The pelvic floor is formed by a group of muscles at the bottom of your pelvis. Unfortunately, our daily life does not exercise these muscles sufficiently. Hence, they lose strength and start sagging with age, pregnancies or chronic constipation. The pelvic floor keeps our internal organs like bladder, sexual organs and rectum in their correct position inside the pelvis. In case of descending pelvic floor, these organs can “slide” downwards and lead to incontinence or problems with defecation. This may lead to uncontrollable flatulence, urinary incontinence, stool smearing, incomplete or difficult stool elimination. Stool incontinence may also be a result of sphincter injury. This can occur during difficult vaginal delivery (forceps or vacuum extraction), after anal operations (fistula) or impalement traumas.

We treat women and men equally. In men, stress incontinence often occurs after prostatectomy (removal of the prostate) or with prostate hyperplasia (enlargement).

 “Incontinence won’t kill you but it takes your life.” (freely adapted from H.J. Melchior, resource: Springer)

In our practice we can individually evaluate your problem in a consultation and examine the muscles with manometry, anal ultrasound and anal EMG (electromyography). We will then plan a personalized treatment concept for you. We work hand in hand with physiotherapists who are specialized in the treatment of pelvic floor and sphincter muscles. We instruct you in techniques of biofeedback and electrical stimulation (ES) and teach you different techniques for hygiene and stool regulation. Our goal is always to achieve strengthened pelvic floor and sphincter muscles and giving you a better quality of life back. Auxiliary methods we can show you are irrigating the colon before leaving the house or fitting anal tamponade.

 We offer further diagnostics in cooperation with other specialist centres in Hamburg, such as defecography, MRI of the pelvic floor, or urodynamic testing in preparation for a possible operation. Besides conservative treatment options there are numerous surgical methods, such as sphincter reconstruction, sacral nerve stimulation, or attachment of the rectum to the sacral bone (sacropexy). Oftentimes, an additional resection of elongated rectum will be combined with this (resection rectopexy).

Spasms of the pelvic floor can also lead to painful sensations, for example with constipation or during sexual intercourse. These spasms can be chronic or acute and might only be intermittent (Proctalgia fugax).

In all of these cases you can learn to tense and relax your pelvic floor with the help of pelvic floor exercises, biofeedback or electrical stimulation.