Posts Tagged ‘pelvic floor disorders’

Implications Of Increase In Incidence Of PFD

Wednesday, December 4th, 2013

It is forecasted that one in three women will be diagnosed with one or more types of pelvic floor disorder (PFD) by the year 2050, based on the results of a study presented at the Urogynecologic Society on its 30th Annual Scientific Meeting. Representing an increase of 56 percent, this means 50.1 million women will suffer PFD from the existing 32.2 million reported cases.


In 2050, urinary incontinence which may continue to be the most common PFD will increase to 28.4 million from the present 18.3 million. For the same period, the number of women expected to suffer fecal incontinence is seen to reach 16.8 million from the present 10.6 million. Pelvic organ prolapse (POP), which is being experienced by an estimated 3.3 million women today may increase by 46 percent bringing the number of POP patients to 4.9 million.


Healthcare providers have expressed grave concern over these alarming projections. They foresee several implications that may have a great impact on the women and they realize the need to take necessary actions to address these issues.


An increase in the demand for the care of these women may become necessary due to the enormous increase in the prevalence of these disorders. Many fear that in dealing with these disorders, there might not be enough fully-trained doctors. These women may not be adequately attended by capable medical experts unless more physicians are encouraged to specialize in this field.


Other measures which can be taken up to address this potentially disastrous situation include a more comprehensive research on this subject and a massive education program directed at women who may be at risk of developing these disorders. Discovering remedies for these conditions should not be the sole objective but should also focus in dealing with obesity which has been acknowledged as a prime risk factor which has seen an increase in the country in epidemic proportions.


The classification of obesity as a disease may go a long way in helping women in their struggle to maintain ideal weights. While this may be a positive initial step, much has still to be done before these women can triumph in their fight against excess weight.


Experts also see the need to educate women on these disorders by convincing them that they do not have to suffer in silence. They should come forward and report their symptoms in order to have the appropriate treatment for their conditions and should not take these disorders as a cause for embarrassment.


It should be noted that in treating these disorders, the need for innovative and better options may trigger competition among different companies. Concerned sectors are hoping that companies such as Ethicon will put the welfare of the patients before any other considerations, financial or otherwise, and that they have learned something from the vaginal mesh tragedy. This controversy has resulted to the filing of legal actions against mesh manufacturers with Ethicon expected to have the most number of vaginal mesh lawsuits.



Women Report Improved Sexual Function After Weight Loss Surgery

Monday, December 2nd, 2013

Medical experts say, citing results of different clinical trials, that it has been long accepted that addressing obesity through bariatric surgery may benefit people in terms of improvement in one’s medical condition. In a report published online recently in JAMA Surgery and presented at the Obesity Society Annual Scientific Meeting, results of a new clinical trial have shown that this method of losing weight does not only help in managing diabetes, heart problems, and other major illnesses, but may also improve a woman’s sexual function.


With the objective of determining changes in sexual function, sex hormone levels, and relevant psychosocial variables in women, a study was undertaken by Dr. David B. Sarwer and a team of researchers from the Perelman School of Medicine of Pennsylvania in Philadelphia. According to Dr. Sarwer, this study is significant since sexual health is a key component of quality of life but is often overlooked in weight reduction studies.


This study involved the participation of 106 women who underwent bariatric surgery from 2006 to 2009 in two of the Longitudinal Assessment of Bariatric Surgery centers. Of this number, 85 had a Roux-en-Y gastric bypass while the remaining 21 women underwent laparoscopic adjustable gastric banding. Average age of these women was 41 years, a median weight of 123.6 kilograms, and an average body mass index of 44.5 kg/m2 at baseline.


The Female Sexual Function Index (FAFI) questionnaire was used by the researchers in determining the overall sexual satisfaction particularly on the areas of desire, arousal, lubrication, orgasm, satisfaction, and pain. Blood was drawn from the subject to determine levels of reproductive hormones and were asked to answer questionnaires to find out data on health-related quality of life, body image, satisfaction levels in selected variables.


A significant improvement after one year from bariatric surgery was reported by the subjects in overall sexual function especially in the areas of desire and satisfaction. By the second year, it was reported that sexual function continued to improve, which huge increases in the aspects of arousal and lubrication. In addition to these outcomes which are sexually-related, dramatic improvements were also experienced by respondents in overall quality of life, body image, depressive symptoms, and relationship with their partners.


It is indeed very encouraging to note that weight loss through bariatric surgeries have benefited countless women in many important aspects of life such as sexual function and in addressing medical conditions. Only recently, it was reported that this method of weight reduction may negate the need for surgical procedures such as vaginal mesh surgeries in the treatment pelvic organ prolapse (POP) and stress urinary incontinence (SUI), two common conditions affecting women.


In view of the controversy surrounding the use of vaginal mesh devices, women may now have an alternative in managing these pelvic floor disorders. Thousands of women may be spared the possibility of suffering severe complications attributed to these mesh implants. Legal steps such as filing of vaginal mesh lawsuits against mesh manufacturers have been taken by patients as a result of the serious injuries they experienced. So far, these lawsuits have been moving quite well except for a minor setback where a complainant lost the opportunity to recover losses and instead ordered to reimburse legal expenses of the defendants.



Learning The Main Causes Of PFD In Menopausal Women

Saturday, November 30th, 2013

Medical experts have long accepted menopause, along with pregnancy and childbirth, as one of the primary reasons for the occurrence of pelvic floor disorders (PFD), particularly stress urinary incontinence (SUI), the most common form of PFD. SUI is foreseen to be experienced by more than 40 percent of women in the menopausal stage and by the time they reach 80 years of age, the risk of surgery will be 20 percent.


Reasons for this occurrence are presented below to allow women to gain an understanding and hopefully help them in addressing these life-altering conditions:


Weak Pelvic Floor Muscles

Just like the rest of the muscles in the body, the pelvic floor muscles also start to weaken and lose mass as one gets older. Studies have shown that muscle strength deteriorates by five percent every decade after the age of 30. This ageing process is also closely tied with menopause with women experiencing this stage between the ages of 45 and 55 years.


Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) may result when the pelvic floor muscles lose strength since it may not be able to support pelvic organs such as the bladder and bowel causing these to descend or drop from their normal positions towards the vaginal wall.


Bladder Becomes Less Elastic

As a woman ages, the bladder may also become less elastic, just like the weakening of the muscles. This loss of elasticity may irritate the bladder making it difficult to stretch causing the muscles of the bladder to be overactive. Stress incontinence or frequent urination may result which is made worse by the weakening of the pelvic floor muscles.


Vaginal Dryness

Menopause has been associated with the loss of the hormone estrogen. Once the level of estrogen drops, vaginal dryness in the vaginal lining and urethra may be experienced by the woman. The onset of incontinence and other pelvic disorders such as urinary tract infections may be hastened with this dryness.


Gain in Weight

Women start gaining weight as they grow older, even before the onset of menopause. Due to several other factors, this weight gain becomes more pronounced as women enter the menopausal stage.


Any additional weight may tend to put a strain on the pelvic floor muscles which may result to the weakening of these muscles. The muscles may not be able to support the bladder and bowel leading to incontinence once this happens.


While the menopausal stage in a woman’s life may be considered an inevitable, this does not mean that one has to live with these disorders. There are many things a woman may do to prevent or manage these conditions without undergoing invasive treatments, as proven by clinical trials. In addressing these problems, behavioral and lifestyle changes have been shown to be very effective, even allowing women to maintain a positive quality of life.


With these conservative measures, it is hoped that a woman suffering from POP or SUI may not have to undergo a surgical procedure for treatment. In light of the controversy surrounding vaginal mesh surgeries, this surgical option may only put unnecessary risks to women. These procedures, which have become very common recommendations among doctors, have caused severe complications resulting to serious injuries.


This pain and suffering experienced by these victims have compelled them to take legal remedies such as filing of vaginal mesh lawsuits. Lawsuits have already been scheduled with some already decided by juries, with one case in the news lately with the upholding of the $2 million verdict given by the jury.



Risk Of Surgery For POP, SUI Jumps From 11% To 20%

Sunday, November 24th, 2013

By the time a woman reaches 80 years of age, the lifetime risk of having a surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI) repair will almost be doubled to 20 percent, based on the results of a study which was presented to the American Urogynecologic Society during its regular scientific meeting. For those suffering from these conditions, the risk of surgery had been estimated at only 11 percent for over two decades and perhaps in millions of publications on pelvic floor disorders.


Undertaken by a team led by Dr. Jennifer Wu of the University of North Carolina, this study was based on data using population-based MarketScan databases for the period 2007 to 2011. From the claims of 51.8 million privately insured women, the team was able to identify 311,070 surgeries involving POP and SUI repairs performed during the period.


Analysis of the data showed that by the age of 80 years, a woman’s lifetime risk for SUI surgery is 14.5 percent and 13.7 percent for POP. The combined risk for either surgery was placed at 16 percent at age 70 years and to increase to 20 percent by the time the woman reaches 80 years of age.


These new figures may bring about a number of significant implications which have caused grave concerns to the medical world. It is worth noting that in the coming years, the actual number of women requiring surgery may actually be more than double since the women who will be growing older represent a very large portion of the population.


With more women requiring medical services, the need for more healthcare providers specializing in this field becomes very pressing. In meeting the needs of these women, there might not be enough doctors, at the present rate of new surgeons learning this sub-specialty. This raises also the vital need for research and education directed at effectively addressing this problem which may become epidemic in proportion.


The very important issue of the method of surgery in treating these pelvic floor disorders may be raised anew, particularly the use of the very controversial surgical mesh. In the absence of any order discontinuing the use of these pelvic implants in the repair of pelvic floor disorders and with a large number of surgeons advocating the use of these devices; it might not be farfetched for the vaginal mesh problem to drag on.


While the debate on the merits of using vaginal mesh devices rages on even among doctors, numerous surgeons continue to use these devices in treating their patients. Even with the guidelines set by the Food and Drug Administration (FDA) on using surgical mesh, patients will always put their unwavering trust on their attending physicians.


That the new crop of vaginal mesh devices will be rigorously tested for its safety and efficacy may be argued by mesh manufacturers, but events in the recent past cannot be ignored easily. A big number of women have suffered serious injuries from these devices which experts have labeled as defective. Legal actions such as vaginal mesh lawsuits against mesh manufacturers have been resorted to by these victims.