Urology, Urogynaecology and Pelvic Floor Dysfunction Department

Pelvic organ prolapse and urinary incontinence are affecting millions of women around the world. A significant percentage of female population will undergo a surgical treatment for these disorders.

The Department

Responding to current womans’ needs and demands, MITERA Hospital has established a new Department, in order to develop assessment and adequate management of Pelvic Floor Dysfunction disorders.

Specialized medical professionals, high end technology equipment and Urodynamics Investigation system warrant an accurate diagnosis and effective approach of every patient.

Female Urinary Incontinence Definition

The presence of an episode of involuntary loss of urine, a loss of urine that occurs without the patients control.

Types of incontinence

The most common types are:
– Stress urinary incontinence: the loss of urine noted on cough, laugh, sneeze, lifting weight, physical exertion or any other situation of increased abdominal pressure. It is the most frequent type.
– Urge urinary incontinence. the loss of urine that occurs after a sudden urge for urination (e.g. before a woman reaches the toilet)
– Mixed urinary incontinence: the complaint of both stress and urge incontinence symptoms

Risk factors:
Most important risks factors for the development of urinary incontinence are:
– Pregnancy
– Parity
– Prolonged vaginal delivery
– Menopause
– Chronic disorders that contribute to increased abdominal pressure e.g. constipation, asthma, obesity, profession
– Previous pelvic floor surgery
– Genetic factors

How can it be diagnosed?
A detailed patient and symptom related history, a clinical gynaecological examination and urodynamic examination are basic prerequisites pelvic floor disorders diagnosis. More specifically urodynamic investigation can offer advanced information on the type and severity of incontinence, as an important diagnostic tool for an individualized and effective treatment.

What are the treatment options?
Treatment options can vary depending on the type and severity of incontinence symptoms. It could be conservative including pelvic floor muscle training, bladder retraining, pharmacotherapy, biofeedback, or invasive with modern, minimal surgical options.

Pelvic Organ Prolapse (POP)

What is it?

It is a condition in which one of the pelvic organs, such as the bladder, the uterus or the rectum, protrude through the vagina. Depending on the protruding organ(s), a cystocele, a uterine or a vaginal vault prolapse, a rectocele or a combination of at least two or more of the above may occur.

What causes Pelvic Organ Prolapse?

Predisposing causes factors for pelvis organ Prolapse are:
• Previous labours
• Difficult obstetric operations, such as forceps delivery
• Menopause
• Conditions which increase  intra-abdominal pressure, such as obesity or chronic constipation or chronic respiratory syndromes
• Previous surgical procedures
• Genetic factors

Which are the symptoms?
Most women complain about:
• A feeling of ‘’pressure’’ in the vagina
• Chronic pelvic pain
• A feeling of a bulge, a ‘’foreign body’’ in the vagina
• Sexual dysfunction
• Lower urinary tract disorders , such as difficulty in evacuating the bladder
• Bowel disorders, such as constipation

How can it be diagnosed?
Upon obtaining the patients history, the doctor records the symptoms and the factors that predispose to the condition. The gynecological examination will define the type and the stage of Pelvic Organ Prolapse. Urodynamic studies are useful to indentify and assess concomitant urinary symptoms, such as urodynamic stress urinary incontinence, or occult incontinence, urge incontinence or mixed incontinence and provide useful information on designing the therapeutic plans.

What is the treatment?
Treatment is mainly surgical. Modern, less invasive operational procedures are very often implemented and hospitalization lasts in most cases one or two days. Individualized for each patient, the appropriate reconstructive surgical procedure for restoring the anatomy and function of the area is selected.