That being said, if you fall into the category of “squeamish” you probably shouldn’t read on. However, I thought this topic important enough to share because, sadly, not enough people even know what POP is. I had absolutely no idea what it was, and looking back, I’m pretty sure I was experiencing symptoms several years before finally figuring out what the hell was going on.
One of my readers turned friend emailed me when she hadn’t heard from me in a while. When I told her I’d recently had surgery and was considering writing a post about it, she encouraged me to do so despite my reservations because bringing awareness to this condition would be helpful to other women. Thank you for that little push, Cissy. Here goes nothing!
POP stands for pelvic organ prolapse. I’m going to steal the description of POP from Sherrie Palm’s Association for Pelvic Organ Prolapse Support web site.
“Pelvic organ prolapse (POP) can occur when the PC or pelvic floor muscles weaken and one or more organs shift out of their normal positions into the vaginal canal. In advanced cases of POP, tissues push through the vaginal canal and bulge outside of the body. The worst-case scenario is a woman's uterus can be completely outside of the vagina. There are 5 types of POP; organs that can prolapse are the bladder (cystocele), intestines (enterocele), rectum (rectocele), uterus (uterine), and vagina (vaginal vault). There are 4 levels of severity; grade 1 is the mildest, grade 4 the most severe.”
As I already mentioned, I believe there was a time or two that I was showing signs of POP, but my first and most dramatic indication that something was wrong happened when I was on a family trip to Disneyland over two years ago. It was the end of our second day of extensive walking, and I’d been on my feet the majority of the time. My low back was screaming with pain and while in the shower that night, I felt what could only be described as a pronounced bulge down below while washing. It was terrifying.
Turns out that was my bladder, folks.
I didn’t know it was my bladder until later, but that night I was scared out of my mind. I thought it was my uterus. Every winter I suffer from a chronic cough brought on by allergies that lasts several months (which I’m convinced has contributed greatly to my problem), and I tried so hard to stifle my coughs as I lay in bed that night, convinced I was going to send my uterus flying across the room.
Upon returning home, I made an appointment to see my OB-GYN right away. During my visit, I explained to her what happened during my trip, and after examination she informed me I had a bladder prolapse. She said that my bladder might stay as it was and not get any worse, or it could worsen with time. When I asked how I would know if it was getting worse, she casually answered, “Oh, it will just start coming out.”
To which I replied, “Oh, no it will not!” I was horrified. Now, I adore my doctor - she has been my OB-GYN since I was eighteen. But I was shocked by how nonchalantly she stated my bladder might at some point exit my body! And why – after years of having annual pelvic exams – was I never told about this? Not only not told that I had it, but not even informed that it was a thing! And now that I know how common this is, I don’t understand why doctors are not forewarning women in their younger years that this is something that can happen to their bodies.
After being referred to a urogynecologist, I learned that I not only had a cystocele, but a rectocele and uterine prolapse as well. The doctor assured me it wasn’t dangerous and that he saw women in far worse shape than me who choose to live with it, while others who have milder cases opt for surgery. He stressed that it was a personal choice.
At the time, I decided I would try and live with the hot mess that was my pelvic region because I wasn’t suffering from any incontinence aside from the occasional sneeze or cough. Women are accustomed to joking about that as one of the byproducts of having babies. However, not long after, discomfort and pain started kicking in on a regular basis. I would experience a dragging/pulling sensation in my pelvis when on my feet too long, along with daily low back pain. This is when I decided to pursue surgery.
I thought the path would be fairly straightforward, but I was wrong. I spoke with a second urogynecologist about surgery and expressed my reservations about the use of mesh, and after he gave his arguments about why he felt it was the best option, I decided to kick my fears to the curb and scheduled surgery for June of 2017.
By the time I got home, I had buyer’s remorse. When I initially made the appointment with the second urogyno with surgery as my goal, I hadn’t even considered the possibility that mesh would be involved, which I knew very little about. All I could think of were the slew of commercials I’d seen about class action lawsuits involving mesh. Then I started performing the dreaded Google searches, and my fears really kicked into high gear. Basically, what I found during my searching was that surgeries in which mesh was placed vaginally were the ones that had a much higher risk of complications, and the surgeon I’d just met with performed the procedure vaginally.
I cancelled my surgery that same day.
Somewhere along the way I joined a Facebook support group for women who suffer from POP, which has been an absolute godsend due to the wealth of information I’ve gained. However, for a time my confusion only worsened as I read the wide range of results after surgery. Some women raved about their surgeries that used mesh, saying their quality of life greatly improved and it was the best decision they ever made. Others regretted their choice to use mesh because of complications and erosions, creating more health issues and pain than they started with. And still others had POP surgery without the use of mesh, only to have it fail a few months later because the use of natural tissues wasn’t strong enough to hold the repairs.
As my own symptoms continued to worsen, I was upset and confused about what was the right choice for me. My symptoms weren’t as severe as many of the women in the support group, and my heart especially went out to the young women with little ones at home who were already dealing with difficulties of POP. If there was one thing I was grateful for, it was that this condition didn’t start rearing its ugly head until later in my life. Still, it became a huge source of stress and I didn’t want to continue living like I was.
Eventually, I decided to meet with a third surgeon, and the third time was the charm. He explained that he used mesh but performed the surgery abdominally rather than vaginally, and his bedside manner combined with stats on success rates made me feel much more at ease about prognosis.
So, last week I had robotic sacrocolpopexy with hysterectomy. I was extremely anxious about the pain from recovery, but have to say I’ve been relieved by how smoothly things have gone so far. Of course, I’m way too early in my journey to know whether the surgery was a success or if I will experience the improved quality of life I’m hoping for, but I’ve already noticed that I don’t wake with the nagging low back pain I’ve been plagued with for some time, and that’s a good start.
The Association for Pelvic Organ Prolapse Support web page states that “research estimates up to 50% of woman experience pelvic organ prolapse.” Fifty percent! For such a prevalent medical condition, why are we not being educated about this by our doctors? Vaginal childbirth is one of the leading causes, though symptoms may not show themselves until years later. I told my son – my largest baby of three – that I blame him and his big head for my falling lady parts. In the meantime, women are unknowingly participating in activities (running, heavy lifting, etc.) that are potentially exacerbating injuries that are lying dormant without any knowledge that they’re doing so. This needs to change.
It's one thing if a woman makes the choice to engage in activities that may be harming her, but it should be just that - a choice. Not a decision made because she didn’t know better.
This post is for women who may be experiencing symptoms and have no idea why, but all women should know what POP is. I can’t tell you how many stories I’ve read from those in the Facebook group who have been talked down to, dismissed, or at times even yelled at by their doctors when they’ve brought up very real concerns about their symptoms. The best way to advocate for our own health is to be informed. If you think that you may have POP, I strongly recommend visiting the Association for Pelvic Organ Prolapse Support page for more information.
Finally, I want to give huge thanks for all the amazing women in the support group. Though I didn’t post often, my questions and concerns were always met with compassion, encouragement, shared experience, and useful information. No topic is too icky or embarrassing for these awesome ladies. When experiencing the scary and unknown, it truly helps to know there are others who have navigated the path before you.
And that you’re not alone.