Pelvic floor dysfunction: pelvic organ prolapse and urinary leakage

Dr. Revital Arbel
Director of the uro-gynecology unit

Pelvic floor dysfunction is very common in women and their prevalence increases with age. These disorders include, among other things, prolapse of the pelvic organs and leakage of urine and feces. The pelvic organs include the lower urinary system: bladder and urethra; The reproductive system: the uterus and the vagina; and the lower digestive system: the urethra and the anus. These organs sit above the pelvic floor and pass through it. The pelvic floor consists of muscles, ligaments and connective tissue and participates in the functional mechanism of the sphincters. The pelvic organs are in close proximity to each other and a dysfunction in one of the sections can affect the neighboring sections.
Risk factors for damage to pelvic floor function are age, pregnancy, childbirth, genetics, obesity, conditions of increased intra-abdominal pressure such as chronic cough and constipation, and more. With age and the decrease in the levels of the female hormone (estrogen), the tissues weaken and the frequency of the phenomenon increases.

The unit for uro-gynecology and pelvic floor rehabilitation in Shaare Zedek offers diagnosis and treatment of complex disorders in the function of the pelvic floor. The unit specializes in minimally invasive surgeries performed through tiny incisions in a way that allows for quick recovery, short hospitalization and return to normal life within a limited period of time. The therapeutic approach is determined according to the nature and severity of the disorder, the age of the patient and her general health condition. The goal of the treatment is to restore the pelvic floor to a normal state, to treat leakage of urine and feces, and to improve the patient’s quality of life. When necessary, there is collaboration with experts from other fields, including physiotherapists, urology specialists, gastroenterology, colorectal surgery and more.

List of Publications (med)

List of Publicaions (pdf)

Eisenberg VH, Eidelman LA, Arbel RC, Ezra Y: Legionnaire’s disease during
pregnancy: a case presentation and review of the literature. Eur J Obstet
Gynecol Reprod Biol. 1997 Mar;72(1):15-8.

 

Lewin A, Reubinoff B, Porat-Katz A, Weiss D, Eisenberg V, Arbel RC, Bar-el
H, Safran A: Testicular fine needle aspiration: the alternative method for
sperm retrieval in non-obstructive azoospermia. Hum Reprod. 1999
Jul;14(7):1785-90.

 

Menashe M, Arbel RPI, Raveh D, Achiron R, Yagel S: Poor prenatal detection
rate of cardiac anomalies in Noonan syndrome. Ultrasound Obstet Gynecol. 2002
Jan;19(1):51-5.

 

Gal-Moscovici A, Scherzer P, Rubinger D, Weiss RS, Dranizki-Elhalel M, Popovtzer
MM: Stimulation of osteoclastic bone resorption in a model of glycerol-induced
acute renal failure: evidence for a parathyroid hormone-independent mechanism.
Bone 2002;31:488-91.

 

Yagel S, Arbel RC, Anteby EY, Raveh D, Achiron R: The three vessels and
trachea view (3VT) in fetal cardiac scanning. Ultrasound Obstet Gynecol.
2002 Oct;20(4):340-5.

 

Ben shushan A, Tsafrir A, Arbel RC, Rahav G, Ariel I, Rojansky N: Listeria
infection during pregnancy: a 10 year experience. Isr Med Assoc J. 2002
Oct;4(10):776-80.

 

Arbel RPI, Rojansky N, Klein BY, Levitzki R, Hartzstark Z, Laufer N, Ben-
Bassat H: Inhibitors that target protein kinases for the treatment of ovarian
carcinoma. Am J Obstet Gynecol. 2003 May;188(5):1283-90.

 

Brzezinski A, Stern T, Arbel RC, Rahav G, Benita S: Efficacy of a novel pH-
buffering tampon in preserving the acidic vaginal pH during menstruation. Int
J Gynaecol Obstet. 2004 Jun;85(3):298-300.

 

 

Neuman M, Luria M, Lev-Sagi A, Arbell RC, Shimonowitz S, Lavy Y: [TVT-
Obturator: preliminary results of the first 100 operations with a novel
procedure for the treatment of female urinary stress incontinence]. Harefuah.
2005 May;144(5):314-6, 384. Hebrew.

 

Liebergall-Wischnitzer M, Hochner-Celnikier D, Lavy Y, Manor O, Arbel
RC, Paltiel O: Paula method of circular muscle exercises for urinary stress
incontinence–a clinical trial. Int Urogynecol J Pelvic Floor Dysfunct. 2005
Sep-Oct;16(5):345-51.

 

 

Arbel RPI, Lavy Y: Vaginal vault prolapse: choice of operation. Best Pract
Res Clin Obstet Gynaecol; 2005 Dec;19(6):959-77.

 

 

Haimov-Kochman R, Barak-Glantz E, Arbel RC, Leefsma M, Brzezinski A,
Milwidsky A, Hochner-Celnikier D: Gradual discontinuation of hormone
therapy does not prevent the reappearance of climacteric symptoms: a
randomized prospective study. Menopause. 2006 May-Jun;13(3):323-4.

 

 

Haimov-Kochman R, Arbel RC, Sciaky-Tamir Y, Hurwitz A, Brzezinski A,
Laufer N, Yagel S: Can ultrasound parameters predict the outcome of medical
abortion? Ultrasound in Obstetrics and Gynecology; 28(4):493-493.

 

Haimov-Kochman R, Barak-Glantz E, Ein-Mor E, Arbel RC, Brzezinski A,
Milwidsky A, Hochner-Celnikier D: Duration not severity of the climacteric
syndrome predicts resumption of hormone therapy after discontinuation: a
prospective cohort study. Hum Reprod; 2006 Sep;21(9):2450-4.

 

Lavy Y, Lev-Sagi A, Arbell RC, Shimonowitz S, Neuman M: [A new
minimally invasive procedure for the conservative treatment of uterine
prolapse–the posterior IVS]. Harefuah. 2006 Jun;145(6):404-7, 472. Hebrew.


Haimov-Kochman R, Arbel RC, Sciaky-Tamir Y, Brzezinski A, Laufer N,
Yagel S: Risk factors for unsuccessful medical abortion with mifepristone and
misoprostol. Acta Obstet Gynecol Scand. 2007;86(4):462-6.

Beller U, Arbel RPI: [Treatment of vaginal vault prolapse: was a solution
found?]. Harefuah 2008 May;147(5):403, 478).

 

Boldes R, Ariel I, Shen O. Rabinowitz R. Weintraub A, Arbel RPI.: P 34.18:
Chorangiocarcinoma in a term placenta, a rare placental tumor. 2008
Aug;32(3):433-433.

 

Ariel I, Boldes R, Weintraub A, Reinus C, Beller U, Arbel RPI.:
Chorioangiocarcinoma: a case report and review of the literature. Int J
Gynecol Pathol. 2009 June;28(3):267-71.

 

Arbel R, Stanleigh J, Ioscovich A: Pain management following abdominal
hysterectomy: novel approaches and review of the literature. J Clin Gynecol
Obstet 2013 Sep;2(2):51-55.

 

Abu akar F .Arbel R .Benninga Z. Aboo Dia M. Steiner-Birmanns B: The
Istanbul protocol (manual on the effective investigation and documentation of
turture and other cruel, inhumanor degrading treatment or punishment):
implementation and education in Israel. Isr Med Assoc J. 2014;
Mar;16(3):137-41.

 

 

Livovsky DM, Arbel A, Edden Y, Meyuhas R, Bar-Gil Shitrit A, Lysy J.:
Sa1369 A repeated anorectal manometry 9 months after a 3rd degree obstetric
anal sphincter injury may change the recommendation about the preferred
mode of delivery in future pregnancies. Gastroenterology 2015 Apr;148(4):S-
305-S-306.

 

Beninninga Z, Steiner-Birmanns B ,Arbel R ,Abu Akar F, Aboo Dia M;
Recognition and treatment of enforcement violence against detainees and
prisoners: A survey among Israeli physicians and medical students. Turture.
2017; 27(1):42-50.

 

 

Shlian I, Lavy Y, Arbel R C, Shveiky D, Woloski-Wrubel A, Michal Libergall-
Wischnitzer : Urinary incontinence type, symptoms, and quality of life: A
comparison between grand multipara and non-grand multipara aged >50 years.
Jpn J of Nurs Sci 2018, Oct;15(4):309-317

 

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