Pelvic floor

The pelvic floor is a fascia-covered muscle that fulfills a dual function:

• Closure of the pelvic floor and support of the organs located within the pelvis
• Controlled opening for emptying the bladder and rectum as well as for childbirth

Due to the physiological weakness and the stress during the pressing process during childbirth, the female pelvic floor is generally more prone to insufficiency. This can lead to a complex of symptoms with lowering of the perineum, with prolapse of pelvic organs and with stool and urination disorders.

A prolapse of the rectum is a rare but debilitating condition that requires surgical correction not only to treat the annoying symptoms (stool smear), but also to prevent progressive damage to the anal sphincter.
In advanced rectal prolapse, the rectum protrudes through the anal opening. Manual repositioning may be required over time. Mucus discharge and fecal contamination are common. There remains considerable controversy over the most appropriate surgical technique. In Europe, minimally invasive ventral mesh rectopexy has become widespread, but the type of mesh used (synthetic vs. biological) is currently being discussed.

A pelvic floor weakness is often not just an isolated rectal prolapse, the vagina and urinary bladder also lose their hold and sink. With a careful history, clinical examination and appropriate imaging (magnetic resonance examination), such complex changes can now be precisely diagnosed. In cooperation with other specialists (e.g. gynecologists and urologists), an individual therapy recommendation can then be worked out: e.g.

• Transanal / transvaginal reconstructions
• Minimally invasive
  colpo-recto-sacropexy