The natural course of medical evolution is to research and experiment, adjust treatment techniques as need dictates, and shift health best practices forward. Hippocrates maintained that disease processes may have natural causes and put forth the Hippocratic Oath, First Do No Harm, to guide treatment practice. Somewhere between 129 - 216 AD, Galen established clinical medicine based on observation and experience, resulting in the integrated and comprehensive system that remains in practice to this day.
The path of women’s health is no different. Between 1800 - 1835 BC, the Kahun Papyrus established the practice of gynecology, and pelvic organ prolapse (POP) treatment was first documented. When a new treatment protocol shines a light, the voices of women experiencing pelvic organ prolapse clearly indicate they have renewed hope. The relatively recent development and exploration of radio-frequency and laser vaginal tissue restoration (VTR) therapy is generating buzz without a doubt.
Pelvic organ prolapse is an extremely variable condition. Considering there are five unique types of POP with many of them often occurring at the same time, multiple grades of severity, and a significant variety of non-surgical and surgical treatments available, POP diagnosis and treatment is not all black and white - there are countless shades of gray. POP statistics vary considerably, and within some layers of POP dynamic, don’t exist at all. It’s no wonder women have difficulty understanding pelvic organ prolapse information they read or hear; healthcare, academia, industry, and research are often baffled as well.
I began tire-kicking to find answers regarding vaginal tissue restoration treatments after I attended the Mediterranean Incontinence and Pelvic Floor Society (MIPS) conference in 2015 where research information was presented. I was immediately intrigued because the research papers looked very positive. While VTR research in Europe has progressed over the past 10 years regarding the value of these treatments for atrophy and incontinence as well as other possible POP markers, the US is pensive if a treatment can be considered cosmetic. I’d like to clear the slate regarding this archaic mindset - my personal exploration of these VTR therapies indicate the value extends far beyond the appearance of youthful labia. The most significant impacts I experienced are twofold-I no longer need to get up over and over to use the restroom during sleeping hours - priceless. Shifting from multiple bathroom stops disrupting sleep to one a night makes the treatment worth it all by itself. But I’d like to share something I did not read in any of the research studies I reviewed-the difference in the amount of pelvic pressure post-treatment was shocking. It makes sense if collagen and elastin are being regenerated in vaginal tissue, the resulting increase in support of organs and other structural tissues may benefit all organ systems in the pelvic cavity. It’s not rocket science; it’s common sense. I also experienced daytime reduction of urinary urge and frequency, stronger urine stream, reduction in fecal urge, reduction in gas and capacity to hold it in, and a reduction in fecal residue post wiping. Yes, I am impressed. I won’t know until I hit at least the 6-month mark how long the results last, but I’m hopeful the 6 months to a year standard holds true for me.
Every day presents challenges to navigate related to work, home, and personal life; every day presents challenges advocates must navigate related to the needs of the causes we champion-we want change yesterday. We never feel “enough” has been done. Advocates are often visionaries who utilize roadblocks as stepping stones to generate change.
Pelvic organ prolapse is a condition blanketed in silence, engendering thousands of years of snail pace evolution in awareness and treatment. While it is imperative that healthcare, industry, academia, policy makers, advocacy, and the people experiencing pelvic health issues communicate with each other to generate change and evolution in treatment, the most significant voice in the equation must always be the patient. Treatment often becomes trapped in a standardized viewpoint, disabling “outside the box” thinking. At times, what has been accepted for years as best practice is no longer the best option and upon occasion, we must test the assumptions.
Advocacy clarifies issues within a segment of the population. Advocacy is finding the answers to questions that are not yet recognized. Advocacy is changing attitudes, beliefs, and behaviors. And advocacy is addressing the need for healthcare treatment evolution. Together we will generate change.