Center for Urogynecology and Reconstructive Pelvic Surgery
The Urogynaecological Unit of the Gynaecological-Obstetrics Department is an accredited urogynaecological centre of EUGA/EBCOG. The urogynecological team operating at our hospital provides super-conciliar services in diagnosing and treating urinary incontinence of women and in pelvic floor disorders. It performs a full range of urogynecological operations. We constantly introduce new surgical and diagnostic procedures, including ultrasound diagnostics, which is performed at the highest international level. Our workplace has long-term experience with surgical treatment of pelvic organ prolapse, providing a comprehensive spectrum of surgical procedures. Based on our resereach we plan to provide dhanges in the surgical treatment of pelvic organ prolapse, especially in decision-making before surgery based on knowledge of the patient's pelvic floor status and thus providing individualization of surgical treatment to increase efficacy and decreases complication rates related to surgical treatment.
Based on the monitoring of patients after instrumental vaginal delivery, to suggest changes to current obstetrical practice with extraction technique for pregnancy termination (vacuum, forceps). To elaborate surgical technique to solve severe complications following tape and mesh surgery, and the modification of surgical techniques.
Current aims of scientific work:
1. The primary aim is to create a new algorithm for the surgical management of the pelvic organ prolaps. The group of women suffering from pelvic organ prolapse is not homogenous. One of the criteria for patient stratification is the presence or absence of pelvic floor injury. Information about pelvic floor status is potentially important in two ways: firstly, the presence of pelvic floor injury increases the risk of recurrence, and secondly, knowledge about this status facilitates subsequent individualized surgical approach and treatment. Failure to detect such risk factors can lead, for example, to excessive use of transvaginal mesh, which in many cases is superfluous and only increases risk for the patient without any further benefits.
2. A second goal, based on the monitoring of pelvic floor injury following complicated instrumental vaginal delivery, is to propose changes in the technique of extraction for instrumental vaginal deliveries.
3. A further aim is to develop new surgical techniques for management of complications of mesh surgery and for vesicovaginal fistullas surgical repair.
Current projects:
1. A multicentre prospective study to evaluate the effect of pelvic floor status on the results and efficacy of laparoscopy sacrocolpopexy. In the next step we plan to organize a multicenter randomized trial to compare the efficacy of laparoscopy sacrocolpopexy compared to the vaginal approach (traditional vaginal wall repair or transvaginal mesh).
2. Longitudinal monitoring of child-bearing women following complicated instrumental vaginal delivery with or without anal sphincter tears.
3. Surgical management of patients with severe complications following mesh surgery (tension free vaginal tapes or transvaginal mesh for pelvic organ surgery). Longitudinal follow-up of patients after surgical treatment of vesicovaginal fistulas following oncogynecological or gynecological surgery)