[Pelvic floor medicine--innovative versus conservative approach]

Female pelvic floor medicine treats a variety of conditions including urinary and anal incontinence, pelvic floor prolapse, overactive bladder, periurethral lesions and chronic pelvic pain. A third of the women are expected to experience one of these conditions, and one out of 9 women will have a pelvic floor surgery. Pelvic floor dysfunction impairs patients' quality of life and results in social embarrassment and psychological distress. Aging of the population and requirements for a better and an active life in old age resulted in an increased demand for medical treatment. Since pelvic floor organs are anatomically and physiologically connected and because many women have several pelvic floor diseases, treatment should be obtained by several medical disciplines: female-urologist, urogynecologist, colorectal surgeon and rehabilitation pelvic floor physiotherapist. This review presents the problematic aspects of treating women with pelvic floor dysfunction. Comparisons between conservative and innovative approaches will be discussed.

Integrated multidisciplinary pelvic floor service represents the innovative approach. The service includes all the medical disciplines that treat women with pelvic floor problems and could provide a "one stop shop". This kind of service should provide quick, economical and effective treatment. The collaboration between different disciplines should save compound bureaucracy and prevent unnecessary tests and procedures. Complex cases can be managed more easily, clinically and surgically, without referrals. Centralized service encourages usage of clinical protocols and guidelines and potentially reduces the risk of medico-legal claims. The quality of the treatment and the patients' satisfaction should be improved.