Bladder hernia (cystocele)

A cystocele is a medical condition that occurs when the tough fibrous wall between a woman's bladder and her vagina allows the bladder to protrude into the vagina. There are different grades of cystocele. In grade I, changes in the outside are not discernible, while higher grades of cystocele protrude through the entrance of the vagina. Women can feel it as a “smooth lump” at the entrance to the vagina, and they generally suffer from a feeling of uncomfortable pressure, especially in the evening. Some women have problems because this condition may cause rubbing against their underwear, which can lead to pain and inflammation, and they often suffer from impeded urination.

At Juna clinic we have gained considerable experience in laser treatment of high-grade cystoceles. Similar to the syndrome of vagina laxity, we utilize the thermal effect of the Er:Yag laser. This results in a contraction of collagen fibres in connective tissue and accelerates a long-term collagenesis (the formation of new collagen) and neovascularization (improving of blood flow to the tissue). The result is a narrowed and firmer vaginal collective tissue providing an enhanced support of the bladder. The laser treatment reduces the bladder prolapse at least for one grade, possibly even more. Laser treatment is performed in an outpatient clinic, it is non-invasive, and does not entail any tissue removal. It has virtually no side effects. The treatment does not require any anaesthesia. Due to this treatment, the pelvic floor support is significantly increased, and so is the quality of life of women suffering from this condition. A number of laser treatments sessions are required, their number is determined individually.
In terms of side effects, about 10% of patients may suffer from a temporarily impairment or a newly formed urge incontinence in response to the altered position of bladder after a successful treatment.

Hernia of the rectum (rectocele) and intestine prolapse (enterocele)

Similar to a bladder prolapse, a posterior rectum prolapse is a condition of the bulging intestine protruding into the vagina due to the laxity of the rear wall of the vagina. Here, too, we distinguish several grades of prolapses, i.e. the sagging of the vagina rear wall. In grades II-I, rectocele protrudes from the entrance to the vagina outside. Women suffering a posterior prolapse have problems in discharging the bowel content. Because of the weakened vaginal tonus they find it difficult to squeeze the bowel content from the rectum. As a result of this condition, rectal content stagnates in this area and women feel as if they did not completely empty the bowels.
In treating posterior and intestine prolapse, the photo thermal effect of laser has proved a successful method for reducing the grade of posterior prolapse (rectocele) for at least one grade, and thus significantly improving the quality of life of women suffering from this condition. Repeated laser treatment sessions are required too.

Uterine prolapse

Uterine prolapse occurs when ligaments stretch and weaken. We distinguish several grades, from minor sagging, i.e. the so-called descensus, to the full slip, i.e. uterine prolapse, where the uterus can protrude from the entrance of the vagina. In these cases, the laser treatment is only partially successful. By shrinking of the vagina we may slightly help to retain the uterus at a higher position. However, we cannot provide any impact on the tissue which supports the uterus in the abdominal cavity. Nevertheless, in many cases this is satisfactory to improve the quality of life and temporarily avoid or least postpone major surgical procedures.