At Mediclinic City Hospital we are proud to have one of the most advanced female pelvic floor diseases units in Dubai
11 February 2019
| Last updated on 12 February 2019We offer 360 degree services, from accurate diagnosis to medical and minimally invasive surgical therapy for:
- Rectal prolapse
- Chronic constipation and obstructed defecation syndrome
- Pelvic dyssynergia
- Haemorrhoids or piles
- Bladder and uterovaginal prolapse
- Urinary and fecal incontinence
- Pelvic and anal pain
- Anal fistula
- Anal fissure
- Anal stenosis
Multidisciplinary team
We are a multidisciplinary team composed of a female general surgeon specialised in Pelvic Floor Diseases, Gynaecologists, Urologist, Gastroenterologists, Clinical Nutritionist and pPhysiotherapist.
We provide anoscopy, rectoscopy, colonoscopy, anorectal manometry and rectal sensation, tone and compliance test directly in the proctology office. We also offer endorectal 3D ultrasound, very useful for studying anal fistula and muscular damage after episiotomy.
In selected cases, we perform MR defecogram or proctogram, a special magnetic resonance exam performed in order to correctly evaluate pelvic floor prolapses. Full Uro-gynaecological evaluation is also available with ultrasound, pap-smear, urodynamics tests and much more.
Therapy
We strongly believe that medical therapy has an important role in pelvic floor diseases, suggesting that patients adopt a healthy lifestyle and giving them diet advice in association with our clinical nutritionist and gastroenterologists.
Other therapy includes
- Biofeedback and pelvic floor rehabilitation during and after pregnancy
- Biofeedback for pelvic dyssynergia, urinary and fecal incontinence from our expert female physiotherapist
Surgery
We offer the latest up-to-date minimally invasive techniques for all female pelvic floor diseases.
Most of our surgical minimally invasive techniques are performed in a day surgery or one night stay setting, guaranteeing a short, smooth and painless postoperative course and quick return to daily activities.
What is Obstructed Defecation Syndrome (ODS)?
In obstructed defecation, faeces reach the rectum, but rectal emptying is extremely difficult. Despite repetitive attempts, complete evacuation of rectal contents is either not possible or very problematic. ODS is normally caused by either a defect of pelvic support or abnormal function of the pelvic floor musculature.
Chronic constipation is a common problem that affects up to 30% of people, and 30-50% of these patients suffer from Obstructed Defecation Syndrome (ODS).
Women are most affected by obstructed defecation syndrome, especially after multiple pregnancies and/or traumas during childbirth. In fact, childbearing and childbirth might stretch muscles, soft tissues and innervation of the pelvis. Cumulative tissue and nerve damage cause chronic and repetitive fecal stasis, leading to decreased rectal sensory perception.
Symptoms of ODS are:
- Prolonged and unsuccessful straining
- Feelings of incomplete evacuation
- Needing of a digital help to complete evacuation
- Chronic laxative use and/or abuse
Predisposing factors are:
- Multiple pregnancies and/or traumas during delivery
- Hysterectomy
- Chronic constipation
- Obesity
- Chronic cough
- Familiar predisposition (laxity of tissues)
Careful history and clinical examinations with anoscopy are mandatory to formulate a correct diagnosis. In addition, anorectal manometry, balloon expulsion test (BET), defecography or MR defecography are the most frequently used tests.
Biofeedback and pelvic floor rehabilitation are the backbone of therapy of obstructed defecation syndrome and are able to solve patients problems with a 90% success rate.
Surgery for ODS is rarely necessary, but in case is needed, we offer the latest up-to-date minimally invasive techniques for all female pelvic floor diseases.
STARR (Stapled Transanal Rectal Resection) is a new surgical procedure that was introduced for such morphological anomaly.
Longo proposed the use of two circular staplers: the first to reduce the intussusception and the bulging rectocele anteriorly, correcting the anterior wall muscle defect, the second to correct the intussusception posteriorly.
In our hospital we are proud to offer even a newer technique, first in the UAE, allowing us to use only one stapler with a bigger case.
Don’t wait until your problems get more complicated, book your visit today.
Dr. Valentina Giaccaglia, Consultant General Surgeon, together with a female team, is here to help you with the utmost respect, care and dedication.
Dr. Valentina Giaccaglia
Consultant General Surgeon
Mediclinic City Hospital