Urogynaecology and perineology

60% of the women will encounter problems of incontinence or other pelvic floor issues during their lives. The first symptoms are often already present during the first pregnancy.

The perineum or pelvic floor is a complex whole of different organs under pressure in the abdomen.

The different organs are connected to each other by connective tissue and ligaments, they will rest together on the muscles of the pelvic floor like on a trampoline.

The most frequently encountered problems

Urine loss during effort or stress incontinence = urine loss when coughing, sneezing, running…
= a mechanical problem due to a loss of support


Risk factors for effort incontinence are a difficult delivery, chronic constipation, overweight, chronic cough, tobacco, menopause and frequently lifting heavy objects.

Treatment of effort incontinence:

• Adaptations of daily habits
• Physical therapy with pelvic reeducation gives very good results.
  
  
  
• Surgery: the placement of a tape under the urethra in order to give support.
  
  
  

Urge incontinence

= urine loss not going along with effort but with an urge to urinate.

Risk factors for urge incontinence are excessive use of coffee, tea, gas containing beverages, bad peeing habits, recurrent bladder infections, some sicknesses (diabetes, Parkinson) and some treatments (radiotherapy).

Urge incontinence can be treated by a combination of daily habit changes, physical therapy with pelvic reeducation, medication and/or botox.

Prolapse or descent

A genital prolapse is a descent of one or different organs from the pelvis (vagina, uterus, bladder or rectum) It is due to a loss of support

Prolapse treatment

• Physiotherapy (pelvic reeducation)
• The placement (on consultation) of a vaginal ring, silicon tampon or pessarium
• Surgery: sewing a bladder, gut, vagina and uterus