Association for Pelvic Organ Prolapse Support - APOPS

10/16/2026

Say it ain't so..........

We all want the one and done for surgery. But a rectocele (re**al type of pelvic organ prolapse, rather than re**al prolapse) can recur after surgical repair, and a new or persistent bulge can appear at a different location along the re**um or va**nal wall.

This may be due to the repair strengthening a particular area, but adjacent tissue may remain weak or later stretch.

A new defect occurring somewhere else.

Persistent pelvic floor dysfunction, where chronic straining, obstructed defecation, or poor coordination of the pelvic floor can continue to place stress on the tissues.

Or a different underlying condition such as an enterocele (intestines bulging into the va**nal space), perineal descent, or internal re**al intussusception causes pressure or evacuation issues. The average adult re**um is 5-6 inches long. Picture a bulge repaired at the bottom of the image below, and then a second bulge appearing right alongside the original one in patients who have Ehlers Danlos Syndrome, a tissue integrity disorder.

Bottom line, the first round of surgery can be perfectly successful, but issues occur at a different location in the re**um. Here's a mature whisper from the Dietz tribe.

https://pubmed.ncbi.nlm.nih.gov/30904935/

The more we know, the more we need to know.

10/15/2026

Are SUI, UUI, and OAB symptoms of pelvic organ prolapse—or stand alone conditions?

All of these issues originate within the same interconnected network of pelvic floor muscles, nerves, and ligaments. They frequently co-occur. They can directly influence each another.

Stress urinary incontinence (SUI)Relationship to POP - Changes in urethral support and bladder-neck mobility. But also note significant prolapse can kink or compress the urethra, masking leakage that becomes apparent when the prolapse is reduced or repaired.

Urge Urinary Incontinence (UUI)Relationship to POP - Altered bladder outlet mechanics, bladder irritation, and associated pelvic floor dysfunction may contribute to irritation. But also note, UUI is a type of urinary incontinence commonly associated with overactive bladder, but other causes of urgency and leakage should be considered.

Overactive bladder (OAB)Relationship to POP - Prolapse may coexist with OAB and may contribute to bladder storage symptoms in some women. But also note OAB can occur without prolapse and is not proof that the bladder has shifted out of position.

POP-related urinary dysfunction is complex, not simply the bladder shifting out of position. There may be: Altered anatomical support.Urethral support changes. Bladder outlet obstruction. Altered bladder function.

So many layers to consider, no wonder it's muddy.

10/13/2026

How many women fitted with a pessary for pelvic organ prolapse receive, understand, and are able to engage in appropriate maintenance and follow-up instructions regarding insertion, removal, cleaning, concerns to watch for?

There are three categories of pessaries, but likely at least 30 styles divided between the support, stemmed, and space-filling categories. Within the support category, how many women are advised that a commonly utilized ring pessary may:

Spring out of your hand and land on the floor when you fold it in half to insert it? Wash well with soap and water fix.

POP out of your va**na and into the toilet if you bare down a bit to have a bowel movement if you don't bridge the l***a (press your two first fingers in the shape of a V against the l***al lips)? Wash a tad more aggressively with the soap and water fix.

Irritate dry va**nal tissues upon insertion in women with peri, menopausal, or chemo related atrophy if estrogen therapy is not utilized?

That limited hand mobility, arthritis, reduced flexibility, pain, or anxiety can make insertion more difficult?

May cause odor if Tri-o-san to balance va**nal PH is not utilized?

Can not get "lost" inside of you?

An informational document handed to patients during the fitting visit for a pessary is priceless. And a picture is worth a thousand words within that document to shine a light for new patients in anxiety about this new, weird shaped device that looks way too big to insert va**nally.

A small study found that:

31.5% Found insertion difficult

41.9% Reported difficulty inserting or removing

57.9% Thought an applicator would help.

https://lnkd.in/gc6Eh9AR

Part of moving women's health forward is making basic educational insights user-friendly to review. A handout during an appointment is often worth a thousand words. So many forget the details shared the minute their hand hits the exit door of the examination room, especially after an awkward internal exam.

10/12/2026

Repairing placement of organs that have pushed into va**nal space and are moving outside of the body is not the same as repairing the underlying muscle injury that may have contributed to this occurring.

Levator avulsion (LA), injury to the muscles that support organs in the pelvic cavity, can't be diagnosed via the naked eye like pelvic organ prolapse can. Levator ani muscles must be imaged to clarify structural tears including muscle ripped completely off the bone, which sometimes occurs during childbirth. Imaging rarely occurs related to POP symptoms.

While there is exploration in imaging for levator avulsion, there is currently no widely accepted, established surgical procedure that reliably reattaches an avulsed levator ani muscle to the p***c bone and restores normal pelvic floor function. Currently, evidence remains insufficient to establish the best surgical approach to address LA. Women with LA suffer horribly long-term.

We have so much more to learn. Thank you to the few researching this!

https://pmc.ncbi.nlm.nih.gov/articles/PMC12161685/

10/09/2026

TGIF

10/08/2026

I LOVE to see new innovation in the pelvic floor space!

One of the coolest things I appreciate about working on the patient advocacy side of womens pelvic floor health is that innovators and biomed students reach out to me regularly to brain pick and share vision. Had a very intriguing convo today with Monika Liikamaa at Lignum Medical.

Women addressing stress urinary incontinence (SUI) get so fed up with using pads. Expensive. Always feeling moist and less than clean. Leakage at the worst times.

I'm not very well versed on injectible bulking agents, but I know they serve a purpose for a select group of women. I'm learning more about an organic solution made from birch trees.

We have so much more to do!

https://www.lignummedical.com/

Lignum Medical develops a patented nanocellulose-based bulking agent — a next-generation, biocompatible treatment for urinary incontinence.

10/05/2026

I'm nearly always on-point and perfectly content focusing on . The women APOPS serves are always in my heart, no matter when I roam.

When I'm maxed out with work & life stress, I headed to north woods to reboot my soul. Fresh air. Bury a fur-buddy. Capture a whisper of ohm to level my brain.

Yet everywhere I look in nature, I see reflections of women, how the think about themselves, how they FEEL about themselves.

My perspective:

The lines in the wood log end remind me of the face I see staring me back in the mirror, going in all directions.

That walking stick is me on the days I am bloat-free. (woop-woop!!!) And yes, he was sitting on my kitchen sink. :)

I checked out the red leaf up close and could see the tiny green dots of color that it used to have before the red color fully turned on, and the blend of colors in the in-between stage. Reminds me of my hair when it's time to hide the grays.....

My little frog buddy appeared when I was burning garbage, looking totally how I feel on my bloat days! He seemed perfectly comfortable with his shape though!

My property up here is filled with granite boulders that I use every place I can to accent the woods and wildflower landscape. I love big rocks (what chick does not love big sparkly rocks!?!) 🤣

The woodland cam captured a 7-point buck strutting his stuff with about a 2 year old buck with rack in development close behind learning the ropes, a bobcat, a fox, and in the past I've had a flock of turkeys strutting through the back yard and at one point a bear cub sitting on one of those boulders like a circus bear posing for pics (and undoubtedly mama bear not too far out of site). Life comes in all shapes, sizes, layers of yikes and ohm. Color me a farm-girl, I can't seem to shake the dirt out from under my nails and in all honesty, don't ever want to.

Where ever you are, I hope you know how and where to find your ohm when you need it.

Gotta head home tomorrow. Good-by fresh air, open meadow space, and woodlands until I meander back.

10/04/2026

Resharing this today. I need to get my 3 year old bad ass tude on and just DO IT!

10/02/2026

Now this is interesting.

For years the pelvic organ prolapse dialogue has been indicating that the pelvic organs push into the va**na and move downward. But this study indicates the bladder, uterus and re**um followed different, nonlinear trajectories. This could be one of the reasons why two women with the same POP types and stage can have what seems to be illogical symptoms.

We have so much more to learn.

https://pubmed.ncbi.nlm.nih.gov/42260382/