Features Australia

Women suffer while doctors earn a fortune

2 December 2017

9:00 AM

2 December 2017

9:00 AM

Imagine a medical breakthrough which could save the government billions of health care dollars on unnecessary hysterectomies, useless tests and investigations, and enable half of the residents of aged care facilities to return to their family homes.

Now imagine that same breakthrough preventing millions of post-menopausal Australian mothers wasting time and money on doctor’s visits, incontinence pads and useless pills.

Imagine, further, that this is a breakthrough which doesn’t only apply to Australia, but to every nation throughout the world, affecting more than an estimated 600 million women, potentially earning this country billions in exports.

The breakthrough in how the muscles and ligaments inside a woman’s pelvis actually work in conjunction was discovered 30 years ago by a brilliant Australian surgeon, enabling doctors for the first time to cure incontinence and a number of other medical problems suffered by a third of all older women. Yet this Australian Professor of Gynaecology has been shunned and excoriated by the medical establishment, subjected to legal threats and denounced in the media.

Incontinence for older mothers is a serious but rarely discussed problem. Many women, who suffer urinary or faecal incontinence are told by their doctors that there’s no known cause, and that there’s no cure, only temporary relief.

They’re told to exercise their pelvic floor muscles and are forced to use incontinence pads. They’re sent for expensive urine flow analysis, which shows nothing more than they have a problem with incontinence. In serious cases, women have to plan every part of their day to determine where public toilets are located in their travels.

Yet exercises, medication and other treatments have almost no curative effect, and millions of women have to live their later years with embarrassment, inconvenience and often in pain. In serious cases, older women can’t leave their houses, and nursing and elderly people’s homes are full of women who simply don’t need to be there. This is because all previous treatments have been directed at the wrong cause.

Yet a simple operation to support and strengthen the ligaments of a woman’s pelvis is conducted in hospitals daily by surgeons in Japan, Germany and Turkey, where the operation is performed with 85 per cent complete success, and dramatic improvements in the remaining 15 per cent.

So why is the operation banned in Australia? Why are Australian women denied a relatively simple and inexpensive procedure which requires a minimal stay in hospital and usually leads to a complete cure?

This injustice is what a growing number of pelvic floor surgeons is fighting hard to overcome. And one of them, senior lecturer in surgery at the University of New South Wales, Dr Darren Gold, is so frustrated with governments, as well as some of his medical colleagues, that he’s just published a book, Pelvic Flawed, which defines the entire issue.

The breakthrough discovery was made thirty years ago by a young gynaecologist in a Perth hospital, Dr Peter Petros, who treated a middle-aged woman patient suffering from uncontrolled incontinence. Examining her, he noticed that when he put slight pressure on the ligaments supporting her pelvic floor organs, the leakage stopped immediately; when he released the pressure, the flow began straight away. He realised, in contradiction to established medical teaching and practice, that it was the ligaments which were fundamental in controlling the flows of waste, and not, as is still thought and taught today in medical schools, solely the muscles.

What Petros had discovered was how the muscles and the ligaments work together to control the waste pipes within a woman’s body.

In two thirds of older mothers, these muscles and ligaments continue to work as they did when they were young. But if they have given birth to a slightly larger-than-normal baby, or one who emerged in other than perfect geometrical precision, as in one third of all cases, the pelvic ligaments are stretched. Ligaments usually return to normal until menopause when the flow of protective oestrogen stops and they return to their over-stretched state, which is when incontinence problems start. If the ligaments don’t return to normal after childbirth these problems can begin at a much earlier age. Petros’ discovery explains why.

Petros invented a tape device for support, which could be anchored into the woman’s ligaments simulating the support which the internal organs had previously had. When other gynaecologists realized that a fortune was to be made from this or similar devices, they created meshes, inserted in the wrong places without reference to his detailed analysis of the function of the pelvic floor, which Petros had specified must never be done.

And so the problems for women began, with gynaecologists inserting the wrong kinds of mesh, anchored to the wrong places inside a woman, and causing serious internal damage.

Yet had these doctors accepted and understood Petros’ theory, they would have realised that this operation was a near-total cure for incontinence, urgency, and other pelvic floor conditions, and could have obviated the need for more than half of all hysterectomies conducted on women by gynaecologists. And one of the main reasons elderly people become residents of nursing homes and aged-care facilities is because of their incontinence. A simple operation could enable them to return to their homes.

A small cabal of surgeons in Australia has militated against Petros and those doctors, such as Darren Gold, who are demanding the acceptance of this operation by Australian governments so they can cure incontinence in older women. And when the Petros operation is finally permitted to be used, many expensive gynaecological operations will become unnecessary, urodynamics labs which make a fortune out of useless urine function tests will become obsolete, and manufacturers of incontinence pads will lose most of their market once the operation becomes a standard cure. This is a huge global commercial industry. The market value of incontinence pads, pathology tests and pills, much of which will disappear when his operation is widely used, is valued at tens of billions of dollars.

No wonder there’s a conspiracy to deny these surgeons a voice.

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