Functional disorders of the pelvic organs (bladder, bowel and sexual organs)

Regaining bladder control by stimulating the genital nerves

Electrical stimulation of the pelvic nerves (genital nerve stimulation, GNS) is a treatment option for an irritable bladder, especially if it occurs in combination with urinary incontinence. It may be considered if, for example, behavioural therapy does not lead to success with an overactive bladder. GNS therapy may also be the treatment of choice for urinary incontinence alone. Nerve stimulation can alleviate or completely eliminate the symptoms.

With this procedure, a microstimulator system a few millimetres in diameter, is placed behind the pubic bone on the genital nerves using minimally invasive laparoscopy under local anesthesia. The nerves are specifically stimulated via electrical impulses. The patient controls the duration and level of the electrical stimulation with a remote control. Genital nerve stimulation is a reversible therapy that can be interrupted at any time. The operation is performed on an outpatient basis under local anesthesia and takes less than 30 minutes.

Electrical stimulation of the urethra leads to relaxation of the bladder muscles and contraction of the bladder sphincter. In this way the overactivity of the bladder is reduced and urinary incontinence is controlled at the same time. In addition to GNS therapy, which is based on stimulation of the genital nerve, the PN-Stim-LION method can also be used. This focuses on the pudendal nerve, which is primarily responsible for controlling the bladder, rectum and sphincters.

Controlling the bladder and rectum through genital nerve stimulation - "GNS therapy"

In cases of fecal incontinence or simultaneous bladder and bowel incontinence, stimulation of the pudendal nerve produces excellent results. The pudendal nerve controls the sphincters of the bladder and rectum.

In order to stimulate the pudendal nerve electrically, a laparoscopic procedure is performed under general anesthesia - the so-called LION procedure. This procedure is the first technique that allows the selective placement of electrodes on specific pelvic nerves. During the approximately 45-minute operation, a tiny electrode is attached directly to the pudendal nerve. A thin wire with a diameter of less than one millimeter then emits a harmless and painless electrical impulse. The stimulation of the pudendal nerve produces:

• a contraction of the sphincters of the bladder and intestine (therapy for urinary) and fecal incontinence
• relaxation of both the rectum and the bladder (therapy for an irritable bowel and bladder)
• an improved bladder and bowel control and thus a better emptying of bladder and bowel

Treatment of endometriosis of the rectum, bladder or ureter

Deeply infiltrating endometriosis in the rectovaginal septum - the region between the intestine and the vagina - is particularly difficult to treat. Endometriosis often infiltrates the rectum, ureter, bladder or even the pelvic nerves that control the rectum, bladder and sexual functions. Extensive endometriosis of the rectum can lead to bowel obstruction, bleeding from the bladder, blockage of the ureters and thus irreversible kidney damage or destruction of the bladder wall.

In this serious form of the disease, surgical removal of the endometriosis is necessary, possibly with simultaneous removal of parts of the affected organs. Such an operation can be performed by laparoscopy or open surgery. The advantage of laparoscopy is that all pelvic nerves become visible, making their preservation possible. Complex neurosurgical procedures can also be performed using laparoscopy. The "Laparoscopic Neuro-Navigation" (LANN) is the result of this development. Prof. Possover has proven that the LANN technique can prevent postoperative nerve dysfunction, such as bladder, intestinal and sexual dysfunction, through its particularly nerve-sparing approach, even during very complex operations.

Sexual dysfunction correction with genital nerve stimulation - "GNS therapy"

Sexual function in men and women requires the involvement of the pelvic nerves. If sexual satisfaction does not occur, despite intimate activity, the cause may be a dysfunction of these pelvic nerves.

Sexual satisfaction without erectile dysfunction - with the help of genital nerve stimulation

The nerve tracts involved play an important role in penis erection, ranging from the penis to the spinal cord to the brain. If these nerves are not intact, erectile dysfunction can result. If the cause of the erection problems can be found in the genital nerves, GNS therapy (genital nerve stimulation, GNS) developed by Prof. Possover, can lead to a significant improvement - and a return to a state of sexual satisfaction.

In the treatment procedure, a microstimulator system a few millimetres in size is positioned behind the pubic bone on the genital nerve. The procedure is performed under local anesthesia through a small incision, concealed by the pubic hair. The stimulation of the genital nerve, which leads to sexual arousal as well as to a penile erection, which is maintained during sexual intercourse, is carried out with the help of a remote control. No further use of Viagra is necessary. Genital nerve stimulation considerably improves sexual satisfaction. The procedure is reversible and can be discontinued at any time by switching off or removing the device.

Sexual disorders in women: sexual satisfaction through GNS (endometriosis )

With thousands of nerve endings, the clitoris is the most sensitive part of the female genital region and thus the source of intense sexual pleasure. Stimulation of the clitoris will often - but not always - lead to orgasm. Genital nerve stimulation (GNS) can also bring about a clear improvement in disorders of female sexual satisfaction and contribute to a balanced and satisfying sexual life. The procedure is the same as for men. In women, electrical stimulation causes the erection of the clitoris without the aid of a vibrator.