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Pelvic floor problems

Issues with the pelvic floor can have a lot of influence on your ability to function daily, the way you feel, and often your sex life as well. These issues can have many different causes, like a prolapse of your pelvic organs (uterus/intestine/bladder). Most often something can be done about these issues. In the initial consultations at Karmenta the options will be discussed.


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  • Explanation

    Through an internal examination and an ultrasound we’ll be able to tell how severe the prolapse is and what organs it involves. When the bladder is prolapsed we will ask you to keep a record of your urinations to get information about the functionality of your bladder in your daily life. This will involve keeping a record of how much you drink and pee, as well as when you drink and pee. This examination will mostly be done with women who also have other issues with their bladder, such as urine incontinence. Aside from that we will also examine the functionality of the bladder through urodynamic examination if needed, and check for potential infections of the urethra. Through the urodynamic examination we will get information about the way the bladder functions when it fills up, and when you cough, pee, etc.

    It’s also possible the pelvic floor muscles don’t function properly, which in some cases means a physiotherapist will be consulted to look at the functionality of the muscles. 

    A large part of the pelvic floor issues can be treated by training the muscles. That happens under the guidance of our specialist pelvic physiotherapist. Depending on the nature and size of the prolapse there are also other treatments possible. We could, for example, place a ‘ring’ (pessarium) that very simply works to keep the organs in place, without you noticing it at all. In other cases it may be necessary to operate. 

    The pelvic floor is a tendon plate, that is strung between small hip bones (between the tailbone and pelvic bone, and between the two ischium humps) kind of like a hammock. The pelvic floor has two main functions: 1) the carrying of the pelvic organs (bladder and intestine), and 2) the closing of various openings (urethra and anus).

  • Complaints

    One common pelvic floor complaint is the sagging of the vagina. Almost half of all women will experience this at some point during their life. This often happens because of giving birth earlier in her life, but the issues will get worse as she gets into menopause.

    Of these women 20 percent will be so affected by this that she will visit a doctor. The tendons and muscles at that time won’t be able to keep the organs in the abdomen in their place. It can happen, for example, that the bladder (partly) sags through the vagina, or the uterus itself, or sometimes even the rectum. 

    The direct symptoms are limited to a ‘pushing feeling’ in the vagina. Woman will feel pain in their hips, stomach or lower back, as well as during sex. But a prolapse can also cause issues for other organs, like the bladder with recurring infections for example. With a serious prolapse of the uterus other issues can occur, such as constipation and incontinence.

  • Treatment

    We realise a lot of unrest and uncertainty exists around operations for pelvic floor prolapses. Especially the so-called ‘meshes’ are discussed frequently. We will therefore do everything in our power to inform you as well as we can about the pros and cons of all treatment options, so you can make a well-informed decision.

    At Karmenta we do not place meshes.

    Sometimes a sling can be considered to help involuntary urination (TVT-O or Urolon). This is an alternative option if training the muscles proves ineffective. 

    The ‘Stichting Bekkenbodempatiënten’ (foundation for pelvic floor patients) offers a lot of detailed information, about prolapses among other things.

    The Professional Association for Gynecologists, NVOG has an online brochure about pelvic floor complaints for women.

    The inspection for healthcare also provides information about so-called ‘meshes’.

    Karmenta's treatment options for pelvic floor problems:

    Pelvic floor training

    The pelvic floor is a tendon plate, that is strung between small hip bones (between the tailbone and pelvic bone, and between the two ischium humps) kind of like a hammock.

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We are proud of the enthusiastic reactions we receive

What do women think about Karmenta

  • Ada, 19, Schijndel

    Very satisfied and very lovely people! Thanks for the help.
  • Preferably without name, 60, Geldrop

    I was seen by Dr Bouwma, she immediately understood my issues and fears that came with them. She had a solution for me with the Mona Lisa Touch treatment. Now I feel free and like a woman again!
  • Emmy, 58 years, Veghel

    I was able to come by really quickly. Got seen in a very friendly and calm manner. The Gynecologist dr Haitsma was very helpful, understanding and careful. I’ve never received that kind of treatment at a gynecologist before and I’ve been to many hospitals. If I ever have to go to a gynecologist again I will definitely come to Schijndel. Thank you very much for the nice way of helping me.
  • Preferably anonymous, 58 jaar, 's-Hertogenbosch

    I want to give a massive compliment to Dr Bouwma. Been dealing with issues for years. Nobody took me seriously. 1st check-up at Karmenta she immediately identified that I had an abdominal prolapse. The operation couldn’t be done in Schijndel. I got referred to St Anna in Geldrop because I didn’t want to go to JBZ. I was operated there and the result was perfect. I’m so happy txs.
  • Preferably anonymous, 30, Uden

    Very nice, the constant explaining of what is gonna happen, how something looks and what the effect is.
  • Anonymous, 60, Sint-Oedenrode

    I’m so happy that I can come to someone with my menopausal complaints who actually understands what I’m talking about! And then also does all the medication and check-ups.

    Your visit to Karmenta, practical information

    Easier, more approachable and with more time and attention. Just more women-friendly than you’re used to.

    • 1. Referral GP
      1. Referral GP
    • 2. Making an appointment
      2. Making an appointment
    • 3. How can you find Karmenta?
      3. How can you find Karmenta?
    • 4. In the doctor's office
      4. In the doctor's office
    • 5. Follow-up
      5. Follow-up
    • 1. Referral GP

      First go to your GP

      If you have any issues, you should initially go to your GP. Talk about your complaints with them and then decide if you need to go to a medical specialist, and which one will fit your situation the best. If your GP wants to refer you to a gynecologist, then he can choose Karmenta. You can ask for that yourself as well. Usually you’ll be seen quicker at Karmenta than at a hospital-based gynecologist.


      If your GP refers you to Karmenta, it will almost always go through ‘Zorgdomein’. You will get a note from your doctor with information about Karmenta and how to make an appointment with us. If your GP doesn’t refer you through ‘Zorgdomein’ you will get a letter of referral from your GP that you have to bring with you to your appointment at Karmenta.

    • 2. Making an appointment

      Call Karmenta at +31-(0)73 - 7200 993.

      Your call will be answered by Lieke, or one of the other team members, like Cynthia, Anky or Gerard. If you were referred through ‘Zorgdomein’ we should already have all of your details and your letter of referral in our electronic patients dossier. We will just check your details with and fill in your phone number(s) and email address. If you have any questions don’t be scared to ask them. We will usually look at your letter of referral to see if you need to come in to a specific doctor or at a specific time. After that we’ll make an appointment during our consultation hours for you. We will confirm this in an email.

      Were you not referred through ‘Zorgdomein’?

      Then we’ll have to look up your data, which can be done using your BSN-number, or your postcode and date of birth. You will have to bring your letter of referral to your appointment.

      Do you not have/want a referral from your GP?

      In some cases you will also be able to be seen at Karmenta without a referral from your GP. If you want to make an appointment for a treatment that will not be covered by your insurance (uninsured care). An example of that is for specific (fertility) ultrasounds, or the Mona Lisa Touch treatment. If you don’t have a referral, we will still register you in our system when you call of course, we will just register you as a new patient and ask for some additional personal information.

    • 3. How can you find Karmenta?

      Karmenta is easy to find in the Medical Centre Schijndel. If you come in through the sliding doors and you will be able to sign in at the reception, there we’ll ask you for your ID. We’ll also check your data, like your GP, health insurer and will add a pharmacy that we could send a prescription to if needed. 

      After this you will be able to sit down in the waiting room, where we will offer you a cup of coffee while you wait.

      Directions  Public Transport to Karmenta

    • 4. In the doctor's office

      If you end up in the gynecologist's office, we will discuss your issues. The gynecologist wants to really understand you and it is very important to us that we thoroughly explain what all your options are and what they will mean for you. That’s why at Karmenta you will spend a lot more time in the office than you would in a hospital. We will discuss the result we’re aiming for of course, but we’ll also tell you about the risks and possible complications. We will check if you’ve understood everything and might give you some additional information to read so you can come to a good decision. 

      Prepare for your appointment

      It is important that you are prepared for your talk with the gynecologist. You can bring someone you trust with you (your partner, mother, friend) so they’ll be able to follow the conversation as well. That way they will be able to discuss the conversation with you. 

      You can write your questions in advance, or write down any steps you’ve already taken to alleviate your symptoms. A great starting point for questions is this website: 3Goedevragen.nl (Dutch)

    • 5. Follow-up

      After your talk with the gynecologist you may have to come in for another appointment. You can make that appointment with the assistant at the reception. The doctor will walk with you to the reception and explain to the assistant what the next steps are and what the appointment is for.


      If a sample was taken (smear test) during the consultation, we will make sure it is examined in the lab and that we get the results of the test. Sometimes your blood, tissue or urine has to be tested by an external laboratory. In that case you will get a form that has the laboratory in question listed and the type of research marked on it. You’ll have to bring the form with you to a branch of Pathologie-DNA or of Diagnostiek voor U. The assistant will help you with that. On the website you’ll find which branch is closest to you. Or you can make an appointment for the research at the blood taking site run by Bernhoven Ziekenhuis at Medical Centre Schijndel. (Opening times of the blood taking site).

      Collecting your medication at the pharmacy

      Sometimes the gynecologist will write out a prescription for medication. You’ll be able to pick this up at your local pharmacy. It is vital therefore, that you know what/where your local pharmacy is, so we can register it in the electronic patients dossier. Karmenta will electronically send the prescription to the pharmacy, and will try to do that as soon as we can after your consultation. This means that the pharmacy will already have your prescription when you go to collect it.

    We’re in the middle of Brabant and will welcome you with open arms

    And coffee in the waiting room! You’ll find us in the middle of Brabant, not far from ‘s-Hertogenbosch and Eindhoven. A 10 minute drive from the A2, right next to a square with tons of free parking space.

    Medisch Centrum Schijndel

    Visiting Address

    Telephone : +31-(0)73 - 7200 993
    Fax : +31-(0)73 - 7200 908
    e-mail : This email address is being protected from spambots. You need JavaScript enabled to view it. 

    Opening Times

    • Work days :

      08:30 - 17:30 uur

    • Lunch
      12:30 - 13:00 uur

    Karmenta can be reached over the phone on all work days from 08:30 - 17:00

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