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Reasons for Transvaginal Mesh Use

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While pelvic organ prolapse (POP) or stress urinary incontinence (SUI) can happen to any woman at any age, it is more likely to happen after specific events.

Researchers say an estimated 50 percent of all women between the ages of 50 and 79 have some form of prolapse. While less common in younger women, it’s still very possible. The events that lead to POP or SUI are varied:

Childbirth

Initially, researchers thought that POP and SUI were typically the result of a vaginal delivery, but growing research is showing that women who undergo a Cesarean section have similar problems. In a recent study, researchers examined the pelvic floor structure of women who have utilized either natural childbirth or a C-section birth. They found that 82 percent of women, especially white women, who delivered vaginally had abnormalities in their pelvic floor muscles both 6 weeks and 6 months postpartum. But more surprising was that 66 percent of women who delivered via C-section without labor and 75 percent of women who delivered via C-section after labor also had evidence of pelvic floor muscle injuries.

These findings suggested that pelvic floor muscle injuries are common regardless of the childbirth situation. “Overall, the relatively small difference between the vaginal and Cesarean groups was surprising, since Cesarean delivery is presumed to protect against pelvic organ prolapse,” researchers said during the 27th Annual Scientific Meeting of the American Urogynecologic Society (AUGS). “These results suggest that some deterioration in pelvic organ support may be inherently due to pregnancy or to labor.”

Menopause

Following the cessation of menstruation, called menopause, women undergo a decrease in normal bodily hormones, including estrogen. Estrogen plays a key role in the female menstrual cycle by regulating the cycle and keeping the pelvic support muscles strong. When estrogen levels decrease, the elasticity and tone of the vaginal walls and pelvic floor muscles decrease.

Hysterectomy

When the uterus is removed in a hysterectomy, the entire support structure of the pelvic region is disrupted. Without the uterus, the top of the vagina may fall into the vaginal opening. The drooping also puts additional strain on the pelvic floor muscles and ligaments.

Other Causes

  • Advanced Age – As women age, the bodily tissues loses normal elasticity. When this happens in conjunction with a reduction in estrogen, POP or SUI is more likely to occur.
  • Ethnicity – Women who are of Northern European and African-American descent have a higher incidence of vaginal prolapse.
  • Genetics – Research suggests that incidence of POP or SUI runs in families. Women with sisters or mothers who have had a prolapse are more likely to develop a prolapse.
  • Obesity, smoking, chronic bronchitis or asthma – Anything that causes increased pressure on the abdominal and pelvic floor areas can lead to POP or SUI. Women who are obese have a 40 to 75 percent increased risk of POP. Obesity and the chronic coughing and breathing troubles that comes with bronchitis or asthma can put added pressure on the organs and press them downward.