Assoc. Prof. Adnan Orhan

The pelvic floor is the muscular and connective tissue structure that supports the bladder, uterus and bowel. Birth, age, menopause, excess weight, chronic constipation and cough can weaken this support.

As a result, two symptoms stand out: urinary incontinence due to coughing, sneezing or straining, and downward prolapse of the organs. The two can also exist together. Since complaints can limit daily life and social activities, it is important to question them.

Examination, urinalysis and, when necessary, urodynamics are used in the evaluation. Treatment is not always surgical. Support methods such as pelvic floor exercises, weight control, constipation relief and pessary are among the first options. Surgery is planned according to the type of complaint.

Urodynamics is an examination that measures the behavior of the bladder during filling and emptying. The bladder is filled in a controlled manner while intra-bladder pressure is recorded with thin catheters.

The aim is to distinguish the type of urinary incontinence. The treatments for incontinence caused by strain and incontinence caused by a sudden feeling of tightness are different. Without this distinction, the treatment chosen may not provide the expected contribution.

Examination is not required in every patient. It is usually requested if the complaints are mixed, if there is no response to previous treatment, or if surgery is planned. Before the procedure, the urine culture is expected to be clean. There may be a short-term burning sensation afterwards.

Myomas are benign masses arising from the uterine muscle. Endometriosis is the placement of tissue similar to the inner lining of the uterus outside the uterus. Both can cause pain, menstrual irregularities, and difficulty conceiving.

Not every myoma requires surgery. The decision is made by evaluating the size of the mass, its location, the severity of the complaints and pregnancy plans together. Treatment of endometriosis may also start with medication.

When surgery is required, closed methods are used in appropriately selected patients. It is entered through small incisions in the abdominal wall and studied under an enlarged view. In cases where adhesions are widespread or the mass is large, the open method can be used. This possibility is discussed beforehand.