Pelvic floor disorders impact many women and can cause a variety of problems including incontinence. In Limpopo, patients were commonly referred to Johannesburg for treatment because the province didn’t have an integrated urogynaecology service.
Because of the difficulty this posed for patients, Dr Dakalo Arnold Muavha – who has super-specialised in the field of urogynaecology – decided to take his services to his birth province.
Muavha is the first black South African, and one of only four gynaecologists and obstetricians in the country, to have super-specialised in this field.
Urogynaecology is a relatively new sub-speciality globally, and Muavha has established the first private urogynaecology unit for the treatment of pelvic floor disorders at Netcare Pholoso Hospital in Limpopo. He opened his practice in August 2019.
Whereas in the past many women would have been referred to a urologist for bladder problems, then sent to a gynaecologist for womb problems, only to be later referred to a colorectal surgeon to treat bowel disorders, the urogynaecologist is trained to deal with all issues related to the pelvic floor and organs, including the bladder, uterus or womb, and rectum.
Embarrassing incontinence disorders
Pelvic floor disorders can lead to many problems including incontinence, and although these disorders are not life-threatening, Muavha says they occur quite commonly and can have a devastating impact on the lives of those affected.
“There are numerous older women in particular who live with severe and embarrassing incontinence disorders. Many are unaware that these can be treated, while others are too embarrassed about the condition to seek medical assistance.
“Some are discriminated against, lose their partners and become susceptible to anxiety and depression,” he said.
In Australia it’s estimated that at least half of women who have had more than one child have some degree of pelvic organ prolapse, and South African trends are believed to be similar to those recorded internationally, urologist Dr Preena Sivsankar told IOL.
According to Muavha, the impact extends economically on families when some women have to give up their jobs and still find the means to spend R1 200 a month or more on adult diapers. Muavha, who is skilled in the management of pelvic floor disorders as well as in laparoscopic surgery and medical research, says that because most women with the disorder can be treated with relative ease, it is "a great tragedy" that they aren’t receiving the help they need.
Older women at higher risk
Pelvic floor disorders have a variety of causes, but occur more commonly in women over the age of 50 who have given birth to a number of children, explains Muavha. However, the risk also increases in overweight individuals.
Muavha says that he feels blessed to be afforded the opportunity to play an active role in this regard.
“It is my vision to improve access to care through new urogynaecology units within both the private sector at Netcare Pholoso Hospital, as well as the public sector via the Polokwane/Mankweng Hospital complex,” he said.