Treatment of urinary incontinence pelvic organ prolapse with implantation of polypropylene mesh Monarch in University Hospital Ulm

About the department

The Department of Adult and Pediatric Gynecology, Mammology, Obstetrics at the University Hospital Ulm offers high-precision diagnostics and effective treatment of the full range of diseases of the female reproductive system and breast pathologies. The medical facility also employs a competent team of obstetricians, whose responsibilities include comprehensive management of pregnancy, childbirth, and postnatal care for mother and baby. More than 3,000 babies are born in the department's delivery rooms annually. The department cooperates closely with the UniFee Reproductive Medicine Center, which allows gynecologists to treat female infertility together with reproductive medicine specialists. The department's gynecologists focus on women with reproductive system cancers. The medical facility is certified by the German Cancer Society (DKG) as a specialized center. The specialists also successfully treat endometriosis, one of the most common benign gynecologic diseases. In the field of mammology, priority is given to the provision of medical care to women with breast cancer. Doctors perform comprehensive diagnostics, surgical and conservative treatment, and reconstructive plastic surgery after mastectomy. The department's specialists use state-of-the-art technical resources and their professional skills to provide each patient with high-quality medical service.

The department is headed by Prof. Dr. med. Wolfgang Janni, one of the most reputable obstetrician-gynecologists in Germany, which is confirmed by the Focus magazine rating and the high credibility among patients, including those from foreign countries. The doctor underwent training in renowned medical facilities in the United States and held positions at the leading German university hospitals, including the University Hospital of Ludwig Maximilian University of Munich and the University Hospital Duesseldorf. With over 25 years of experience, Prof. Janni specializes in treating women with gynecological pathologies and providing obstetric services. During this time, he has dealt with the most complex clinical cases. He is the winner of four Awards of Merit in Medicine from the American Society of Clinical Oncology and an Award from the German Society of Obstetrics and Gynecology. His scientific publications exceed 430 works in the medical literature.

The department's gynecologists have gained a solid reputation in the treatment of cancer of the female reproductive system. The specialists have vast experience in treating uterine, cervical, ovarian, vulvar, and vaginal cancer. The department has a powerful technical base for comprehensive diagnostics in cases of suspected cancer, including ultrasound, MRI, and PET-CT. A biopsy for subsequent histological examination is performed under local anesthesia for the maximum comfort of patients. A treatment regimen is developed individually during interdisciplinary tumor boards. The best treatment results are achieved through a combination of surgical resection of the malignant tumor (advanced stages of cancer require major surgery involving the removal of the affected organs and adjacent anatomical structures), drug therapy (chemotherapy, hormone therapy, and targeted therapy), and radiation therapy. The department's specialists prefer to perform operations using minimally invasive techniques. Surgeons also successfully use the da Vinci high-precision surgical system. Such operations are performed only in the world's leading medical complexes.

An integral part of the department's clinical practice is the treatment of endometriosis, a benign disease that can potentially lead to infertility, painful periods, pelvic pain, and even cancer. In patients with this disease, endometrial tissues (the inner mucous membrane lining the uterus) overgrow outside the uterus. Endometriosis is a widespread disease. Therefore, the department houses a specialized center for the treatment of this condition. Women with this diagnosis can receive comprehensive medical care here. Patients undergo a thorough diagnosis, including a gynecological examination, ultrasound, MRI, and laparoscopy, as well as an individually developed treatment regimen. The optimal type of therapy depends on the stage of endometriosis and the severity of the symptoms. In the early stages of the disease, the department's specialists use only hormone therapy, and in the advanced stages, the most effective method is surgery. Almost all surgical procedures for endometriosis are performed in the department using minimally invasive techniques. Gynecologists at the medical facility also have vast experience in robot-assisted surgery for endometriosis using the da Vinci surgical system, known for its high precision, minimal trauma rate, and barely noticeable scars.

The department also houses an advanced Breast Center that provides the full range of services for women and men with benign and malignant breast diseases. Of particular interest is the treatment of breast cancer, which is one of the most common types of oncology among women worldwide. The therapeutic process begins with an individual consultation with a breast specialist, followed by a complex of diagnostic tests, such as mammography, ultrasound scans, MRIs, and biopsy (if a suspicious neoplasm is detected during imaging tests). If the cancer diagnosis is confirmed, the center's breast specialists begin to elaborate a treatment regimen that is based on the surgical resection of the malignant tumor. In more than 75% of cases, the specialists manage to perform breast-conserving surgery. If it is impossible to preserve the patient's breast, options for reconstructive surgery with autologous tissues or silicone implants are considered. In most cases, the treatment regimen also includes conservative methods such as chemotherapy, antihormone therapy, antibody therapy, immunotherapy, and radiation therapy. It is worth noting that the department's specialists, in cooperation with radiation therapists, successfully perform intraoperative radiation therapy (irradiation directly during a surgical intervention).

The department's range of therapeutic options is complemented by the provision of high-quality obstetric services (Level I Perinatal Center). More than 3,000 babies are born in the department's delivery rooms every year. The department's obstetricians have vast experience in the management of multiple pregnancies and high-risk pregnancies. The specialists give preference to natural childbirth, but they can also perform a C-section whenever required. Childbirth takes place in four well-equipped delivery rooms with a pleasant atmosphere, and there is also a special room for water births. A competent team of obstetricians, gynecologists, and pediatricians works around the clock here, thus ensuring maximum safety for patients and babies. Obstetricians also focus on minimizing pain during childbirth, so they offer modern pain management options such as epidural anesthesia, homeopathy, and acupuncture. Special attention is paid to postpartum bonding in order to form a subtle and intuitive bond between mother and baby.

The department's range of medical services includes:

• Gynecology
  • Diagnostics and treatment of benign gynecologic diseases
    • Menstrual disorders
    • Menopause and its symptomatic manifestations
    • Chronic pelvic and lower abdominal pain
    • Infections of the external and internal female genitalia
    • Ovarian cysts and benign tumors
    • Myomas
    • Cervical dysplasia
    • Endometriosis
    • Urinary incontinence
    • Pelvic organ prolapse
    • Chronic bladder inflammation (cystitis)
    • Various forms of infertility
    • Hormonal imbalances due to gynecologic pathologies
  • Diagnostics and treatment of malignant gynecologic diseases
    • Uterine cancer
    • Cervical cancer
    • Ovarian cancer
    • Endometrial cancer
    • Vaginal cancer
    • Vulvar cancer
  • Diagnostics and treatment of gynecologic diseases in girls and young women
    • Vaginal bleeding before the onset of the menstrual cycle
    • Vaginal discharge
    • Vulvovaginitis
    • Synechiae
    • Congenital malformations
    • Puberty disorders
    • Presence of a foreign body in the vagina
• Mammology
  • Diagnostics and treatment of benign breast diseases
    • Mastopathy
    • Breast cysts
    • Breast fibroadenoma
    • Intraductal papilloma of the breast
    • Gynecomastia (breast enlargement in men)
  • Diagnostics and treatment of malignant breast diseases
    • Breast cancer
• Obstetrics
  • Medical care before, during, and after childbirth
  • Prenatal diagnostics and therapy (non-invasive and invasive methods)
  • Pregnancy management, including high-risk and multiple pregnancies
  • Childbirth: natural childbirth and C-section
• Other medical services