Surgical resection of the rectovaginal fistula with closing in Hospital zum Heiligen Geist Frankfurt am Main

About the department

The Department of Gynecology, Mammology and Obstetrics at the Hospital zum Heiligen Geist Frankfurt am Main provides the widest range of preventive, diagnostic and therapeutic services at the highest level of modern medicine. The priority fields of the department's clinical activities include the treatment of oncological diseases of the female reproductive system and breast, the treatment of uterine fibroids and endometriosis, medical care for urinary incontinence and pelvic organ prolapse in women. The department's team of doctors uses both conservative and surgical treatments. At the same time, the specialists of the medical facility successfully perform sparing minimally invasive surgery and endoscopic procedures for gynecologic diseases. The department also offers comprehensive obstetric services: pregnancy management in all trimesters, childbirth and postpartum care for mother and child. More than 1,000 babies are born in the department's delivery rooms annually. The entire medical staff of the department makes sure that each patient receives effective medical care in a pleasant and friendly environment. The department is headed by Prof. Dr. med. Jörg Engel.

Of particular clinical interest for the department's specialists is the provision of medical care to women with gynecologic oncological diseases: uterine, cervical, ovarian, vulvar, vaginal and fallopian tube cancers. If earlier the diseases of this spectrum were usually diagnosed in middle-aged and elderly women, now young girls are increasingly faced with oncopathology. In this regard, the department's specialists recommend to undergo regular preventive check-ups by a gynecologist, which makes it possible to exclude the presence of cancer or to detect it in the early stages, when the chances of a full recovery are quite high. The diagnostic protocol for suspected gynecologic cancer includes laboratory tests, imaging scans and invasive diagnostic procedures (hysteroscopy, colposcopy, biopsy, etc.). If the diagnostic results confirm the presence of oncology, the department's specialists begin to develop an individual treatment regimen. As a rule, the fight against gynecologic cancer begins with a surgical resection of the tumor. In the advanced stages of oncology, a radical surgical intervention may be required with the total removal of the affected organ (uterus, ovaries). With appropriate clinical indications, the department's doctors use low traumatic surgical techniques. However, a single operation is usually not enough for the full recovery, and therefore chemotherapy, immunotherapy, antibody therapy are used depending on the clinical case. The patients with end-stage stage receive palliative therapy, which allows them to get rid of the pain syndrome. In addition, women diagnosed with cancer receive professional psychological assistance aimed at getting rid of fears and normalizing their psycho-emotional state.

The department also admits patients with benign gynecologic diseases. The most common of these include uterine fibroids and endometriosis. In some cases, there is no need for specific treatment in the early stages of these pathologies, so the doctor recommends only monitoring by highly specialized doctors. If diagnostic data indicate the need to initiate therapy, then drug therapy or invasive therapeutic procedures (usually minimally invasive) may be considered.

The department's team of doctors also successfully copes with the treatment of urogynecologic pathologies: urinary incontinence and pelvic organ prolapse. During the diagnostics, the specialists resort to ultrasound and X-ray scanning, as well as urodynamic testing. Should the diagnosis be confirmed, the attending physician considers the best treatment options. Whenever possible, the doctor uses only special therapeutic exercises, drug therapy and pessary therapy. If the pathological process is in the early stage, doctors have to resort to surgical interventions through open, laparoscopic or vaginal access.

An integral part of the department's work is the diagnostics and treatment of breast diseases. In this field, special attention is paid to the treatment of breast cancer, which is one of the most common and aggressive types of cancer in women. The classical diagnostic protocol for the patients with suspected breast cancer includes an accurate clinical examination and palpation, study of the patient's medical history, ultrasound scanning, mammography, and histological examination of a biopsy sample of the suspicious breast area. The first-line treatment is tumor resection surgery. In 75% of cases, the department's surgeons perform breast-conserving surgery. In complex clinical cases, it is not always possible to preserve the patient's own breast, and therefore the resection may be followed by plastic breast reconstruction in order to restore an aesthetically attractive appearance.

The department also specializes in the provision of obstetric services. The specialists monitor the course of pregnancy in all trimesters, deliver babies, as well as take care of the mother and baby after childbirth. The department has four modern delivery rooms, equipped with everything necessary for the successful childbirth. The delivery rooms also have baths for water births. The department's obstetricians prefer natural childbirth, but if necessary, C-section may be performed. The specialists make sure that the woman in labor feels as comfortable as possible, so they use various pain relief methods, including acupuncture, homeopathy, massage, aromatherapy and others.

The department's main clinical activities include:

• Gynecology
  • Diagnostics and treatment of malignant diseases of the female reproductive system
    • Uterine cancer
    • Cervical cancer
    • Ovarian cancer
    • Vulvar cancer
    • Vaginal cancer
    • Fallopian tube cancer
  • Diagnostics and treatment of benign diseases of the female genitourinary system
    • Uterine fibroids
    • Endometriosis
    • Urinary incontinence
    • Pelvic organ prolapse
• Mammalogy
  • Diagnostics and treatment of breast diseases
    • Breast cancer
• Obstetrics
  • Integrated management of pregnancy
  • Childbirth (natural childbirth and C-section)
  • Postnatal care for mother and baby
• Other medical services

The department's therapeutic options include:

• Conservative treatment
  • Drug therapy
  • Chemotherapy, immunotherapy and targeted therapy for cancer
  • Special therapeutic exercise programs for pelvic floor muscle strengthening and pessary therapy for urinary incontinence
• Surgical treatment
  • Sparing minimally invasive surgery for gynecologic cancer and breast cancer
  • Radical surgery for gynecologic cancer and breast cancer
  • Reconstructive pelvic floor plastic surgery with autologous tissues or mesh implants for pelvic organ prolapse
  • TVT and TOT sling procedures for urinary incontinence
  • Burch colposuspension and Richardson's operation for urinary incontinence
  • Laparoscopic surgery for uterine fibroids or endometriosis
• Other treatment methods