Restoration of damaged structures

Urge incontinence occurs because of descensus of the pelvic organs – usually by a general connective tissue. This means that the holding bands in the pelvis, involving uterus, vagina, bladder and intestine, lose their elasticity and also their holding function. The bands are severely impacted, especially during pregnancy and often lead to typical pain. Depending on the degree of exposure, the bands may remain stretched after birth or even tear. Also increasing age ( menopause)  leads to a weakening of the connective tissue and pelvic floor muscles and the holding bands lose their holding function. A descensus of the pelvic organs is the consequence and this leads to urge incontinence.

For a better understanding the anatomical structures are represented as a bridge.
beckenanatomie_bruecke04

The following illustrations show strongly simplified examples for typical situations:

The front holding bands are intact but the rear holding bands are stretched. This leads to starting problems to hold the urine.

The front holding bands are intact but the rear holding bands are stretched. This leads to starting problems to hold the urine.

The rear holding bands are teared off completely. Affected women suffer from a compulsion to urinate frequently and the urine can not be held properly any longer..

The rear holding bands are teared off completely. Affected women suffer from a compulsion to urinate frequently and the urine can not be held properly any longer.

Abbreviations: S = Ischium U = Uterus B = Bladder  R = Rectum V = Vagina  PB = Pubic Bone USL =rear holding bands PUL = front holding bands 

The aim of the CESA / VASA surgical method is to bring back the organs in their previous, i.e. the correct position, to restore the function again.

correct anatomy

correct anatomy

Since it is not possible to tighten the own holding bands, these have to be renewed. For this purpose, plastic (PVDF) holding bands, so-called textile implants are used, similar to the form used since many years for surgical hernia repair and others. They are sutured exactly at the point where the bands originally were placed and thus provide a full replacement.

restored anatomy

restored anatomy