Pelvic floor disorders have multifactorial reasons and can have a huge impact on a woman’s life. They can result in descensus of bladder, uterus, vagina or rectum and are often accompanied by incontinence. Symptoms like downward pressure, pain, incontinence or bladder voiding dysfunction develop slowly and are still highly taboo. Gynecology differentiates between descensus of the anterior, central and posterior compartment. A descensus in the anterior compartment causes a cystocele, with can either present as a pulsation cystocele or a traction cystocele. A descensus of the apical compartment leads to a uterine prolapse or vaginal stump descensus, while a descensus of the posterior compartment results in a recto- or enterocele. Urinary incontinence can be divided into stress and urge incontinence. The most important tool for the diagnosis of pelvic floor disorders is the clinical examination. Regarding the therapy of pelvic floor disorders, conservative therapy measures should first be offered. If these fail, an individually optimized surgical therapy should follow. The spectrum of surgical possibilities has expanded considerably in the last three decades. In particular, implanting alloplastic meshes has improved long-term stability. Finally, preventive measures also play a central role.
Part of the book: Pelvic Floor Dysfunction