The Politics of Prolapse: A Revisionist Approach to Disorders of the Pelvic Floor in Women

And this, he said, is the reason why the cure of many diseases is unknown to the physicians of Hellas, because they disregard the whole, which ought to be studied also; for the part can never be well unless the whole is well. ' Socrates, in Plato's Charmides [1] Pelvic floor dysfunction, particularly as manifested by genital prolapse and urinary or fecal incontinence, remains one the the largest unaddressed issues in women's health care today. These problems result in substantial social embarrassment, emotional distress and physical discomfort, and are the cause of tens of thousands of surgical operations each year. However, many women with these afflictions continue to bear them stoically in resigned silence, regarding them as normal and inevitable parts of aging -which they are not. The economic costs of these problems are also immense and similarly unappreciated. At at consensus development conference held in October 1988, for example, the National Institutes of Health estimated the total direct and indirect costs of managing adult urinary incontinence alone at $10.3 billion per year-far more than the current costs of the AIDS epidemic While the public at large has remained oblivious to these facts, the paper products industry has launched a multimillion-dollar campaign to promote the sales of a vast array of absorbent pads, panty-liners, and undergarments in hope of opening up this gigantic source of