Treatment of urinary incontinence pelvic organ prolapse with implantation of polypropylene mesh Monarch in ViDia Hospital Karlsruhe

About the department

The Department of Gynecology, Obstetrics and Mammology at the ViDia Hospital Karlsruhe carries out the diagnostics and treatment of the full range of diseases of the female reproductive system, provides comprehensive care and monitoring for the future mother and child during pregnancy and after childbirth, and delivers babies in comfortable delivery rooms. Special attention in gynecology is paid to the treatment of endometriosis, uterine myomas, urinary incontinence, pelvic organ prolapse, and female reproductive cancers, including uterine, ovarian, and vulvar cancers. The department's breast specialists provide comprehensive medical care for women with breast cancer. More than 1,600 babies are born in the department's delivery rooms annually. All the necessary resources are available here for safe childbirth in comfortable conditions for women. It is worth noting that the department has been awarded prestigious quality certificates by the German Cancer Society (DKG) for the treatment of gynecologic malignancies, cervical dysplasia, and breast cancer. The treatment rooms and operating rooms at the medical facility are equipped with advanced technology, thanks to which doctors can perform minimally invasive treatment through small incisions (only 1-2 cm) or natural openings (transvaginal approach). Sparing treatment allows doctors to minimize the risks of complications during the surgical intervention and in the postoperative period, relieve pain, and shorten a hospital stay. The team of the department's doctors makes every effort to provide each patient with personalized, top-class treatment. The Head Physician of the department is Dr. med. Oliver Tomé.

An important area of the department's specialization is the treatment of cancer affecting the female reproductive system, including uterine, cervical, ovarian, and vulvar cancers. Women with cancer diagnoses receive medical care at a specialized center certified by the German Cancer Society (DKG). This certification signifies the provision of high-quality medical services using the very latest treatment methods. The doctors at the center follow a multidisciplinary approach, so the patients receive medical care from a large team of specialists consisting of gynecologists, oncologists, radiation therapists, radiologists, and psycho-oncologists. Treatment can be provided both on an inpatient and outpatient basis, with surgical interventions most often requiring a hospital stay, while chemotherapy or hormone therapy is performed on an outpatient basis.

The most effective treatment method for gynecologic cancer is surgical resection of the malignant tumor. In advanced stages, the removal of the affected organs may be necessary as well. For example, for patients with ovarian cancer, gynecologists perform laparoscopic surgery to remove the ovary from one or both sides, while for cervical cancer treatment, the department's doctors use conization of the cervix or perform laparoscopic interventions. Patients with uterine cancer may undergo laparoscopic surgery with a transvaginal approach to remove the uterus and ovaries (hysterectomy with adnexectomy), total laparoscopic hysterectomy with adnexectomy, or open surgery to remove the uterus, ovaries, and affected lymph nodes. As a rule, surgery is supplemented with chemotherapy, radiation therapy, hormone therapy, immunotherapy, and other conservative treatment methods. It is important that the treatment regimen for each patient be elaborated at an interdisciplinary tumor board. Such an approach allows the doctors to choose the most effective, but at the same time, sparing treatment methods. Experienced psycho-oncologists also work with patients throughout the therapeutic process. Their task is to help women accept their diagnosis and motivate them to fight against oncopathology in order to achieve optimal results.

In January 2004, the Breast Cancer Center was established in the department. The center has been successfully certified by the German Cancer Society (DKG) for many years in a row. The doctors at the center cooperate with colleagues from other departments of the hospital, including gynecologists, oncologists, radiologists, and radiation therapists. Highly qualified doctors with vast clinical experience take care of breast health. Patients undergoing their treatment at the center receive medical care both on an inpatient and outpatient basis. The first stage of the therapeutic process is a comprehensive diagnosis, based on the results of which an individual treatment regimen is elaborated, taking into account the stage of the disease, the specifics of its course, the age of the patient, and her general health condition. In most cases, the first-line treatment is a surgical procedure. The therapeutic protocol also often includes chemotherapy, radiation therapy, immunotherapy, antibody therapy, etc. For women undergoing mastectomy (breast removal surgery) due to breast cancer, the department's plastic surgeons perform breast reconstruction using silicone implants or autologous tissues. Reconstructive plastic surgery after breast removal plays an important role because women may develop complexes about their appearance or depressive states.

The department has 3 modern delivery rooms that meet current international medical standards. Each delivery room is equipped with comfortable birth chairs and pools for water births. The delivery rooms also have a special chair, a gymnastic ball, wall bars, and other aids to relieve pain during contractions and facilitate natural childbirth. For pain relief during childbirth, expectant mothers are also offered homeopathy, aromatherapy, and relaxation baths. The department performs C-sections using the Misgav Ladach method, if necessary. After childbirth, obstetricians and nurses provide support for breastfeeding and care for both mother and baby. Shared accommodation rooms are also available in the department, as the first hours after childbirth are particularly important in forming a bond between the mother and baby. Postnatal care is an integral part of the department's work. The doctors also hold post-discharge counseling, including breastfeeding support, monitoring postpartum recovery, and monitoring the baby's development during the first year of life. The department's team of obstetricians and nurses strives to make such an important event as the birth of a child as pleasant and comfortable as possible.

The department's range of medical services includes:

• Gynecology
  • Diagnostics and treatment of malignant diseases of the female reproductive system
    • Uterine cancer
    • Cervical cancer
    • Ovarian cancer
    • Vulvar cancer
  • Diagnostics and treatment of benign diseases of the female reproductive system
    • Ovarian and uterine cysts
    • Uterine fibroids
    • Endometriosis
    • Cervical dysplasia
    • Urinary incontinence
    • Pelvic organ prolapse
• Mammology
  • Diagnostics and treatment of malignant breast diseases
    • Breast cancer
  • Diagnostics and treatment of benign breast diseases
    • Cysts
    • Fibroadenomas
    • Lipomas
    • Mastopathy
• Obstetrics
  • Comprehensive pregnancy management in all trimesters
  • Childbirth: natural birth, including in water, and C-section
  • Postnatal care for mother and baby
• Other medical services

The department's therapeutic options include:

• Conservative treatment
  • Drug therapy for benign diseases
  • Systemic treatment for malignant diseases: chemotherapy, hormone therapy, antibody therapy, immunotherapy, and radiation therapy
• Surgical treatment
  • Surgical interventions for benign and malignant gynecologic diseases
    • Hysteroscopy
    • Hysterectomy, including laparoscopic supracervical hysterectomy and total laparoscopic hysterectomy
    • Ovariectomy
    • Adnexectomy
    • Vulvectomy
    • Lymph node dissection
    • Conization of the cervix
    • Uterine artery embolization
  • Resection of malignant breast tumors, mastectomy (breast removal surgery), and reconstructive plastic surgery using silicone implants and autologous tissues
• Other treatment methods