This means reconstructing pelvic organs prolaps by using surgical techniques.
Pelvic floor reconstructive surgery may be applied in the following cases:
- incontinence caused by urethra prolapse,
- vaginal prolapses,
- perineal rupture,
- uterine descent,
- uterine prolaps.
There has been a long history of techniques to treat these problems but due to relapse, new surgical methods have been introduced.
New surgical methods to prevent relapse
To improve your quality of life – if chance for relapse is relatively high, according to the most recent protocols, we apply tapes and synthetic meshes in pelvic floor reconstructive surgery.
What does the effectiveness of the surgery depend on?
Tapes have to be inserted with great accuracy as the effectiveness of the surgery largely depends on this. The exact place of tapes can be determined with the help of ultrasound diagnosis (pelvic floor ultrasound scanning) based on international certification which is currently applied only by a few doctors in Hungary.
These mild, flexible, tissue-friendly tapes can fully integrate into the body. Applying these special techniques minimise the risk of relapse and this type of surgery leads to lasting results.
Tailor-made solutions, lasting results
Applying Tension-Free Vaginal Tape (TVT) is a widely used surgical technique to treat incontinence. TVT is placed under the urethra. In 90% of the cases, even after 5 years following the surgery symptoms do not return. Another techique is the so-called Trans-Obturator Tape (TOT) surgery. The TOT Procedure provides support to the bladder by placing a synthetic mesh (which acts as a sling) under the mid-portion of the bladder neck (urethra) through a small incision in the vagina. Photos: TVTand TOT slings.
If the prolapse is present not only in the urethra but also in other tissues or the slings of the uterus, bigger meshes are needed to restore pelvic floor anatomy.
Surgical solutions are always matched to the requirements of the patient, building on professional guidlines and anesthesiological considerations in each case.
Besides the vaginal solution, more and more frequently we use abdominal approaches with synthetic meshes. This is the so-called promontofixation.
In certain cases, this can be done by laparoscopic surgery with the help of which the uterus does not need to be removed. It may take several months following the surgery that the tissue-friendly material integrates into the body. Until then some discomfort/sensitivity is expected, e.g. during sexual intercourse.
Results – chances of recovery
Recovery rate after surgery is high, most patients report a full or partial disappearance of their earlier problems. And quality of life improves in all cases.
In 5% of the cases, there may be disturbance in the healing of the wound or in the integration of the mesh into the body. In some of these cases, further correctional surgergy may be necessary.
During health check of patients, different types of examinations may be needed (e.g. urodynamy).
Following accurate diagnosis, it may be the case that surgery is not needed. In simpler cases, conservative therapies can produce adequate results. E.g. pelvic floor musculature training can improve the patient`s condition.
In other cases, when the patient refuses to undergo an operation or if they cannot be operated (e.g. due their general health condition), there are pessaries available that can be placed into the vagina. This can also contribute to improving quality of life of the patient by reducing symptoms.