Northwestern Memorial in top ten health providers for women
Posted by on April 2, 2014 - 2:55pm

Prentice Women’s Hospital: Under the Northwestern Memorial Hospital Chicago, was recently named one of the top ten women's health providers by HealthCare Global Magazine.   It was noted that the hospital  provides a wide variety of services and specialized care just for women, through all stages of their lives- from gynecologic and pregnancy care to menopause and bone health.   The Women's Health Research Institute has worked with Prentice on several programs including:

  • Advocacy and promotion of specialty clinics in neurology, depression, cardiology, skin health, sleep disorders, and pelvic health that are described HERE
  • The creation of an interactive menopause website that provides the latest options for menopause symptom management.
  • Provided professional education on sex differences beyond reproductive and maternal health.

To learn about the entire top ten, visit Healthcare Global.

Concerns about mesh used for pelvic organ prolapse
Posted by on October 17, 2012 - 9:22am

Pelvic Organ Prolapse (POP) affects approximately 30- 50 percent of all women between the ages of 49 and 80. It's a condition that usually occurs in women as they approach and move through menopause. Women who have given birth are more likely to be diagnosed with POP, as are Caucasian women, smokers, women who are overweight, and women who have suffered severe pelvic injuries.

Surgical treatment is not always necessary, and one surgical procedure could put the patient at risk for serious complications. When doctors use transvaginal mesh to provide the support for tissues compromised by POP, they may be compromising the health of their patient.

Pelvic Organ Prolapse occurs when weakened muscles and connective tissues in the pelvis allow the uterus, bladder or bowels to drop into the vaginal canal. Sometimes this weakening is so minor that women don't feel any symptoms. In these cases, treatment is usually unnecessary, or doctors may prescribe Kegel exercises or lifestyle changes, which can reverse symptoms and prevent further weakening.

Some women experience more moderate to severe symptoms. In these cases, surgical procedures may be performed in order to correct POP. Prior to the use of transvaginal mesh, doctors used a patient's own tissues to support the weakened muscles. However, once transvaginal mesh was approved by the Food and Drug Administration (FDA), it became the medical device of choice for many surgical procedures to correct POP.

Transvaginal mesh  used for POP was approved in 2002 under the FDAs 510(k) Clearance Process, which is a "fast-track approval" program for new devices that share similarities with similar pre-approved devices on the market. Unfortunately, vaginal mesh products do not perform as successfully as their similar mesh product counterpart, which is used to treat hernias.

Vaginal mesh erosion is the main culprit of the thousands of transvaginal mesh complications reported to the FDA since the early 2000s.

Complications associated with vaginal mesh can include:

  • Erosion of mesh material into the vaginal tissues and/or other organs
  • Protrusion of the mesh into the vagina
  • Pain in the vaginal canal and/or pelvic region
  • Pain or discomfort during sexual intercourse
  • Incontinence
  • Difficulty with bowel movements
  • Unusual discharge or bleeding

It can often require more than one revision surgery in order to reverse any damages related to transvaginal mesh and there could be permanent health issues.   Women with POP should understand their risk with regards to Pelvic Organ Prolapse and its treatment. Non-invasive surgeries should be used whenever possible, and if surgical intervention is necessary, women should be aware of the risks of vaginal mesh.

Guest blogger:  Elizabeth Carrollton writes for Drugwatch.com.

Sources:

http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm262435.htm

http://www.medscape.com/viewarticle/746285

 

 

Biking and women's pelvic health
Posted by on August 3, 2012 - 7:05am

Women cyclists who set their bikes' handlebars lower than the saddle tended to show a degree of impaired genital sensation, researchers at Yale U reported.  Among 41 competitive cyclists, the 19 who rode bikes with relatively low handlebars had, on average, significantly higher vibratory thresholds in the anterior vagina, compared with riders whose handlebars were level with the bike saddle, according to Marsha K. Guess, MD, and colleagues.

Measurements of perineum saddle pressure also showed significant increases in the riders with low handlebars, Guess and colleagues reported online in the Journal of Sexual Medicine.  "Correcting modifiable risk factors for pelvic floor damage may serve as the most important next step in enhancing riding safety in women cyclists," the researchers wrote.

Genital numbness has been a recognized complaint of male as well as female cyclists.  Saddle design appears to contribute to the problem, but, the researchers noted, how the riders sit on the saddle is also a factor, and perhaps the dominant one.

An earlier study by another group had found that pressures on the pelvic floor in both sexes were related to the relative positions of the handlebars and saddles.

Consequently, Guess and colleagues reanalyzed their data from the 48-rider sample, focusing on 41 participants for whom information on their bikes was available.   Low handlebars force the rider to exaggerate their forward lean, decreasing the trunk angle and increasing the pelvic tilt. Guess and colleagues hypothesized that this position would put more weight over the perineum region relative to the ischial tuberosities (commonly called the sitz bones).

Results were reported for 22 riders whose handlebars were level with their saddles compared with the 19 with lower handlebar positioning.

They concluded that low handlebar positions "yield detrimental effects to the female pelvic floor," but they also conceded that higher positions may increase the riders' wind resistance and reduce their speed.   "This exemplifies the ongoing struggle between selecting a more aerodynamic bicycle position for control and speed or a more ergonomic position to reduce neurovascular compromise," Guess and colleagues wrote.

Source:   Partin S, et al "The bar sinister: Does handlebar level damage the pelvic floor in female cyclists?" J Sexual Med 2012; DOI: 10.1111/j.1743-6109.2012.02680.x