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05.02.2019 09:48:41
It must be admitted that merely the words “uterine prolapse” send a shiver. Patients describe the sensation of a foreign body, as if something is pulling in the direction of the vagina. Symptoms also include long-lasting pain in the lower abdomen and back, a feeling of pressure on the bladder or rectum. Atony of the bladder and incontinence are frequent, inconvenient concomitant phenomena. In the most severe cases, the uterus partially or even completely comes out of the vagina. In such cases only its removal will help.
In a healthy woman the uterus is held by elastic ligaments. At the same time, it is supported by the pelvic floor that consists of connective tissues and muscles. The uterus may descend if the ligaments and muscles of the pelvic floor become weaker. In this case, it is separated from the wall of the pelvis and slips down.
Uterine prolapse is not an unusual phenomenon. Approximately 30-50% of all women suffer from this condition.
At elderly age, the tissues become weak, the muscle volume is reduced. Pregnancy and childbirth also wear or stretch ligaments and muscles. Excess weight, carrying and lifting weight have a negative effect on the muscles of the lower abdomen. Atony of the bladder quickly makes itself felt, above all, during laughter or unexpected sneezing.
Do not be afraid of surgical treatment for uterine prolapse. Modern surgical techniques, such as the insertion of vaginal mesh in the hypogastric area, usually lead to excellent results. So, for example, the polypropylene (a type of plastic) mesh fixes the uterus and vagina and ensures that the uterus, vagina, bladder and intestines again take the right positions.
It is placed between the vagina and the bladder, where it quickly grows together with the body tissues. The intervention does not require general anaesthesia, and in most cases patients can leave the clinic after a week without pain.
Privat-docent Dr. Hornemann for the first time successfully used the patient’s knee tendon instead of a mesh composed of synthetic materials to stabilize the uterus. The patient who had come from the Netherlands especially for this purpose was able to leave the clinic four days after surgery. This is sensational! Dr. Hornemann has managed to do what no doctor has succeeded in yet.
For this, privat-docent Dr. Hornemann closely collaborated with Dr. Franz of the ETHIANUM Hospital in Heidelberg. Dr. Franz specializes in knee surgery. He has developed the remarkable Internal Brace surgical technique, when the tendon is removed and inserted into the injured thigh or lower leg. Due to the close cooperation of two specialists in different fields, it became possible to use this technique successfully in gynaecology.
Such an original tendon transplantation in case of uterine prolapse can help to avoid possible complications during surgery, since a patient’s own tissues are not rejected by the body. In some cases this can occur with a plastic mesh. By the way, it didn’t damage the knee from which the popliteal tendon was taken. For decades it has been considered normal that when a cruciate ligament is operated on, a tendon is taken from the knee and used for enhancement in the required area.
