Could a Simple Swab Test Predict Pelvic Organ Prolapse?

 

Pelvic organ prolapse is one of many pelvic floor disorders we are able to treat here at Revitalize Physical Therapy. Never heard of it? I’m not surprised! It doesn’t get the coverage it should. Data on how many women are dealing with it also appears to vary. It affects approximately 3% of women in America, according to WebMD; however, the University of Chicago Medical Center says that as many as a third of women can have it by age 80. No small amount!

 

Pelvic organ prolapse is the medical term for what happens when organs, such as the bladder, small intestine, rectum, vagina or uterus, fall either into or out of the vaginal canal or the anus. This can happen due to issues, including pregnancy, delivery, pelvic organ cancers, and constipation. Any woman at any age can be affected potentially, but it’s most prevalent in midlife and among younger senior citizens.

 

Pelvic organ prolapse goes by different names, so you may hear your medical provider use a word like rectocele for a prolapse of the rectum, or cyctocele, when the bladder moves into the vagina. (Cyctocele is in fact the most common form of pelvic organ prolapse.) Pelvic organ prolapse can result in urinary frequency, incomplete emptying of the rectum, or painful sex, to name a few.  

 

So now that you’ve heard about pelvic organ prolapse, your next question might be: How can I avoid it? Fair enough! Some risk factors can be averted and others can’t. You can’t help things like, say, a history of this in your family or having had a baby, but you can make sure you are eating sufficient fiber (25-30 grams/day), and drinking enough water (8 cups/day) to try to avoid constipation. Furthermore, both urination and defecation should be completely passive processes. No straining is required, and if you must strain or push excessively to pass bowel movements, speak to your friendly neighborhood pelvic floor PT! Finally, don’t start smoking or give it up if you are already in the habit (which is a good idea anyway).

 

If you suspect that you have pelvic organ prolapse, the issue may be diagnosed by an ultrasound of your pelvis or other tests involving the bladder or urination. Physical therapy, a pessary and, when all else fails, surgery are used to treat pelvic organ prolapse. (It is worth noting, though, that surgery has a high chance of not working.)

 

Happily, science may be coming along to help further: Researchers at UT Southwestern Medical Center have found a potentially noninvasive way to screen for pelvic organ prolapse. They have discovered a vaginal swab test that may identify women who are prone to developing pelvic organ prolapse. The study appears in a medical journal called Aging Medicine. This test found that certain proteins were higher in the vaginal secretions of postmenopausal women who were diagnosed with pelvic organ prolapse. 

 

If we know which women are likely to have pelvic organ prolapse, a doctor or pelvic floor therapist can initiate a preventative plan rather than one that treats them when they already are showing symptoms. When it comes to prophylactic treatment, I like to say that an ounce of prevention is worth more than a pound of cure!

 

The article doesn’t specify when the swab test will be available, but I hope it will come and soon. And you can rest assured that as soon as I have any more updates, I will keep you posted, dear readers. In closing, the sooner we know what’s going on with our pelvic floor health, the better. 

 

RESOURCES/FURTHER READING:

 

https://www.utsouthwestern.edu/newsroom/articles/year-2023/july-pelvic-floor-disorders.html

 

https://www.totalurologycare.com/services/pelvic-organ-prolapse?gclid=Cj0KCQjwtamlBhD3ARIsAARoaEypktyKARrFGB9toCH_X7KJD2u1nmb3wLQZTDxeCXhzkr6Ji2WUY8kaAptfEALw_wcB

 

https://nyulangone.org/conditions/pelvic-organ-prolapse/diagnosis?cid=sem_google&googadcamp=Virtual_Urgent_Care_Performance_Max&googadgroup=Performance_Max&googkeyword=&googmatchtype=&insitesid=1367&gad=1&gclid=Cj0KCQjwtamlBhD3ARIsAARoaEw2MHvExjQ5YaXD_OT05Fv35GhbOr1sSjuD3EFS1uVz4aS8OVrC6qUaAg3KEALw_wcB

 

https://www.webmd.com/women/pelvic-organ-prolapse

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166938/

 

https://www.uchicagomedicine.org/conditions-services/obgyn/urogynecology/pelvic-organ-prolapse

Fetus Facts

As I sit outdoors on a beautiful, sunny spring afternoon, listening to Hamilton while I write this blog, the future is looking brighter both literally and figuratively. I am so grateful that much progress has been made thus far in our fight against Covid-19, and I think it is safe to say that thank God, our current circumstances are better than they were one short (yet seemingly very long) year ago. For example, I didn’t have to resort to cutting/accidentally butchering my bangs before Passover this year, because I was able to once again return to my hair salon. (You may have noticed that I had a different hairdo than my usual signature bangs in several of my Pelvic Pearls YouTube videos. The pulled back headband look was inspired by that experiment gone awry. Secret’s out!)

Joking aside and obviously more importantly, we now have two viable vaccines available. While I respect anyone who chooses to refrain from receiving the vaccine at present for whatever reason, I am a fully vaccinated, strong proponent who is grateful for this incredible development. Fortunately, approximately 20% of the country has been fully vaccinated with many more pending. New York has now offered vaccinations for anyone over the age of thirty regardless of one’s profession, and the Pfizer vaccine has been approved for teenagers aged 16-19.

Until recently, very few studies have focused on the effects of the vaccine on pregnant women as it was feared to be unsafe. Sadly, over 80,000 pregnant women have been infected with Covid-19, and 88 have passed away in the United States. In addition, this demographic is more likely to exhibit severe symptoms, to need intensive care admission, and to require a ventilator compared to their non-pregnant counterparts.

Fortunately, a recently approved and conducted NIH study revealed that Covid-19 vaccination during pregnancy resulted in improved maternal and fetal immunity. The presence of antibodies in both breast milk and the placenta indicated that vaccination during pregnancy confers immunity to the developing fetus. Furthermore, the vaccinated study participants exhibited higher antibody levels than women who naturally had antibodies during pregnancy due to actual infection. It is interesting to note that antibody levels were higher in women who received vaccination earlier in their pregnancy. The side effects were similar in both the pregnant and non-pregnant groups.

While individual consultation with one’s own ob/gyn is warranted and encouraged, it is nice to be able to share these positive findings. May we continue to share additional good news and to experience more promising developments.

Reference:

Gray KJ, et al. COVID-19 vaccine response in pregnant and lactating women: a cohort study. American Journal of Obstetrics and Gynecology. 2021.