Surgical treatment of vulvar cancer with metastases in the lymph nodes with radical vulvectomy and lymphadenectomy in Luisenhospital Aachen

About the department

The Department of Gynecology, Obstetrics and Mammology at the Luisenhospital Aachen provides diagnostics and effective treatment of diseases of the female reproductive system and breast pathologies, pregnancy management in all trimesters, childbirth, and postnatal care. The department's specialists have impressive experience in the treatment of breast cancer, urinary incontinence, and pelvic organ prolapse. Patients suffering from the above-mentioned pathologies are treated at highly specialized centers that have ÄKzert and DIN EN ISO 9001:2015 certifications. The medical facility is also one of the best in the region in the treatment of menorrhagia (heavy menstrual bleeding) using the innovative NovaSure technique. About 100 such procedures are performed here every year. The department's gynecologists work in state-of-the-art operating rooms adapted for minimally invasive surgical interventions, including laparoscopic supracervical hysterectomy (LASH), total laparoscopic hysterectomy (TLH), laparoscopically assisted vaginal hysterectomy (LAVH), hysteroscopy, etc. Whenever possible, breast specialists perform organ preservation surgery for breast cancer, and in cases requiring a mastectomy, women are offered reconstructive plastic surgery. Childbirth takes place in modern delivery rooms, where everything is available for a comfortable and safe delivery. The department is headed by Dr. med. Uwe Heindrichs.

The department offers high-quality medical care to women with benign and malignant gynecologic diseases. As for benign diseases, the department's doctors most often treat endometriosis, ovarian cysts, and uterine myomas. In many cases, benign gynecological diseases respond well to conservative therapy, but in advanced stages, minimally invasive procedures are often performed. To remove ovarian cysts, large uterine myomas, or endometriosis foci, the department's gynecologists perform minimally traumatic laparoscopic or hysteroscopic interventions that allow for the preservation of the affected organs, which plays an important role for young women planning to have children in the future. Laparoscopic and hysteroscopic interventions are often performed on an outpatient basis. These operations not only provide patients with excellent therapeutic results but also leave barely noticeable scars.

The department's medical team also specializes in the treatment of menorrhagia (heavy menstrual bleeding) using the innovative NovaSure endometrial ablation technique. When performing this procedure, gynecologists remove the inner mucous layer of the uterine wall that causes heavy uterine bleeding. The NovaSure procedure is performed under sedation on an outpatient basis. The duration of the manipulation is about 5 minutes. The department performs about 100 NovaSure endometrial ablation procedures every year.

The department has vast experience in providing medical care to women with cancer of the reproductive system. The most common types of oncological diseases in the department's clinical practice are uterine, ovarian, and vulvar cancers. The treatment is based on the surgical resection of the malignant tumor, and in the advanced stages, it is often necessary to remove the affected organ. The department's specialists use modern low-traumatic surgical techniques, such as laparoscopic supracervical hysterectomy (LASH), total laparoscopic hysterectomy (TLH), and laparoscopically assisted vaginal hysterectomy (LAVH). After these surgical interventions, women recover faster and experience significantly less pain in the postoperative period. When treating young women with malignant gynecologic diseases, doctors strive to preserve fertility. Surgical treatment is supplemented with chemotherapy, radiation therapy, hormone therapy, targeted therapy, and other types of systemic treatment to completely destroy malignant cells.

An important focus in the clinical practice of the department's gynecologists is the treatment of urinary incontinence and pelvic organ prolapse. These conditions are more common in older women, but they can also be diagnosed in young women, as a rule, after childbirth. The department offers both conservative and surgical methods for treating urinary incontinence. With appropriate clinical indications, the specialists strive to perform only conservative therapy, namely hormone therapy, pessary therapy, electrical stimulation, and therapeutic exercises to strengthen the pelvic floor muscles. In complex clinical cases, gynecologists perform surgical treatment for urinary incontinence. The most effective interventions are sling operations to place synthetic mesh implants. Pelvic organ prolapse is treated in the department with minimally traumatic laparoscopic and transvaginal interventions.

The department houses the Breast Center, whose specialists provide diagnostics, treatment, and follow-up care for patients with breast cancer. The center offers medical services in accordance with the modern medical standards of the European Society of Mastology (EUSOMA). The department's breast specialists prioritize personalized treatment, taking into account the peculiarities of each specific clinical case. They therefore hold weekly tumor boards with the participation of breast specialists, oncologists, radiologists, and radiation therapists. The main treatment method for breast cancer is a surgical intervention to resect a malignant tumor, and in the advanced stages, the removal of the affected organ is often required. The department's breast specialists give preference to organ preservation surgery and always strive to preserve the patient's breast. When it is not possible, the experienced reconstructive plastic surgeons who successfully perform breast plastic surgery are involved in the therapeutic process. Surgical treatment is usually complemented by chemotherapy, radiation therapy, hormone therapy, and other procedures, which are carried out by oncologists.

The department's team of obstetricians offers the full range of services in the area of its specialization, from comprehensive pregnancy management to postnatal care for mother and child. Upon admission to the department, physicians accurately study the patient's medical history and hold consultations to exclude risk factors for the woman and baby. Advanced ultrasound systems allow the doctors to monitor the course of pregnancy in all trimesters, and if congenital abnormalities are detected in the womb, they can plan the optimal treatment for the child in advance. Childbirth takes place in comfortable delivery rooms equipped in accordance with modern standards. In addition to conventional births, water births are also performed here. Obstetricians also offer various pain management methods, including relaxing baths, acupuncture, homeopathy, and epidural anesthesia, for the comfort of expectant mothers.

The department's key clinical focuses include:

• Gynecology
  • Conservative and surgical treatment of malignant diseases of the female reproductive system
    • Uterine cancer
    • Ovarian cancer
    • Vulvar cancer
  • Conservative and surgical treatment of benign diseases of the female reproductive system
    • Uterine myomas
    • Endometriosis
    • Ovarian cysts
    • Pelvic adhesions
    • Menorrhagia (heavy menstrual bleeding)
    • Genital warts
    • Ectopic pregnancy
  • Conservative and surgical treatment of urogynecologic diseases
    • Urinary incontinence
    • Pelvic organ prolapse
• Mammology
  • Conservative and surgical treatment of breast diseases in women and men
    • Breast cancer
    • Benign breast tumors
• Obstetrics
  • Comprehensive management of pregnancies
  • Childbirth: natural birth, water birth, and sitting birth
  • Postnatal care for mother and baby
• Other medical services