Questions and answers
What symptoms can be improved by the Petros/Goeschen techniques?
Urine loss due to stress, feeling of urgency, urinary frequency, having to get up at night to pass urine, inability to empty the bladder properly, deep pelvic pain during sexual intercourse or pain of otherwise unknown origin in the lower spinal column or the sacral bone, faecal incontinence and other bowel problems.
What is the basic difference between the Petros/Goeschen method and other traditional methods?
Traditional methods are based on three different theories: muscular weakness, abnormal function of the bladder and wrong position of the bladder neck.
The Petros/Goeschen method is holistic. Whether surgical or non surgical, the method is based on the same universal principle (the integral theory): to identify damaged vaginal tissue and ligaments of the pelvic floor (front, middle, back). The damaged muscles and the inserting points of the ligaments are strengthened with electrotherapy and pelvic floor exercises or reinforced using the Petros/Goeschen "keyhole" surgery.
What is the difference between the Petros method and traditional testing methods for urinary incontinence?
Traditional testing methods can only diagnose that something is wrong, but they cannot diagnose which part of the vagina is damaged. The Petros procedure uses a whole series of parameters including symptoms, pad test, natural bladder volume and special gynaecological examination to arrive at the conclusion as to which part of vagina may be causing the bladder symptoms.
What is the difference between Petros/Goeschen "keyhole" surgery and traditional incontinence surgery?
Traditional bladder neck elevation operations need large skin incisions of about 10 cm, are painful, require catheterisation, and require up to two weeks post-operative recovery in hospital. They claim to cure only stress incontinence. The patient cannot return to normal life for at least six weeks after the operation.
“Keyhole" surgery requires only 2 to 7 days of in-patient stay in hospital after the operation. The operation techniques precisely reconstruct ligament weakness in the front, middle, or back parts of the vagina. They cause very little pain, and require catheterisation only for some hours after the operation. Patients return rapidly to normal daily activities, like shopping, house duties, driving a car, etc., after discharge. The "keyhole" surgery of the Petros/Goeschen method, which interprets the pelvic floor as an integral compartment, gives those patients who were operated upon unsuccessfully with TVT a new hope for success.
Many other symptoms such as urgency, having to pass urine frequently, getting up frequently at night to the toilet, inability to empty the bladder properly, pelvic pain of otherwise unknown origin, faecal incontinence and other bowel problems in the pelvic area can be cured.
What are the results of "keyhole" surgery?
Recent results were published several times in the International Journal of Urogynaecology and in other scientific journals (Der Frauenarzt). The results are as detailed below:
Symptoms Reported = Improvement
stress incontinence = 88 %
frequency = 85 %
nocturia = 80 %
urge incontinence = 80 %
emptying symptoms = 50 %
The mean value is 77,8 %
What is the difference between the Petros/Goeschen "keyhole" surgery and traditional prolapse surgery?
Traditional vaginal surgery requires approximately 10 to 14 days of post-operative stay in hospital, urinary catheterisation after the operation and is painful. Keyhole" surgery requires an urinary catheter only for some hours after operation and does not require a painful vaginal tamponade, means only 2 to 7 days of post-operative recovery in hospital and is nearly painless.
What can be done should the operation fail?
Because the vagina is not excised, there is no point of no return. Since the operation is so minimally invasive it can quite easily be repeated. Most post-operative failures occur within a few weeks after surgery.
Does it mean that my operation has failed if symptoms return?
Not necessarily. Another part of the vagina may be prolapsed. The ligaments of the pelvic floor act like shock absorbers. Replacing them may divert the pressure inside the abdomen to other parts of the vagina (front, middle and back part), and cause it to prolapse. This may cause similar or further symptoms, usually different to those before.
