Pelvic Floor Surgery

Pelvic Floor and Urogynecology

Urogynecology is a field that intersects gynecology and obstetrics with urology, focusing on the diagnosis and treatment of overactive bladder, pelvic organ prolapse, urinary incontinence complaints, and deformities and functional loss in the genital area in women. The pelvic floor is a network of muscles and connective tissue that supports the uterus, bladder, and intestines from below. When this support structure weakens, prolapse and urinary incontinence complaints often occur together.

What Is Urinary Incontinence and Who Does It Affect?

Urinary incontinence is the involuntary, uncontrolled leakage of urine. It is a common problem in women and its frequency significantly increases especially after menopause. Although it is often difficult to express this complaint, it should never be considered normal at any age.

Types of Urinary Incontinence

• Stress type: leakage occurring during sudden increases in intra-abdominal pressure such as coughing, laughing, or sneezing.
• Urge type: leakage following a sudden urge to urinate whether the bladder is full or empty.
• Mixed type: a combination of stress and urge types.

Treatments Applied for Pelvic Floor Disorders

Treatment is not limited to a single method; depending on the type and severity of the complaint, the following options can be used alone or in combination:

• Exercises aimed at developing planned toileting habits,
• Pelvic floor muscle exercises,
• Various medical tools and devices developed for this purpose,
• Medication therapy,
• Injection of synthetic materials,
• Botulinum toxin application to the bladder muscle layer.

Medication can be used for urge-type incontinence; however, its role is limited in stress-type incontinence.

When Is Surgery Considered?

Surgery is the most experienced treatment approach for stress-type urinary incontinence. The most commonly used method is placing a sling (mesh) under the urethra to provide support. If pelvic organ prolapse accompanies the condition, repair of the weakened support tissues can also be planned in the same session; the extent of the surgery is determined based on examination findings.

Continuing pelvic floor exercises before and after surgery, managing weight, and preventing constipation contribute to the durability of the treatment. The appropriate approach for you is determined by evaluating the type, duration, impact on daily life of your complaint, and your overall health status together.

What Is Done During the Examination?

The first step of the evaluation is a detailed history of the complaint: when the leakage occurs, how many times it happens during the day, whether pad use is necessary, and how much it restricts social life are questioned. Then, a gynecological examination assesses the condition of pelvic floor support and whether prolapse is present. This information determines which treatment should be prioritized. There is nothing to be ashamed of regarding leakage and prolapse complaints; early evaluation allows progress with exercises and lifestyle changes at a stage where surgery is not yet required.

The information on this page is prepared for general informational purposes and does not replace a doctor's examination. Please be sure to consult a doctor for your complaints.