Loss of urine or prolapse of the bladder, uterus, and intestines are increasingly reported symptoms as women age. In addition to the natural aging process, another significant risk factor is pregnancy and childbirth. Vaginal delivery of heavier babies (sometimes weighing more than 4 kg) poses a real challenge to the pelvic floor.
Stress urinary incontinence:
Urinary incontinence during coughing, laughing, or sneezing is very bothersome for women. We are observing an increase in these symptoms among younger patients. The first treatment step is to strengthen the pelvic floor muscles with the help of a specialized rehabilitation professional. If this proves to be insufficient or if the patient does not wish to pursue this treatment, surgical intervention can be considered. If urinary incontinence is present and there is also prolapse of the bladder and uterus, the Unilateral Pectineal Suspension (UPS) procedure can be performed robotically, and can significantly improve urinary incontinence. If proving insufficient, or if there is no prolapse, the option of a TOT sling can be considered. This involves the placing a mesh under the urethra to address the urinary incontinence issue. Both UPS and TOT are day surgery procedures.
In case the bladder or uterine prolapse cause bothersome symptoms, pelvic floor repair can also be performed. In the past, the uterus was frequently removed through the vagina and the bladder was suture-fixed, often without a convincing reason to perform this hysterectomy. Many women consider this a difficult decision to make, prompting Dr. Maene and Dr. Bafort to seek out a new technique. They learned the robotic-assisted corrective UPS technique from Professor Cosima Brocker and Professor Demetrios Politis in Nuremberg in October 2022. Through a precise and short procedure, the uterus or vaginal dome is reinserted in the correct direction.
This intervention avoids the use of meshes while providing excellent results and a satisfaction rate of over 80% among patients. Additionally, it avoids a more invasive vaginal hysterectomy, leading to faster recovery, quicker return to work, and fewer postoperative complications for patients
