Incontinence, vaginal prolapse: modern surgical treatment with little strain

Do you have incontinence or a bladder hernia? Even if only minimally, is your problem impairing your quality of life? You don't have to give up! With the help of Dr. Zsolt Domján, a urologist at the Duna Medical Center, we present the causes and the surgical options that can be used to treat these problems in the long term.
Incontinence, vaginal prolapse: modern surgical treatment with little strain

What are the most common causes of incontinence and vaginal prolapse?

Incontinence and prolapse of the vaginal organs can occur at any age, but the frequency of their appearance may increase with advancing age. Due to the aging of the population in our country and in the world, these problems affect more and more women. The complaints may be caused by the development of congenital connective tissue weakness, but may also be related to childbirth. Depending on whether the connective tissue weakness affects the suspension of the urethra or a higher-level damage zone, incontinence or prolapse of the pelvic organs (bladder, rectum, small intestine, uterus) may develop. It is important to emphasize that urinary incontinence often occurs alone, without a bladder hernia, but not infrequently in combination with vaginal prolapse. The surgical plan must be designed accordingly.

Which specialist should be consulted?

The treatment of vaginal prolapse is the so-called belongs to the field of urogynecology. Gynecologists and urologists also deal with its treatment. Their goal is to achieve the right result with a single intervention, possibly with an additional incontinence surgical solution, which means a low recurrence rate with the best possible quality of life.

What new surgical technique can be used to improve this condition?

Vaginal prolapse was previously treated with various vaginal wall plastics and removal of the uterus, but due to the high rate of recurrence, new surgical techniques were developed. One of them is vaginal mesh implantation, during which a non-absorbable mesh is placed from the vagina. The disadvantage of this is that mesh rejection can often occur, and it can have several side effects that impair the quality of life, such as painful intercourse.

Today, it is possible to implant nets through the abdomen with a minimally invasive procedure (keyhole surgery solution), which prevents the vagina from prolapse by restoring the original anatomical state, so that the organs are supported like a hammock. According to modern principles, it is now necessary to remove the uterus only in case of significant enlargement (myoma), bleeding disorders, or suspicion of a malignant tumor.

Literature data prove the long-term effectiveness of laparoscopic reconstruction and patient satisfaction. There is no net rejection and painful intercourse after the operation, which is an advantage for sexually active patients. Removal of the uterus is usually not necessary, but laparoscopic mesh implantation can be performed together with hysterectomy.

The surgical solution of stress incontinence requires a simpler intervention. After a proper examination, a thin polypropylene tape is inserted under the urethra from a small vaginal incision. Different types of ligaments can be implanted in one session with laparoscopic surgeries for vaginal prolapse.

This technique requires an experienced laparoscopic specialist - Dr. Zsolt Domján has already performed several such procedures at the Duna Medical Center after hundreds of procedures. The surgery can also be performed as part of a one-day surgery, and the patient can go home within 24-48 hours.

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Dr. Zsolt Domján