Pelvic Organ Prolapse: Why Surgery May Not Be the Best Alternative

Women often hesitate to speak about problems related to reproductive organs. They may visit a gynecologist when planning a pregnancy or during the motherhood journey. However, many women suffer in silence when they encounter pelvic organ prolapse. The condition is caused by the weakening of pelvic floor muscles and ligaments.

While POP is less prevalent than urinary incontinence, it still affects almost 3% of American women. The prevalence is higher in older women because aging contributes to the sagging of muscles and ligaments in the pelvic region. The suffering in most cases is unnecessary, but the bigger concern is that waiting to seek help only worsens the situation.

At the same time, aggressive treatment like surgery may not be the best choice for everyone. Statistics show that 200,000 inpatient surgeries for prolapse are performed in the US annually. However, many of them are not actually required. Moreover, you should weigh the costs and benefits of this option before proceeding with it.

We will explain why a surgical procedure may not be an ideal alternative for pelvic organ prolapse. 

Risk of Complications

Like any surgical procedure, pelvic organ prolapse surgery has risks related to infection and bleeding. Potential complications include injury to surrounding structures, such as nerves and blood vessels.  Further, the procedure entails mesh-related complications like infection and dyspareunia.

The vaginal mesh lawsuit highlights the gravity of mesh-linked complications of the procedure. Further, the FDA ordered manufacturers of surgical mesh for transvaginal repair of POP to stop selling the device in 2019. Women who already had an implant are filing lawsuits to claim compensation for complications like mesh erosion and organ damage.

TruLaw notes that 59% of women have reported experiencing problems with their implants. Unfortunately, they were unaware of the risks related to the implant before the surgery. The legal system permits them to hold the manufacturer responsible and seek compensation for their pain and suffering. 

Recurrence Rates

Recurrence rates are another major concern of pelvic organ prolapse surgery. The procedure does not guarantee a permanent solution. According to surveys, they also have a high reoperation rate with a lifetime risk of 10-20%, a considerable number. You may also require mesh removal surgeries in case of complications like erosion.

Factors such as age, lifestyle, and overall health determine the chances of the prolapse recurrence after surgery. The last thing you want after surgery is a series of procedures to correct the condition or remove a faulty implant. Remember to discuss the risk with your doctor beforehand to have clear expectations. 

Recovery Period and Downtime

Another reason to think twice before opting for a POP surgery is the recovery period and downtime after the procedure. According to the American College of Obstetricians and Gynecologists, patients usually require a few weeks off for recovery. Precautions include avoiding lifting, straining, and vigorous exercise for the first few weeks. Patients should also avoid sex for several weeks. 

Besides the impact of extended downtime on your daily life, work, and social engagements, you must consider the long-term implications. In the long run, you should avoid any activity that increases pressure inside the abdomen. It includes not lifting heavy objects¸ avoiding constipation, and controlling your weight.

Cost Considerations

Surgical procedures for POP, invasive or minimally invasive, can be expensive because they include more than the cost of surgery. You may have to shell out thousands on the procedure, though its cost may vary according to individual needs. Pre-operative assessments, post-operative care, and potential complications can add to the burden.

Further, you may need to spend on long-term precautions such as getting help for domestic work. You may also need to leave a job involving heavy lifting and bending. For some patients, the cost of a POP surgery is a valid reason to consider non-surgical alternatives that are far more cost-effective. 

Conservative Management Options

Over the years, the controversy regarding mesh-related complications has brought attention to conservative management strategies for pelvic organ prolapse. Non-surgical alternatives include lifestyle changes, physical therapy, and the use of pessaries. These are non-invasive approaches, so you don’t have to worry about pain and complications. 

Physical therapy can strengthen pelvic floor muscles, alleviating symptoms by providing support to the organs. A study comparing patients undergoing POP surgery and pessary treatment showed that both alternatives are significantly effective for reducing symptoms. The latter is evidently better from the safety, cost, and recovery time perspective. 

In conclusion, surgery may be the only option for some cases of pelvic prolapse, but it may not be the right one for every patient. You must consider the potential drawbacks and explore alternative approaches before the procedure. If a non-surgical treatment works, there isn’t a better way to regain control and reclaim your quality of life.