New ways to prevent and cure pelvic organ prolapse (POP) are a big step closer, thanks to major funding for pioneering research at Hudson Institute.
Two world-leading projects have been recognised by the Medical Research Future Fund (MRFF) for their potential to impact this debilitating condition.
Hudson's own POP specialists, Dr Shayanti Mukherjee, Professor Jerome Werkmeister and Professor Caroline Gargett, with lead researcher, Associate Professor Anna Rosamilia, Head of the Pelvic Floor Unit at Monash Health, to receive an MRFF – Clinician Researchers: Applied Research in Health grant totalling nearly $1.4 million over four years.
Prevention and cure of pelvic organ prolapse
Their project aims to transform the field of female pelvic floor health on two fronts: prevention and cure of POP.
POP is a common condition that affects many women, soon after or many years after vaginal birth. It occurs when the muscles and tissues that support the pelvic organs become weak or damaged, causing the organs to drop or press against the walls of the vagina.
They propose that 3D printed (3DP) grafts can improve pelvic reconstructive surgery outcomes and nanostructured hydrogels can reverse birth induced injury and prevent POP in the future, using 3D printing, nanotechnology and cellular bioprinting to advance Australian health outcomes, practice and policy.
A key to their research is the use of 3D printing, nanotechnology and cellular bioprinting in POP surgery, which is where the other award recipient, Dr Kallyanashis Paul, comes in.
He has received an MRFF Early to Mid-Career Researchers Grant worth $800,000 over two years for his project on 3D bioprinted strategies for improving female pelvic reconstructive surgery outcomes.
His research proposes a paradigm shift in pelvic reconstructive practice by introducing absorbable 3D bioprinted grafts boosted with a patient's own cells, aiming to drastically reduce the post-surgical immune response and prevent adverse reactions.
Dr Paul will be testing a range of different designs and those found to work best will undergo further testing by A/Prof Rosamilia and her team.
What causes pelvic organ prolapse?
There are several factors that can contribute to the development of pelvic organ prolapse. These include
- Vaginal childbirth: this can weaken the pelvic floor muscles, ligaments and fascia.
- Age: pelvic muscles and tissues naturally weaken with age, making them more susceptible to pelvic organ prolapse.
- Menopause: the decrease in estrogen levels during menopause can also weaken the pelvic muscles and tissues.
- Chronic constipation: straining during bowel movements can put pressure on the pelvic floor muscles and contribute to pelvic organ prolapse.
- Obesity: excess weight can increase the risk of pelvic organ prolapse of the back wall of the vagina.
- Genetic predisposition: connective tissue disorders such as Ehlers-Danlos syndrome or joint hypermobility.
Types of pelvic organ prolapse
There are different types of pelvic organ prolapse, depending on which organs are affected.
Many women will have mild stages of prolapse that they are not aware of and do not cause any symptoms and don't usually progress. Their GP may note this during a cervical screening test examination.
Women become aware of prolapse generally when they can feel or see the vaginal walls or uterus reach the hymen or vaginal opening.
Treatment options
There are several treatment options available for pelvic organ prolapse, depending on the severity of the condition. These include
- Pelvic floor exercises: also known as Kegel exercises, these can help strengthen the pelvic floor muscles and improve symptoms of pelvic organ prolapse. Topical oestrogen can also help symptoms.
- Pessary: a small soft silicone device that is inserted into the vagina to support the pelvic organs.
- Surgery: in moderate or severe cases, surgery may be necessary to repair the damaged tissues and muscles and provide support for the pelvic organs. It has been estimated that between 13 to 19 % of women will have surgery for pelvic organ prolapse over their lifetime; some women more than once.
