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Pelvic organ prolapse, or POP, occurs when the pelvic organs, such as the vagina and uterus, fall down or slip out of place. This is caused by the weakening of connective tissues, muscles, and ligaments.
Every year, more than 225,000 women will undergo a type of surgery called an abdominal sacrocolpopexy to fix this “falling out” problem. The procedure involves connecting the top of the vagina to a stable ligament from the pelvic bone with a piece of mesh. The surgical mesh is supposed to help support the pelvic organs and keep them where they’re supposed to be.
While abdominal sacrocolpopexy is a common treatment for POP, a new study has found that the failure rate of said treatment gradually increases each year. In fact, the rate of mesh erosion reached 10.5% seven years post-surgery, according to the study, which was published in the Journal of the American Medical Association (JAMA).
The study also found that the risk of urinary incontinence rose each year after the surgery. This is interesting because POP, itself, can cause urinary problems, in addition to constipation and fecal incontinence.
“Surgeries don’t stop time,” said study author Dr. Linda Brubaker, a professor of obstetrics and gynecology and urology at Loyola University Medical Center, regarding why POP surgery may fail. “Women continue to age and the underlying biology continues. Patients may gain weight, too.”
The study included 215 women, and of these women, 104 underwent abdominal sacrocolpopexy, plus another surgery to stop urinary incontinence. The remaining 111 women only had the POP surgery. The women who had both surgeries were less likely to experience urinary incontinence.
Although mesh surgery is “generally safe and effective,” according to study author Dr. Cheryl Iglesia, an associate professor of obstetrics and gynecology and urology at Georgetown University School of Medicine, there are also other treatment options available that don’t involve mesh.
“Go to a surgeon who you can have a legitimate conversation with about treatment options. Talk about what happens if you don’t do anything…Find out if mesh will be used, and if you’ll have an anti-incontinence operation done at the same time,” Iglesia was quoted in a HealthDay News article.