Recto-Vaginal fistula diagnosis in Hannover Medical School (MHH)

About the department

The Department of Adult and Pediatric Gynecology, Mammology, Obstetrics and Reproductive Medicine at the Hannover Medical School offers accurate diagnostics and effective treatment of all diseases of the female genital organs and breast, as well as provides top-class obstetric services. The department specializes in the treatment of breast cancer, female genital cancers, dysplasia, endometriosis, urinary incontinence, pelvic organ prolapse, as well as the treatment of hormone imbalance of gynecological origin. The department’s therapeutic options include conservative methods, surgical treatment using the very latest robot-assisted systems (da Vinci robot) and minimally invasive techniques, psychological care and traditional Chinese medicine. In addition, the department provides the services of experienced reproductologists, whose task is to detect the causes of infertility and carry out the therapeutic manipulations necessary for conceiving a child. The focus of the department’s doctors and nursing staff is on the patient with her individual needs and wishes. Medical care meets strict international standards, due to which high treatment success rates are achieved here.

The department is headed by Prof. Dr. med. Peter Hillemanns. According to the prestigious medical journal Focus, the doctor ranks among the best specialists in the fields of his competence!

A special role in the work of the department's gynecologists is given to the treatment of ovarian, uterine and cervical cancers. The department holds weekly tumor boards, which are attended by all highly qualified doctors and specialists from related fields, including radiologists, radiation therapists, geneticists, psychologists, etc. The purpose of the boards is a detailed consideration of each clinical case and the development of optimal treatment tactics, adapted to the particular clinical case. In most cases, the basis of treatment is surgical resection of the tumor, which, depending on the type and stage of cancer, can be supplemented with chemotherapy, radiation therapy, hormone therapy, immunotherapy and other types of treatment. All therapeutic measures meet the requirements of the specialized groups of the German Cancer Society and the German Society of Gynecology and Obstetrics.

The department's medical team prefers sparing surgeries, and therefore almost all interventions are performed using laparoscopic or robot-assisted surgical techniques. It is worth noting that the department's gynecologists have been performing operations using the state-of-art da Vinci Xi surgical system since 2018. At the moment, the medical facility employs four highly qualified doctors specializing in robotic surgery. In most cases, robot-assisted surgery is used to perform hysterectomy for cervical cancer, surgery for endometrial cancer, and removal of lymph nodes in women with gynecologic cancers. In addition, such operations are performed for benign gynecologic diseases, for example, for ovarian cysts, uterine myomas, for the elimination of fallopian tube obstruction. Robot-assisted interventions have a number of advantages over classical open surgery, since they significantly reduce the risk of postoperative complications, severe bleeding and thrombosis. The da Vinci surgical system provides accurate imaging of the surgical field and eliminates human factors, including fatigue and trembling hands. Patients recover faster after this operation, and the pain syndrome is less severe in comparison with classical surgery.

Breast cancer is one of the most common pathologies in women. The department employs a team of highly professional mammologists for the treatment of this disease. This field is certified by the German Cancer Society, the German Society of Senology and the DIN EN ISO 9001 quality certificate. All certificates testify to the outstanding quality of medical services. Breast cancer treatment methods include breast-conserving surgery, total breast removal, and breast removal followed by reconstruction (immediate or delayed). The department's doctors strive to preserve the patient's breast and remove only the tumor, however, at high risks to the patient's health, radical resections are performed. Surgery is often complemented by radiation therapy. Regular follow-up monitoring is also a prerequisite for a successful outcome.

The main task of the department's obstetricians is the comprehensive management of pregnancy, the organization of safe childbirth and high quality postpartum care. To monitor the course of pregnancy, the department offers all modern examinations in the field of perinatal medicine. The birth takes place in well-equipped delivery rooms, with the participation of an experienced team of obstetricians and nurses. If C-section is required, the procedure is performed according to the sparing Misgav Ladach method. The department uses various methods of pain relief during childbirth, for example, relaxation baths, aromatherapy, homeopathy, acupuncture, pain medications, epidural anesthesia, etc.

The department's therapeutic offer is complemented by the diagnostics and treatment of infertility. During the first consultation, the attending physician holds a conversation with the patient, studies her medical history and the duration of the absence of pregnancy with regular attempts to conceive a child. Then the necessary set of diagnostic tests to determine the causes of infertility is prescribed to a woman. The impossibility of conceiving a child is quite often caused by gynecologic pathology: fallopian tube obstruction, uterine myoma, pathological changes in the endometrium, hormonal disorders, etc. In such cases, the necessary treatment is provided. In more complex cases, assisted reproductive technologies are used. These may be in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), microsurgical epididymal sperm aspiration (MESA), testicular sperm extraction (TESE).

The department also admits children and adolescents between the ages of 0 and 18 with congenital or acquired malformations of the female reproductive system, premature puberty or delayed puberty, menstrual irregularities or amenorrhea in adulthood, polycystic ovary syndrome and other pathologies. The first-line treatment is usually drug therapy. If congenital malformations are detected, surgical repair is often required. The optimal treatment tactics are determined by highly specialized gynecologists who have additional qualifications in pediatric gynecology.

The department's key clinical focuses include:

• Gynecology
  • Diagnostics and treatment of female genital cancers (surgical treatment and drug therapy)
    • Ovarian cancer
    • Uterine cancer
    • Cervical cancer
  • Diagnostics and treatment of cervical dysplasia
  • Diagnostics and treatment of urogynecologic problems
    • Pelvic organ prolapse
    • Urinary incontinence
  • Diagnostics and treatment of endometriosis
  • Diagnostics and treatment of gynecologic endocrine disorders
  • Diagnostics and treatment of gynecologic problems in girls
    • Premature/delayed puberty
    • Menstrual irregularities
    • Menstrual irregularities after chemotherapy, radiation therapy
    • Excessive body hair growth, acne
    • Polycystic ovary syndrome
    • Malformations of the internal and external reproductive organs
    • Genetic developmental disorders (for example, Ullrich-Turner syndrome, Swyer syndrome)
    • Breast malformations
  • Gynecologic surgery
    • Laparoscopic surgery
    • Open surgery
    • Robot-assisted interventions (state-of-the-art da Vinci Xi surgical system)
    • Reconstructive microsurgery
• Mammalogy
  • Conservative treatment of breast cancer
    • Chemotherapy
    • Radiation therapy
    • Hormone therapy
    • Immunotherapy
  • Surgical treatment of breast cancer
    • Organ-conserving breast surgery
    • Oncoplastic breast reconstruction (immediate and delayed reconstruction using the patient's own tissues or implants, reconstruction using expanders)
    • Closure of defects using local skin shifting technique
    • Sentinel lymph node removal
    • Plastic surgery: breast augmentation, breast reduction, breast lift, correction of congenital breast defects
• Obstetrics
  • Prenatal diagnostics
  • Childbirth (natural childbirth, C-section)
  • Bonding to strengthen the bond between mother, father and child
  • Pain relief during childbirth (relaxation baths, aromatherapy, acupuncture, homeopathy, epidural anesthesia and other methods)
• Reproductive medicine
  • Treatment of gynecologic pathologies that prevent the conception of a child (for example, fallopian tube obstruction, endometriosis, uterine fibroids, etc.)
  • Artificial insemination
    • In vitro fertilization (IVF)
    • Intracytoplasmic sperm injection (ICSI)
    • Microsurgical epididymal sperm aspiration (MESA)
    • Testicular sperm extraction (TESE)
• Other therapeutic options