Update of the Integral Theory and System for Management of Pelvic Floor Dysfunction in Females

This paper introduces a new way of thinking. Many bladder and bowel symptoms not considered curable via existing methods may be caused by loose pelvic ligaments, and thus are potentially curable by reinforcing the ligaments. These symptoms include an inability to hold on to the bladder (urge incontinence), going frequently to pass urine during the day (frequency), getting up at night to pass urine (nocturia), involuntary soiling from the bowel, and chronic pelvic pain. These symptoms are major indications for nursing home admission. In this paper we give examples of cure of these conditions in a group of 70-yr-old Japanese women whose ligaments were strengthened using a tissue fixation system (TFS) in a very minimal way. The TFS involves insertion of a thin (7 mm wide) tape through the ligaments that support the uterus. The tape creates new collagen to strengthen damaged ligaments. The new ligaments act as efficient anchoring points for muscles that open and close the urethra and anus, so these can now function more efficiently. A minimum cure rate of 72% was achieved for all the above symptoms. The method is different from large mesh insertions. Only a thin tape is used to repair damaged ligaments. This method can reduce costs, improve quality of life for older women, and potentially reduce admissions to nursing homes.