Pelvic floor dysfunction

The pelvic floor pathology is very varied and includes, mainly, urinary incontinence and the different prolapses: bladder (cystocele), rectum (rectocele), vagina (colpocele), intestine (enterocele) and uterine prolapsed. Its appearence is related to different factors such as age, multiparity, obesity, menopause, previous gynecological surgery, etc.

Symptomatology is varied, not only holds its most frequent symptom, which is urinary incontinence. It also includes urinary infections, heavy feeling in the pelvic area, inconveniences with ambulation, urinary frequency or urgency. The diagnostic study must be detailed and many times, it involves different specialists. After a detailed anamnesis, a genital examination is necessary evaluating also imaging studies.

AVAILABLE TREATMENTS:

• Unstable bladder or urgent urination followed or not by incontinence: Susceptible to pharmacological treatment with anticholinergics or also submucosal treatment with botox.

• Stress incontinence:

· In milder cases, pelvic rehabilitation is applied in order to strengthen musculature.

· TOT meshes are placed if urine incontinence is more severe. It can be placed with regional anaesthesia and with non-admittance surgery. The results are very satisfactory and incontinence disappears in more than 90% of the cases.

• Pelvic floor prolapse associated or not to urinary incontinence: The most complex resolution. Meshes are normally used for the anterior or posterior vaginal compartment. In the most severe cases, colposacropexy is indicated, carried out via laparoscopy or robotics.