By: 4 July 2018
Pelvic floor problems and incontinence: autoprosthesis significantly improves quality-of-life

Due to their anatomical difference and also the particular stresses associated with pregnancy and childbirth, incontinence and pelvic floor problems are particularly prevalent in women. Apart from incontinence, women can also develop pelvic floor muscle weakness, overstretching of the pelvic connective tissue and displacement of the pelvic organs. Their quality-of-life can be significantly improved by surgical transplantation of endogenous tissue to strengthen the affected area of the pelvic floor.  

“This is therefore a form of autoprosthesis,” summarises Heinz Kölbl, Head of the Division of General Gynecology and Gynecologic Oncology at the Department of Obstetrics and Gynecology, MedUni Vienna/Vienna General Hospital.

In this surgical procedure – which is performed when conservative techniques or medications have failed to achieve the desired result – endogenous tissue is taken from an area adjacent to the affected area, tautened and allowed to scar over, thereby producing the desired strength. Says Kölbl: “On average that improves quality-of-life for affected patients by at least 30 per cent.” Research is also being conducted into the use of external stem cell tissue. Says Kölbl: “It is our vision that, in future, we will be able to insert external tissue that is even stronger and more functional, using minimally invasive techniques.” Currently many patients still suffer a relapse, requiring a second or even third operation to strengthen their pelvic floor.

Viennese pelvic floor unit is a world leader
The pelvic floor unit within MedUni Vienna/Vienna General Hospital’s Department of Obstetrics and Gynecology is a world leader with the focus on women’s health. Researchers in Vienna are currently conducting studies using GenePatterns to develop risk profiles for subsequent major pelvic floor damage. “So that we can potentially establish in advance that women from the high-risk group should not be allowed to give birth naturally, for example, in order to prevent subsequent incontinence or other pelvic floor damage,” explains Kölbl, who is also a member of MedUni Vienna/Vienna General Hospital’s Comprehensive Cancer Center. A similar risk profile already exists for women who are less than 160 cm tall: they should no longer be allowed to give birth naturally, if the embryo weighs more than 4,000 g. Says Kölbl: “That would give them a 100 per cent risk of developing pelvic floor problems.”

One in three women has bladder problems over the course of her life and one in 25 women experiences pelvic floor problems after childbirth. And around 3 per cent of all women are affected by symptomatic forms of pelvic floor prolapse.

Source: Medical University of Vienna