Treatment options for pelvic floor disorders :

  • Medical treatment

Anticholinergic drugs are mostly used to treat urge incontinence, urge and frequency (« over active bladder : OAB)

Botox injection in the bladder wall by cystoscopy can also be an option.

  • Neuromodulation

Stimulation of the nerves that control the bladder can treat overactive bladder, urinary frequency and urinary retention. A first approach by stimulation of the tibial nerve can be effective.

  • Physiotherapy

Pelvic Floor Muscle Exercices and Pelvic Floor Electrical Stimulation may be useful in the treatment of stress incontinence, urge, mixed incontinence. They can be also useful in prevention of prolapse symptoms. Mostly, they require guidance from a professional physiotherapist

  • Surgical Treatment

Several surgical procedures can be performed depending on the symptoms incontinence, prolapse, the age, the medical conditions. They can be perfomed abdominaly, vaginaly or by both way.

-Abdominal way (open or by laparoscopy)

Hysterectomy: removal of the uterus (with or without the cervix, the ovaries)

Sacrocolpopexy: attachment of the prolapsed vagina to the sacrum using a synthetic mesh.

Burch colposuspension to treat stress incontinence: suspension of the anterior vaginal wall to the pubic ligaments by sutures.

-Vaginal way

Vaginal Hysterectomy: removal of the uterus by vaginal way.

Anterior colporrhaphy: procedure to reinforce the support between the vagina and the bladder by sutures and reduce the cystocele.

Posterior colporraphy: procedure to reinforce the support between the vagina and the rectum by sutures and reduce the rectocele.

Sacrospinous vaginal suspension: suture of the vaginal vault to the sacro-spinous ligament.

Mesh augmentation to reinforce the Anterior Repair of the cystocele: a 4 arms trans-obturator approach with graft can be use to repair the defect between the vagina and the bladder.

Mesh augmentation to reinforce the Posterior Repair of the rectocele and the vaginal vault: a 2 arms trans-ischiorectal approach with graft can be use to repair the defect between vagina and rectum and attache the vaginal vault.

Combined procedure: anterior and posterior graft repair for total prolapse.

Stress Incontinence procedures: Tension-free-vaginal Tapes. Sub-uretral support by a retro-pubic approach or trans-obturator approach (TVT®, TOT).This less invasive procedure can be perfomed on an outpatient way.