Pelvic organ prolapse (POP) is much extra widespread in India than most realise. Some analysis research have discovered that as much as 21% of ladies could expertise clinically related POP. Whereas nulliparous prolapse (in girls who haven’t given start) accounts for simply 1.5–2% of genital prolapse instances, the incidence jumps to five–8% in girls who’ve had one or two youngsters — among the many highest globally. Though literature stories that fifty% of ladies are affected by POP of their lifetime, medical doctors say the true quantity could also be nearer to 70–80%, with most instances going unreported as a consequence of stigma or lack of expertise.
In line with the World Well being Group (WHO), POP happens when a number of pelvic organs — such because the bladder, rectum, or uterus — descend from their regular positions into or by the vaginal canal, as a result of weakening of the pelvic ground muscle groups and connective tissue. It’s a situation that impacts the lives of hundreds of Indian girls, particularly in their postmenopausal years.
Lack of information resulting in late detection
Although POP has been recorded as early as 2000 BC in historical texts, it stays misunderstood and underdiagnosed, particularly in India. Many ladies settle for the signs as a pure a part of ageing or womanhood. Disgrace, silence, and cultural stigma usually stop them from in search of well timed assist. Solely a small share of ladies bear remedy, regardless of its main influence on high quality of life.
Medical consultants say early detection and intervention can drastically cut back the bodily, emotional, and social toll POP takes on girls. Whereas a big share of ladies expertise a point of prolapse, solely a subset develop signs vital sufficient to hunt remedy. Even then, many stay undiagnosed.
Sapna Raina, senior guide at Narayana Well being Metropolis, Bengaluru, explains, “Pelvic organ prolapse primarily occurs due to the weakening of pelvic ground and gluteal muscle groups. A number of vaginal deliveries, extended labor, use of forceps throughout childbirth, poor antenatal or postnatal care, persistent constipation or cough, menopause, lifting heavy weights, smoking, and weight problems—all contribute to this weakening.”
She emphasises that menopause performs a essential function as a result of pure drop in estrogen, which compromises the power and elasticity of pelvic tissues. She additionally notes that poor way of life practices and delayed care additional worsen the situation.
Significance of in search of care early
POP usually begins subtly. Early indicators embody urinary leakage when coughing or sneezing. Because it progresses, girls could expertise a dragging sensation within the decrease stomach, issue urinating or passing stool, or a visual bulge on the vaginal opening. In superior instances, signs can embody repeated infections, foul-smelling discharge, persistent again ache, and vital discomfort whereas strolling or sitting.
Mannan Gupta, chairman and HOD of obstetrics and gynaecology at Elantis Healthcare, New Delhi, says, “It’s quite common in older girls who’ve had a number of regular vaginal deliveries. The uterus, rectum, and bladder can descend, and in extreme instances, even protrude by the vaginal canal. Remedy at that stage usually requires surgical procedure.” He provides that consciousness stays low, notably amongst aged girls, lots of whom endured childbirth within the Eighties and Nineties below restricted medical supervision. These girls now current of their later years with superior POP.
Jaishree Gajaraj, head of obstetrics and gynaecology at MGM Healthcare, Chennai,says, “Many ladies stay with this for years, considering it’s simply part of rising outdated. However those that bear remedy –whether non-invasive or surgical –often really feel like they’ve regained their life.”
Non-surgical and surgical administration
Early analysis can stop development. Gentle prolapse could be managed with pelvic ground physiotherapy, together with Kegel workouts and strengthening of the core and gluteal muscle groups. Preventive care additionally contains addressing persistent constipation, avoiding heavy lifting, managing weight, and making certain good antenatal/postnatal care.
“Common train and well timed medical consideration are key,” says Dr. Raina. “Within the early phases, prolapse can usually be corrected with out surgical procedure. ”Nevertheless, when the situation advances, surgical intervention could also be obligatory. Dr. Gupta provides, “Delaying care means sufferers could require surgical procedure below common anesthesia, which is riskier for aged girls or these with co-morbidities.” Surgical choices resembling laparoscopic repairs or mesh implants can be found for extra extreme instances. Dr. Gajaraj elaborates on the surgical course of, “When the uterus descends, it pulls the bladder in entrance and the rectum behind. Surgical procedure usually includes eradicating the uterus, repositioning the bladder and rectum, and tightening the vaginal wall to revive pelvic assist.”
Publish-surgery, most ladies report reduction from signs resembling urinary incontinence and pelvic discomfort. Many regain their mobility, independence, and confidence inside a couple of weeks.
Name for consciousness, higher programmes and well timed motion
Regardless of POP’s widespread influence, it stays absent from nationwide well being conversations. Dr. Gupta remarks, “There are campaigns for situations like anaemia and diabetes, however nothing particularly for pelvic organ prolapse.” He requires consciousness programmes, notably in rural and semi-urban areas the place signs are sometimes normalised or ignored.
Dr. Raina confirms that there are presently no devoted authorities programmes for prolapse, although it could be loosely addressed below common maternal and reproductive well being schemes. “Actually, we don’t have standalone packages for this. Some extent of prolapse is seen in 70–80% of ladies, however symptomatic full-blown instances are nonetheless below 5%,” she says.
Most girls don’t even know their struggling is because of a treatable situation,” says Dr. Gajaraj, emphasising the necessity to normalise conversations round pelvic well being, whereas acknowledging initiatives just like the Society of Vaginal Surgeons of India, the place she was previously the director, and stressing that each consciousness and entry to care should enhance.
Consultants stress that POP shouldn’t be accepted as an inevitable consequence of childbirth or ageing. With higher schooling, early detection, way of life modifications, and applicable medical interventions, girls can reclaim not solely their well being, but in addition take pleasure in a greater high quality of life.
Printed – Could 20, 2025 06:57 pm IST
