Statistics show that more women are choosing to have caesarean sections, due in large part it is believed, to concerns that giving birth vaginally will lead to a fallen bladder and uterus in later life. Although the issue has been hotly debated in the medical community, consensus about a link between natural childbirth and pelvic prolapse has been lacking. Now, new research from the University of Michigan Health System establishes one of the strongest connections yet discovered between muscle damage that can occur during vaginal deliveries and pelvic organ prolapse, a condition that causes the uterus, bladder or bowel to fall down later in a woman's life. One of the most common effects of prolapse is urinary incontinence and many women with prolapse experience a protrusion or bulging in the vaginal area. Pelvic prolapse is a common problem and requires surgery in more than 200,000 women each year.
Appearing in the journal Obstetrics & Gynecology, the study found major defects of the levator ani, an important muscle that supports the bladder and uterus, among 55 percent of women with prolapse and just 16 percent of women who don't have prolapse. "Our findings are an important step forward in the search to identify what causes pelvic organ prolapse and subsequent difficulties with other problems, such as incontinence," said study author John O. L. DeLancey.
The study used magnetic resonance imaging to determine the extent of damage to the levator ani muscles. The women's vaginal closure force at rest and while contracting her pelvic muscle were also measured. Interestingly, half of the women in the study with prolapse recalled having forceps used during childbirth, nearly twice the amount (about 27 percent) of women in the study who do not have prolapse who remembered that forceps were used.
But even with the newly established link, the researchers caution women against using the findings as support for elective caesarean procedures. Rather, they say, the study results should be used to help determine how to prevent these injuries in the first place. "The next step is for researchers to look at ways of preventing and treating these injuries of the levator ani muscle in order to reduce the rate of pelvic organ prolapse later in life," said DeLancey.
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New Surgical Procedure For Vaginal Prolapse
Source: University of Michigan Health System
