Urogynaecology, a surgical subspecialty of Gynaecology that focuses on female pelvic floor disorders, addresses conditions such as urinary incontinence and pelvic organ prolapse. Urinary incontinence (UI) is a condition commonly referred to as “loss of bladder control”, resulting in the involuntary leakage of urine. On the other hand, pelvic organ prolapse (POP) is defined as the descending of one or more of the pelvic organs—such as the bladder, intestines, rectum, uterus, cervix, or vaginal apex—from their normal position, causing them to protrude into or outside the vaginal canal due to weakness of the pelvic tissues and pelvic floor muscles. They are highly prevalent yet have a significant, distressing impact on the individual’s psychological well-being, self-esteem, and overall quality of life.
Despite the prevalence and impact of these issues, they remain under the unjust umbrella of stigma and taboo, particularly in many parts of the world, including the Middle East. The cultural and societal norms often prevent women from seeking help, resulting in these conditions being underdiagnosed and underreported. Unfortunately, many women suffer in pain and silence, burdened by fear, embarrassment, and disruptive, overwhelming thoughts such as “What will people say?”, “I cannot be there”, “I will embarrass myself”, “Everyone will know”, and the most heartbreaking, “I feel dirty”. These are just a few of the thousands of thoughts that cross their mind before doing the simplest activity.
This situation is not just a matter of social isolation and extremely destructive thoughts that put their psychological health in great danger, it is also the inevitable impact on their physical health due to lack of knowledge and guidance. Many women are unaware that their symptoms are medical conditions that can be treated. They often perceive these issues as normal aspects of ageing or childbirth and therefore do not seek medical advice. Unfortunately, this can cause their condition to deteriorate and reach advanced, more complex stages.
While conditions such as urinary incontinence and pelvic organ prolapse are associated with advanced age (commonly over 50 or 60), they also affect younger women, including those in their 20s and 30s. Early onset can be associated with various factors, such as genetic predisposition, lifestyle, and engaging in high-impact physical activities. Unfortunately, the stigma and lack of awareness are even more pronounced in younger age groups. This is often due to the common misconception that these conditions are exclusively associated with advanced age, which can cause younger women to feel particularly isolated and out of place. Therefore, it is crucial to shed light on the fact that urogynaecological problems can occur at any age and do not label any woman in particular. Women should feel comfortable to express their concerns without fear of judgment.
Moreover, the consequences of urinary incontinence and pelvic organ prolapse extend beyond the individual, affecting their families, friends, and daily activities. Women dealing with these conditions often find that their struggles have a broader impact on their loved ones and their everyday lives. It typically results in an emotional burden constantly haunted by feelings of helplessness. Family members may also feel frustrated because of the lack of communication or misunderstandings, often arising from the woman’s difficulty in openly expressing their worries or simply choosing to ignore them. Consequently, women with these conditions may find themselves avoiding social gatherings, exercise, and hobbies they once enjoyed due to the constant fear of leakage or obvious signs of discomfort or pain. This isolation disrupts not only their daily life but also their overall quality of life, making simple tasks such as shopping less enjoyable and turning bigger activities such as travelling into impossible and challenging tasks.
Therefore, addressing the stigma surrounding urogynaecology is essential in improving the health and quality of life of countless women; a comprehensive approach should be implemented to tackle this issue. It should include open access to education and workshops aiming to spread awareness, encourage open dialogue, and establish a robust support network. However, before these initiatives can be effective, efforts must be made to eliminate labelling these issues as taboo and empower women to seek timely medical help without fear or hesitation. Such changes will not only transform their experiences and significantly improve their quality of life but also give them the strength to face health problems with a positive mindset.
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The campaigns and workshops should focus on spreading accurate information about urogynaecological conditions and correcting common misconceptions. They should aim to demystify them, highlight their prevalence, and present them as treatable health conditions rather than a source of embarrassment. Additionally, educational material should be made easily accessible to prevent the spread of misinformation and avoid unnecessary negative outcomes. These programs will help spread valuable knowledge and encourage proactive health management.
Dr. Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists (RCOG), underscores the importance of these efforts: “We are calling for improved information provision and education throughout women’s lives. Every health professional has a role to play in tackling stigma and giving women the ability to protect their pelvic health, to improve symptoms they may develop and to recognise when to seek help by making every interaction count.”
Ultimately, breaking the silence and encouraging awareness within a supportive culture will ensure that every woman receives the care, support, and respect she deserves.
