Posted on Mon, Jun. 11, 2012

Barbara Jones is not the type of woman who shies away from picking up heavy things if the need arises.

That could be one of the reasons why she has pelvic organ prolapse, a condition where the pelvic-floor muscles stretch and let the organs drop, often causing incontinence.

The condition is mostly associated with women who have given birth, especially more than once. Even the lightest newborns can cause pelvic organ prolapse. The affliction is also common among women over 50.

Jones, 73, fits into both of these categories. Her first child weighed nearly 10 pounds; her other two children were also heavy newborns, she said.

In her 30s, she underwent a hysterectomy, another factor that could have contributed to her condition.

“It came all of a sudden,” Jones said, noting it began Thanksgiving weekend 2010.

In the summer of 2011, Jones had screen-like slings made from synthetic mesh material inserted through the vagina to form a hammock for the pelvic organs and keep them in place.The slings are a little less than an inch wide.

“When it [the sling] gets put into the body, it becomes a new layer of tissue, a ligament,” said Jones’ physician, Dr. Guillermo Davila, chairman of gynecology and head of the Section of Urogynecology and Reconstructive Pelvic Surgery at Cleveland Clinic Florida in Weston.

Doctors are now offering patients the option of an implantable neurostimulator that targets the nerves to stop incontinence.

Karen Schiff, a senior physical therapist at the Outpatient Rehab at Memorial Hospital West, part of Memorial Healthcare System, said more and more women have been turning to physical therapy to treat their weak pelvic floor muscles.

It’s “like strength training for muscles in your pelvic cavity,’’ she said. “And the stronger those muscles are, the higher those organs can be.”

In bi-weekly sessions for six weeks, Schiff works one-on-one with a patient helping her identify the weak pelvic floor muscles. Once a patient is able to feel those muscles herself, she learns how to contract them, thus strengthening them when sitting down, getting out of the car, or going from standing to sitting.

Schiff uses techniques like biofeedback and electrical stimulation. While biofeedback is a noninvasive procedure where sensors help the patient identify the muscles she needs to strengthen, in electrical stimulation the sensors are inserted vaginally or rectally and artificially contract the muscles.

Schiff also helps patients strengthen their pelvic floor muscles with Kegel exercises, where cone-shaped weights are inserted in the vagina. The patient does different exercises with the aim of keeping the weights in place.

Along with newer and better treatments for pelvic organ prolapse, Davila said the biggest advancement is greater public awareness about the issue.

“Before women would just put up with it,” he said. “Those things are no longer a taboo topic.”