Pelvic Floor Disorders

Changes to and weaknesses in the muscles and tissue of the female pelvic floor can lead to a variety of complaints. One of the most common problems is a loss of control when passing water. Diseases of the pelvic floor are not only afflictions in later life, but can also affect younger women, for instance after giving birth. Trying to get through a day that is governed by her bladder can seriously restrict a woman's quality of life.

At the University Clinic of Cologne, experts in gynaecology, urology, neurology, surgery and physiotherapy work hand in hand. From diagnosis to treatment to after-care, in line with our holistic approach, we support our patients on their way to a comfortable, problem-free future.


Targeted diagnosis and treatment

The latest diagnostic methods are used to establish the individual causes of the problem in order to ensure that the correct, specific treatment can be given. As well as giving the patient an extensive physical examination, we may also use imaging processes as well as other forms of urodynamic functional diagnosis and measure the blood flow through the pelvic floor. Electrodiagnostic examinations may also be carried out in order to establish whether there are any neuronal defects.

Once a diagnosis has been made, we will identify the appropriate form of treatment. Before we opt for a surgical procedure, we first consider a broad spectrum of conservative – that is, non-surgical – treatment options. They include pelvic floor exercises and physiotherapy, relaxation therapy, biofeedback and electro-stimulation or acupuncture, and the use of therapeutic aids (inserts, pessaries).

If none of these options solves the problem, then there are a number of surgical alternatives that can be considered. At the University Clinic of Cologne, we use the latest surgical procedures to strengthen the pelvic tissue or support bladder function. 

Groundbreaking surgical procedure to treat urge incontinence

Doctors and scientists at the University Clinic of Cologne are constantly working towards medical progress. Prof. Dr. Wolfram Jäger achieved a breakthrough with the development of a special surgical procedure to treat urge incontinence.

Straining hard (e.g. when giving birth) can cause the supporting bands of the internal organs in the pelvis to weaken, or over-stretch or even tear them. In the CESA/VASA method in combination with a front band by Prof. Dr. Jäger, the supporting bands are replaced by plastic bands that are a perfect substitute for the body's own bands. This returns the internal organs to their correct positions, restoring the patient to full continence.
This method offers the best prospects of success. The CESA/VASA method has cured over 75% of all women of their urge incontinence – and helped them to take an important step back to an uncomplicated life. The surgical procedure is constantly being developed further at the University Clinic of Cologne.

Overview

Conservative treatment options

  • Behaviour therapy, dietary consultation, losing weight, recommendations on drinking habits
  • Medical therapy (e.g. to suppress the urge to urinate)
  • Pelvic floor exercises and physiotherapy, relaxation therapy, biofeedback
  • Electric stimulation therapy, intravesical electro-stimulation
  • Acupuncture
  • Therapeutic aids (inserts, pessaries) or irrigation treatment

Surgical treatment options

  • Botulinum toxin injections, subcutaneous injections for bladder weakness and urge diseases
  • Implantation of a bladder pacemaker
  • Vaginal and abdominal surgical procedures with or without the use of synthetic materials (loops, nets) to treat incontinence and pelvic floor weakness in women
  • Surgical procedures to lift the internal genitals using the latest procedures (replacement of supporting bands)
  • Bio or synthetic materials to strengthen the tissue, use of stem cells cultured from the patient's own body cells
  • Plastic surgery to treat malformation of the internal sexual organs
  • Fistula surgery
  • Coloproctological surgery by a specialist visceral surgeon