Women's Pelvic Surgeries Soar Since 1990s

woman, abdomen, stomach
  (Image credit: Woman's abdomen photo via Shutterstock)

About 1 in 5 women now will undergo certain pelvic surgeries during her lifetime, nearly double the risk of having one of these surgeries in the 1990s, according to a recent study.

Researchers looked at women's likelihood of undergoing surgery before age 80 for either stress urinary incontinence (a condition that can cause urine to leak during sneezing or laughing), or pelvic organ prolapse (in which pelvic organs begin to droop within a woman's body).

"Surgeries for both of these conditions have increased substantially," said Dr. Jennifer M. Wu, associate professor at University of North Carolina at Chapel Hill's department of obstetrics and gynecology, an author of the study. "The 20 percent figure is nearly double that of earlier U.S. studies, which reported rates of 11.1 percent and 11.8 percent," for stress urinary incontinence surgery and pelvic organ prolapse surgery, respectively, she said. 

Wu said she is not surprised by the results of this study, because stress incontinence and pelvic organ prolapse are very common conditions, which 1 in 3 women will experience in her lifetime. Many women, however, are embarrassed discussing symptoms such as involuntary urine leakage with their doctors, she said. [7 Embarrassing Health Problems (And How to Treat Them)]

"It's often not talked about until they are referred to a sub-specialist," Wu told Live Science. "Many women have suffered in silence for years with problems such as 'accidents' in public places. This can lead to social isolation for many of them."

Stress incontinence can be triggered by any sudden pressure increase within the abdomen. Pelvic organ prolapse occurs when a pelvic organ, such as the bladder, drops (prolapses) from its normal spot in the lower belly and pushes against the sides of the vagina, causing bulging, pressure or urine leakage during intercourse. This can happen when the muscles that hold the pelvic organs in place get weak or stretched from childbirth or surgery.

In the study, researchers used 10 years of data from a database of U.S. health plan claims and doctors' visits that included more than 10 million women from ages 18 to 89.  Previous studies on this topic had small sample sizes, or were limited to one geographic region, Wu said.

The study appears today (May 7) in the journal Obstetrics & Gynecology.

"Many women believe these conditions are a normal part of the aging process," Wu said.  "They're not."

However, surgery is not the only option. "With prolapse, one treatment option is no treatment at all," she said. "We just watch and wait if it's not affecting a woman's quality of life." 

Other options, she said, include treatment with a pessary device, which is used to lift the bladder or apply compression to the urethra during activities certain activities, or pelvic floor physical therapy (Kegel exercises) designed to improve muscle tone.

For women with bladder incontinence, she said, nonsurgical treatments include lifestyle changes such as weight loss for those who are overweight or obese, dietary changes, anti-spasmodic medications, a pessary, Kegel exercises and nerve stimulation.

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Contributing Writer