Pelvic organ prolapse is a descending or drooping of the pelvic organs through the vagina. As a rule, this is a consequence of previous surgery or age-related weakening of the connective tissue. There are different types of prolapse, such as urethrocele, cystocele, enterocele, rectocele, uterine, and vaginal stump prolapse. Doctors in Germany provide a successful pelvic organ prolapse treatment. The specialists prefer sparing and minimally invasive surgical procedures that securely fix the organs in the correct anatomical position and eliminate the symptoms of the disease.
Content
- Conservative therapy
- Surgical treatment
Doctors perform operations aimed at restoring the normal anatomical position to treat urinary incontinence due to pelvic organ prolapse. Instead of the classic abdominal approach, surgeons in Germany perform minimally invasive laparoscopic and robot-assisted operations.
You can undergo your treatment at the University Hospital Ulm, the University Hospital Frankfurt am Main, or the Charite University Hospital Berlin.
We will organize your trip if you make your treatment appointment at a hospital through the Booking Health service. Our specialists will recommend a doctor and a treatment method, organize an appointment on the desired date, help you to apply for a visa and fly to the hospital, provide an interpreter, and a personal coordinator.
Conservative therapy
In most cases, pelvic organ prolapse can be treated with conservative methods. Doctors recommend women do exercises to strengthen their pelvic floor muscles, correct their body weight, and follow a diet to normalize their stools. Patients should stop smoking and avoid physical exertion, as well as any other situations that increase pressure in the abdominal cavity.
If this does not work, doctors move on to a pessary placement. This is a device that is placed in the vagina and holds the pelvic organs. Pessaries have to be changed every few months to avoid infectious complications.
Surgical treatment
Many operations have been developed that eliminate urinary incontinence and restore the normal position of the pelvic organs. The main treatment options are as follows:
Colpocleisis is a surgical procedure that closes the lumen of the vagina. This surgery makes it impossible to have sex or medical procedures that are performed through the vagina, such as an endometrial biopsy. This surgical option is suitable for older women who do not have any sex and do not plan to have it in the future. This is a very effective operation that completely eliminates the manifestations of the disease in 93% of cases.
Sacrospinous fixation can be used for anterior or posterior pelvic organ prolapse. This surgical intervention is performed through a vaginal approach. The intervention is minimally traumatic, but there is a drawback: a posterior displacement of the vaginal axis can provoke a recurrence of the disease in the future.
Iliococcygeus fixation is performed through a vaginal approach. A doctor attaches the top of the vagina to the fascia of the iliococcygeus muscle. The vaginal axis does not change, so an anterior prolapse is very rare after surgery.
Uterosacral ligament suspension is a surgical procedure during which doctors form folds of the uterosacral ligaments and attach them to the vaginal cuff. The disadvantage of this approach is the proximity of the uterosacral ligaments to the ureters.
Abdominal sacrocolpopexy is a surgical intervention to suspend the sacrum through abdominal incisions. The operation provides reliable results, preserves vaginal function, and is effective even when other procedures have failed. This surgical procedure was first performed in 1962, and then it was done through a large abdominal incision. Today, many modifications have been developed, and operations are performed using laparoscopy. If you are receiving medical care at specialized centers abroad, da Vinci treatment (robot-assisted surgery) may be a good option for this intervention. Robot-assisted operations are the safest and least traumatic, reducing the period of general rehabilitation. Both the patient's own tissues and artificial materials can be used to suspend the pelvic organs to the sacrum. In general, preference is given to meshes made of synthetic materials.
You are welcome to contact one of the German hospitals to undergo your diagnostics and treatment of pelvic organ prolapse and urinary incontinence. Please use the Booking Health website to find prices and compare the cost of medical services in different hospitals. Our staff will help you to choose the most suitable clinics in Germany and organize your trip.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
Verywell Health
Web MD
Science Direct