). What good comes of it?

Ya know, if POP is normal, ie experienced by a significant percentage of the population, all doctors need to tell women that. A diagnosis is, according to my dictionary, "identification of disease by means of a patient's symptoms, etc". Presumably the patient doesn't consult the doctor unless she has dis-ease, ie less than optimum health.

A broken ankle is dis-ease, but fractured tibia and/or fibula is the diagnosis. Pelvic organ prolapse is the dis-ease, and pelvic organ prolapse is what we would call the diagnosis as well, but damage and stretching of the endopelvic fascia *should be* the diagnosis. A doctor can say that she doesn't regard it as prolapse unless organs are protruding. This is comforting for the patient but she cannot just change the rules about how doctors describe degrees of prolapse! That is like saying that less people are living in poverty as a result of shifting poverty line downwards, to less $$$ earned per day, so more people are above it! Your doctor seems to be saying that she doesn't recognise POP in you, but you certainly have dis-ease from it. She just has no tools to help you with it. I hope she is happy to refer women to www.wholewoman.com, cos Wholewoman seems to still be the only place in the world that women can go to learn how to manage this dis-ease and stop it from becoming 'real' prolapse.

The problem with the medical system is that it is stuck in a paradigm of fixing things that go wrong with the body; shutting the door after the horse has bolted, then wondering why their treatments are insufficient to roll back the damage. It is not until they get into preventative medicine, the realm of Public Health, which does so in order to prevent people becoming sick, and saving money by keeping people out of hospital beds and away from becoming diseased.

Until Wholewoman techniques become a part of the preventative healthcare landscape women will, as you say Lyricmama, still hammer their bodies with exercises designed for the *male* body. Girls will still be taught to tuck in their tummies and butts *because it will protect their bodies from damage". What a load of horse****!

Educating friends and family are two things we can do, but while we are advising young women to go against what their expensive gym instructors, their OHS tutors and the almighty fashion industry dictate, they will still think we are a mob of loonies. I think it is the public health area where the changes need to happen. The Catch 22 is that public health is advised by medical doctors. Ho-hum. Back where we started.

Keep up the rage.

Louise

Wow, that was interesting, thanks for posting this!
Liv

There is another related article in the sidebar of the page that Lyricmama's article is on, click here . I don't know whether or not I am imagining it but they at last are asking some interesting questions about what *really* happens in women's bodies, both in terms of racial origin, different stages of life, and the differences between the woman's perception of the problem and the actual stage of the POP.

Now, all they need to do is make the quantum leap from there to *helping the woman* to do something about it for herself, without them barging in with their scarey stories and glilnting scalpels. They sound like a very civilised bunch of scientists!

The problem seems to lie not in what these real scientists find, but what their less scientific colleagues in commercial medical practices do with these research results, and how they apply them or ignore the results when women consult them.

Cheers

Louise

Hi Louise,

I’m struggling to see one aspect that is different from the standard medico-gothic-byzantine view of prolapse and incontinence.

The Ann Arbor researchers in paragraph 1 seem to be attempting to prove J.O. Delancey’s (also from the University of Michigan at Ann Arbor) latest gyno-theory, LAD, or levator ani defect. Delancey has managed to drum up an enormous media campaign around his pelvic MRIs supposedly proving these defects. For years this team has been digitally mapping prolapse - all based on inaccurate, cadaveric anatomy. I consider him the greatest living threat to women’s health.

The findings in paragraph 2 contradict decades of study and observation that episiotomy most definitely correlates with urinary incontinence. The same can be said for incontinence and pelvic floor exercises. And to conclude that perhaps they should advise incontinent women to stop breastfeeding? Pure rubbish! These people have no framework around what constitutes pelvic organ support so they grasp at straws.

The third study tells us absolutely nothing. What are the nutritional, psychological and postural factors involved? Btw, I attended an anatomy lecture given by Rebecca Rogers’ a few years ago and was completely appalled.

The final discussion is similar to the issue of VBAC. Don’t you think a qualified natural birth attendant would know something about protecting a compromised perineum? Of course. An unspoken push to section every birth and hysterectomize every woman is not the stuff of fiction.

The pelvic reconstructive approach to prolapse and incontinence is only gaining strength and numbers because the system has virtually infinite resources with which to manipulate perceptions of female anatomy and the surgical response. Big Pharma and Big Surgical write the scripts for studies such as these and our hallowed Universities happily go along because no one knows the difference.

Roll up your sleeves, dear Louise!

Christine

Hi Christine

You are right. It is nothing new. I never thought of Prof DeLancey being involved, but as you say, it is all around his work and in the same University. Yes, there are some really weird possibilities that they raise about what to do about these prolapses. I chose to ignore them because the same sort of possible solutions are in many medical discussions. We ordinary women have been through the 'quit breastfeeding so your POPs will get better' here on the forums. It is not rocket surgery that it doesn't work, and they should have been smart enough to research that route before unmasking their ignorance of work already done.

It is another case of doctors not looking beyond their own specialty, which is defined by the dotted lines they draw all over the human body to separate body's different systems, and which they do not cross in search of deeper understanding of the *whole bodies* of their patients.

What I did find interesting, from the point of view of Lyricmama's original topic, were the observations they made of ordinary women concerning the prevalence and degree of POP in sub-groups of women and the variable relation between occurrence and perception of it. I think this is basic information that is very useful for our newbie Members when we get things a bit out of perspective and are trying to make sense of the doomsday predictions of doctors about our POPs.

Cheers

Louise