When defects occur in the pelvic floor, for example after delivery or under unfavourable connective tissue conditions, organs may drop severely and possibly even cause the uterus to bulge into the vagina. Pronounced lowering of these organs is often associated with urine incontinence during activities such as coughing, sneezing, laughing or climbing stairs. This is referred to as stress incontinence. It is imperative to perform an accurate diagnosis to clarify the matter. Apart from a review of the patient’s medical history, a thorough clinical examination, an ultrasonic examination via the vagina and, where appropriate, a so-called urodynamic examination (measuring the pressure levels inside the urethra and bladder under and without stress) are required.


So-called Stress Incontinence is remedied by inserting a supporting sling (e.g. TVT, TOT or Monarc) or by performing surgery according to Burch et alii, depending on the circumstances. Methods used less frequently today include vaginal implants and sacrospinal fixation. Very pronounced, and especially recurrent bulging is treated by implanting a net to stabilise the pelvic floor (anterior, posterior or full net, depending on the indication and findings).

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