FIRST AID FOR CYSTOCELE

(Or Fallen Bladder or Bladder Proalpse)

Here is another source of information  from www.wholewoman.com

You are not alone.

This is a very common problem. In fact, it's the most common women's health problem in the developed world. More than half of women will experience some form or degree of pelvic organ prolapse in their lifetime.

Unfortunately, literally millions of women like you have been led by the hand down a path of no return to surgery. Before consenting to such an irreversible decision, you owe it to yourself to get information your doctor won't tell you. I'm not being a conspiracy theorist here. Doctors are trained to do certain things and see problems in a certain way. Just because they are doctors doesn't mean they 1) understand the problem of prolapse or 2) know best how to manage it.

To make matters worse, you need to know that you and your doctor have a conflict of interest. What I mean by that is he/she is working in a business. Even if your doctor is part of a large medical system, they are measured by their financial results.

If your doctor has to choose between recommending a hysterectomy, which is a commonly accepted medical practice and will bring tens of thousands of dollars to the system, or recommend a few office visits and maybe a pessary (a silicone rubber device kind of like a diaphragm for holding your organs in place) for a few hundred dollars, what do you suppose he or she is going to do? Your best interests may not get taken into consideration. Doctors are only human.

I'm not trying to condemn individual doctors who by and large are hard working and well meaning, but they are caught up in a system which just...

Isn't a safe place for women.

Christine Kent, RN

About Christine Kent

Christine is the author of what continues to be the definitive and only book on non-surgical treatment of pelvic organ prolapse, Saving the Whole Woman, Natural Alternatives to Surgery for Pelvic Organ Prolapse and Urinary Incontinence, now in its second edition.For over a decade, she has researched pelvic organ prolapse, its causes, management, prevention, and the medical system's approaches to "cures".


For years, Christine has questioned the medical system's understanding of female anatomy and challenged the cavalier attitude with which it conducts surgical experiments on women.


Her web site,www.wholewoman.com has an active forum with almost 3000 members where women with prolapse can find information and support.

Let's talk so we can make informed decisions with our doctors regarding surgical interventions to repair POP and SUI.   But in order to talk with understanding, and knowledge we should know the following scientific facts provided by  Ateş Karateke M.D. ,Istanbul. 
                  ( the next post will feature information from Dr. Ostergard)






 •Meshes have been used in the management of stress
                   urinary incontinence since 1996


           

                                                   Few Randomized Clinical Trials

                      • Few randomized clinical trials comparing subjective and objective cure rates of                      

                        mesh  augmented repairs with traditional repairs 

                      • Minutes after insertion there is a race for the surface of the mesh between host      

                        cells and bacteria

                      • If the host cells win then the surface is protected from bacterial colonization

                      • If the bacteria win and manage to secrete their slime that envelopes them so that  

                        host defenses cannot get to them then the mesh is irreversibly contaminated

                      • These bacteria can remain quiescent for long periods of time with the possibility of                         

                        establishing an actual tissue infection at any time

Gristina AG.Biomaterial –centered infection:microbial adhesion versus tissue integration.Science

1987;237:1588-95

           Ostergard Mesh Erosion Compared With Tissue Incorporation VOL. 116, NO. 4,OCTOBER 2010

                                                       Large Surface Areas

                     • The surface area of the mesh is important in determining levels of bacterial        

                       contamination

                                             – more polypropylene degradation

                                                – increased inflammatory response

                                                  – fibrous tissue stimulation

                      Culligan P.Bacterial colony counts during vaginal surgery.

                                           Infect Dis Obstet Gynecol 2003;11:161-5

                                                  Polypropylene Is Not Inert

                                    • Polypropylene is not inert within the human body

                           • Oxidation of meshes when exposed to the milieu of the human body does occur

                                   – because macrophages secrete acidic compound

                                                           • hydrogen peroxide

                                                           • hypochlorous acid

Clave H, Polypropylene as a reinforcement in pelvic surgery is not inert:comparative analysis of 100

                                   explants.Inf Urogynecol J 2010;21:261-70

                                                            Degradating Rate

                                • 33.3% (21.4%-47.8% depending on density)of monofilament polypropylene

                                                            – Macroporous

                                                            – Low-weight

                                                      – Small-caliber fiber diameter

                                     • 75% of multifilament polypropylene meshes

                   Clave H, Polypropylene as a reinforcement in pelvic surgery is not

         inert:comparative analysis of 100 explants.Inf Urogynecol J 2010;21:261-70

                                                                 IS IT SAFE?

                                       • The use of synthetic mesh is not without complications

                     • Mesh-related complications could have significant impact on the quality of life

                                                     Mesh-Related Complications

                                                    – Vaginal mesh exposure

                                                    – Vaginal mesh extrusion

                                                    – Dyspareunia

                                                    – Pelvic/bladder/urethral pain

                                                    – Obturator nerve damage

                                                    – Pelvic neuropathy

                                              –  Recurrent prolapse

Mesh-Related Complications

• Vesicovaginal or urethrovaginal fistula

• Wound infections

• Recurrent urinary tract infections

• Visceral injuries to bowel,bladder and ureter

• Contraction/Fibrosis

• De novo stress urinary incontinence

• Detrusor overactivity

What do you mean drops?

              ahhh, things are falling down!!!Prolapse (POP)                   
                         more common than you think!
         This when we think gravity gets stronger as we age....

There are estimates that more than 50 percent of all women who have children will suffer some type of prolapse over the course of their lives and nearly 10 percent of these women will require surgery to remedy this condition.


What do you mean drips?


      ohhh, you mean  Stress Urinary Incontinence  (SUI)
      I know I should have just said you pee your pants         
                       when you laugh , cough ,
                sneeze..put stress on your bladder.
   and this is where you can relate to the sign that says I          
          laughed so hard tears ran down my leg.......
                            but it really isn't funny

 SUI can have a huge effect on all aspects of your life – on


 your social life, your working life, your sex life and your   


    mental well being, affecting one in three women at

                          some point in their lives.

What is prolapse? 

PhysioDynamics  offers answers to the following questions you may ask.

What is prolapse?

The pelvic floor consists of a sheet of muscles, tissue and ligaments that supports the organs filling your pelvic cavity: bladder, uterus, colon and small intestine. If these supporting tissues stretch or weaken, some of the internal organs may sink lower in the body. Prolapse occurs when an organ collapses or slips out of position. The collapsed organ appears as a soft bulge of tissue that protrudes through the vaginal opening. While this bulge may not be noticeable in mild cases, in moderate and severe ones it can be uncomfortable, although rarely painful.

Types of prolapse and typical symptoms:

• Prolapsed bladder (cystocele): may lead to urinary frequency, urgency, retention, and incontinence. This can make emptying your bladder difficult, and lead to bladder infections.
• Prolapsed uterus (uterocele): may lead to a feeling of fullness or pressure in your pelvis (like sitting on a small ball), low back pain, and painful sexual intercourse.
• Prolapsed rectum (rectocele): makes bowel movements difficult to the point that it becomes necessary to push on the inside of your vagina to empty your bowel.
• Prolapsed small bowel portion (enterocele): a pulling sensation in your pelvis and backache when standing, relieved when you lie down.

What Causes Prolapse?

Many factors can cause prolapse including genetics; repeated increased pressure in the abdomen (typically caused by chronic cough, straining withconstipation, or heavy weight lifting); childbirth; nerve damage; aging; pelvic surgeries or trauma; obesity; hormones; and medications. Caucasian women are more commonly affected than African Americans or Asians.

When to See a Physician

If you notice a prominent bulge of tissue protruding from the vagina, or have difficulty urinating or defecating, surgery may be necessary. While the benefits of this type of surgery can last for many years, there is a possible risk of recurrence. Women who do not elect surgery or are poor candidates for it may opt to wear a supportive device called a pessary in the vaginal canal which can be used temporarily or permanently. However, in cases of severe prolapse, a pessary may not work.

When to See a Physical Therapist

For women with mild or moderate prolapse, non-surgical treatments (such as using a pessary) along with lifestyle changes and Kegel exercises are often effective. You can strengthen your pelvic muscles by performing Kegel exercises which help the pelvic diaphragm to provide support. A Kegel exercise program is most successful when taught by a physical therapist and followed up with regular visits to check the progress of your muscle strength.

PhysioDynamics' Approach to Treatment

We can teach you how to isolate and exercise your pelvic muscles as well as go about your daily activities without putting extra stress on the prolapsed area. We may provide bladder and bowel re-training, such as learning how not to strain, or suggest ways to protect the pelvic floor during activities that increase abdominal pressure. We can also treat any related musculo-skeletal issues and recommend core strengthening exercises, weight control and fitness training. In addition to providing a comprehensive home exercise program, we may use biofeedback and electrical stimulation technologies to help you achieve better control. If you are recovering from prolapse surgery, we can help you heal faster and teach you prevention techniques that reduce the chance of recurrence.

Pelvic Health

To maintain a healthy pelvic floor:

• Lose weight
• Prevent constipation
• Treat a chronic cough
• Quit smoking
• Avoid heavy lifting
• Perform Kegel exercises (below)

Kegel Exercises

Kegel exercises are designed to strengthen your pelvic floor muscles and can help prevent prolapse or stop an existing condition from getting worse.However, they cannot cure prolapse. Before doing the exercises described below, make sure that the prolapsed organ is pushed up well into the vagina. These subtle internal exercises are most effective when they become habitual. Woven into the activities of daily life, these motions can be performed every time you urinate, laugh, cough, sneeze, blow your nose, lift something or change position. They can be done anywhere, anytime, even in public while walking, climbing steps, or running!

A good way to perform Kegel exercises (if you have not yet been tested by a physical therapist to make sure that you are doing them properly) is by visualization. Visualization prepares the muscles to act.  While doing the exercises visualize:

• “Stopping the flow of urine”
• “Closing off the vagina and lifting up a marble inside”
• “Stopping yourself from passing gas"

Do it quickly repeating it 5-10 times. Then do it slowly holding the contraction for 5-7 seconds, relaxing for 10 seconds and repeating it for 5-10 times. Do them often during the day or at least 2 times a day. Before and while doing any activity visualize “closing off the vagina”, this increases the tension in those muscle and provide extra support to your prolapse and in your perineum.

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     Prolene mesh and your prolapse surgery – 

     erosions, sex, and the latest data from the 

                         official blog 

                 of Laurie Romanzi, MD

Prolene Mesh and Pelvic Organ Prolapseby Lauri Romanzi

Cystocele, rectocele, erosions, sex, mesh shrinkage, folding and thickening

You can’t make this stuff up.

Prolene mesh is the product name for a permanent plastic mesh with many implantation applications in reconstructive surgery. Prolene mesh is used to fix large and small abdominal hernias, inguinal hernias, hernias of the diaphragm; it’s used to resuspend kidneys (nephropexy) rectums (rectopexy), uteri (aka uterus’ plural) (sacrohysteropexy), prolapsed vaginas after hysterectomy (sacrocolpopexy), chin augmentations (mentoplasty), chest wall repair in certain thoracic surgeries, (abdominal hernias (inguinal, umbilcal, ventral) and both male and female urethral sling operations for stress urinary incontinence, to name a few.
Over the last 8-10 years, the use of prolene mesh for vaginal prolapse surgery has expanded to include cystocele and rectoceele repair, In an effort to standardize application and, arguably, make it easier for gynecology, urogynecology and urology surgeons to use the mesh, and, definitely, to market the new pelvic organ prolapse mesh kits effectively, Prolene mesh companies have tweaked mesh pore size (degree of laciness), thickness, and density; they’ve mixed it with other graft materials, impregnated it with various materials, each in an effort to reduce horrific complications and claim clinical superiority. The industry cannot advertise or market superiority without data, so they sponsor scientific clinical trials hoping for favorable data that will legally permit them to claim product  superiority in marketing activities, via studies paid for in part or in full by the companies manfacturing the mesh, often but not always recruiting surgeons who work as paid advisors and consultants, much the same way pharmaceutical companies use paid advisors to participate in clinical drug trials. I know, I’ve been, at various points in my career, one of those advisor/consultants. It is a very fine ethical tightrope clinicians walk when participating at that level. The perks are large. The rewards many. It’s an elite group of clinical industry insiders that trumpet the merits of these meshes. Those surgeons publishing outside of the advisory board arena compete for journal space along side industry funded trials.

Embarrassing Drips and Drops: POP & SUI Info

Embarrassing Drips and Drops: POP & SUI Info

Well blogging is new to me! I think I need a  "Blogging " for dummies book, so bear with me as I learn to construct this blog. Thanks for your patience.. I need one of those under construction signs....

  

Welcome to my blog,where info regarding the problems with leaky ladies' plumbing, and vaginas, tired and sagging under the weight of other organs will be featured.

When our mothers talked to us about the birds and bees they forgot to tell us about what happens naturally to many women as our bodies age and show the wear and tear of childbirth. For some darn reason gravity gets stronger as we get older and more than our boobs droop. Sometimes its not just our faces that need a lift. Thank God that when He allowed us to go through aging He gave us a sense of humour to deal with it. However, it is up to us to use it, up to us to educate ourselves about how to do and look for damage control without finding a fix that may cause more harm than benefit.

 Since the FDA has loop holes that allow untested medical implants onto the medical market for doctors to put in their tool kits, and the lack of mandated reports of medical implant complication hides the real rate of serious complications that are life altering and life threatening we are at the mercy of medical device implant manufacturers whose drive to increase sales and profits does not encourage them to be honest with us when problems with their products are discovered. It has become painfully obvious that it is up to to us to protect our private parts from medical interventions that have no scientific long term testing  to assure us that the hardware they use, (yes I'm talking about screws, staples, sutures , meshes,) hardware designed to be permanent parts of our bodies, is going to remain inert in our bodies for our lifespan.   Leaking in your pants doesn't seem like such a big problem when you cough and sneeze, when you consider the cure may leave you unable to pee without a catheter, unable to have sexual intercourse, and leave you with chronic inflammation and pain for the rest of your life. So what do we do if we don't want a broken vagina that hurts us everyday? We care, we share information to make informed decisions when discussing options for medical interventions with our doctors. We must not assume every doctor knows about the latest and greatest  treatments. We must not assume our governments are protecting us. When things go wrong our private parts aren't very private when our legs are up in those stirrup contraptions and a multitude of doctors looking like miners with headlights on their foreheads are peering into us trying to figure out what went wrong. So please read and share. Please avoid plagiarism by crediting  the authors of the information shared. 

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The official blog of Lauri Romanzi, MD

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Prolene mesh and your prolapse surgery – erosions, sex, and the latest data

by Lauri Romanzi

Prolene Mesh and Pelvic Organ Prolapse

Cystocele, rectocele, erosions, sex, mesh shrinkage, folding and thickening

You can’t make this stuff up.

Prolene mesh is the product name for a permanent plastic mesh with many implantation applications in reconstructive surgery. Prolene mesh is used to fix large and small abdominal hernias, inguinal hernias, hernias of the diaphragm; it’s used to resuspend kidneys (nephropexy) rectums (rectopexy), uteri (aka uterus’ plural) (sacrohysteropexy), prolapsed vaginas after hysterectomy (sacrocolpopexy), chin augmentations (mentoplasty), chest wall repair in certain thoracic surgeries, (abdominal hernias (inguinal, umbilcal, ventral) and both male and female urethral sling operations for stress urinary incontinence, to name a few.
Over the last 8-10 years, the use of prolene mesh for vaginal prolapse surgery has expanded to include cystocele and rectoceele repair, In an effort to standardize application and, arguably, make it easier for gynecology, urogynecology and urology surgeons to use the mesh, and, definitely, to market the new pelvic organ prolapse mesh kits effectively, Prolene mesh companies have tweaked mesh pore size (degree of laciness), thickness, and density; they’ve mixed it with other graft materials, impregnated it with various materials, each in an effort to reduce horrific complications and claim clinical superiority. The industry cannot advertise or market superiority without data, so they sponsor scientific clinical trials hoping for favorable data that will legally permit them to claim product  superiority in marketing activities, via studies paid for in part or in full by the companies manfacturing the mesh, often but not always recruiting surgeons who work as paid advisors and consultants, much the same way pharmaceutical companies use paid advisors to participate in clinical drug trials. I know, I’ve been, at various points in my career, one of those advisor/consultants. It is a very fine ethical tightrope clinicians walk when participating at that level. The perks are large. The rewards many. It’s an elite group of clinical industry insiders that trumpet the merits of these meshes. Those surgeons publishing outside of the advisory board arena compete for journal space along side industry funded trials.