Complicated and complex pelvic floor disorders refer to a group of conditions affecting the muscles, ligaments, and nerves that support the pelvic organs, such as the bladder, uterus, and rectum. These conditions can cause a variety of symptoms, such as pelvic pain, urinary and faecal incontinence, and sexual dysfunction. Complicated pelvic floor disorders typically involve additional medical complications, such as a history of pelvic surgery or radiation therapy, pelvic trauma, or comorbid medical conditions, which can complicate diagnosis and treatment. Complex pelvic floor disorders refer to cases that are particularly difficult to diagnose or treat, often due to the presence of multiple coexisting conditions or a lack of clear understanding of the underlying causes. Treatment for complicated and complex pelvic floor disorders may involve a multidisciplinary approach, including medication, physical therapy, behavioural therapy, and surgery, tailored to the individual’s specific condition and needs. Whilst the majority of primary conditions associated with pelvic floor dysfunction will be managed by gynaecologists and urologists with an interest in female urology and urogynaecology, more complex cases should be managed by a core multidisciplinary team should consist of a urogynaecologist, female urologist, colorectal surgeon, nurse specialist and pelvic floor physiotherapist. Additional members may include neurologists, geriatricians, pharmacists and medical physicists. Since 2020, he has been appointed as a Full Professor at Maastricht University and as Head of the Department of Urology of the Maastricht UMC, the Netherlands. He chaired the Society of Functional and Reconstructive Urology, a body of the Dutch Association of Urology, until 2022. John Heesakkers is an active member of the DUA, EAU and IUGA. Since 2021, he has been the Secretary General of the Association of Academic European Urologists. Since September 2022, he has been the General Secretary of the International Continence Society. He is a faculty member of the European School of Urology. Within ERN eUROGEN, the European Reference Network for Rare Uro-Recto-Genital Diseases and Complex Conditions, he is the Workstream 2 Research Lead and an Expertise Area Coordinator relating to complicated & complex pelvic floor disorders. He is a reviewer of several major urologic scientific journals. He is the author of more than 200 peer-reviewed papers, book chapters and books on urological topics. Finally, in 2017, he completed a fellowship in urethral reconstruction with Prof. Lumen at the University Hospital in Ghent. He did a short replacement of the fellow in functional, reconstructive and neuro-urology under Prof. De Kort and Prof. Bosch at the University Medical Center Utrecht (UMCU), where he was appointed Academic Medical Specialist in Urology at the Urology Department of the Division of Surgical Specialties from January 2018. Michel Wyndaele clinically focuses on academic (third line, last resort) Reconstructive, Functional Urology and Neuro-Urology. He has a growing list of peer-reviewed publications and book chapters, co-promotes 2 PhD students, is an editorial board member of the International Urogynaecology Journal (since 2021) and of Continence (since 2024), has set up a dedicated Robotic Reconstructive Urology service at UMCU with the team, and has been a member of the hospital’s medical ethical committee (NedMec) since 2021. He currently is the ERN eUROGEN Vice Expertise Area Coordinator of Expertise Area 2.1 (Complicated and Complex Pelvic Floor disorders) and the ERN eUROGEN Workstream 2 (Functional uro-recto-genital conditions requiring highly specialized surgery) Clinical Lead. BE Antwerp UZ, BE Leuven UZ, DE Hamburg-Eppendorf UK, ES Madrid 12 de Octubre, ES Barcelona Fundació Puigvert, ES Santander Valdecilla, FR Paris Necker, IT Padua AOU, IT Rome Gemelli, NL Nijmegen Radboudumc, NL Utrecht UMC, SE Stockholm KarolinskaEA 2.1 Complicated & Complex Pelvic Floor Disorders
Expertise Area Coordinator and Vice-EAC
Expertise Area Coordinator: John Heesakkers
Prof dr John PFA Heesakkers, MD, PhD, studied Medicine at the Radboud University of Nijmegen. In 1987, he received his MBA at the Rotterdam School of Management. He started his training in Urology in 1993 at the University Hospital Maastricht. In 1997, he successfully defended his thesis titled: ‘Dynamic Urinary Graciloplasty’ at the University of Maastricht. From 2000 to 2020, he was a full-time staff urologist at the Department of Urology of the Radboudumc and a consultant at the Rehabilitation Clinic St Maarten in Nijmegen, the Netherlands. He headed the Unit of Functional Urology and Neurourology in the Radboudumc.Vice-EAC: Michel Wyndaele
Michel Wyndaele graduated summa cum laude as a medical doctor in 2006, successfully defended a PhD on bladder-bowel interactions in 2014 and completed his national Urology certification in 2016 at the University of Antwerp, Belgium. The same year, he obtained the Fellow of the European Board of Urology qualification. Subsequently, he was the senior clinical fellow in female and functional urology under Prof. Hashim, Prof Drake and Prof Abrams at Southmead Hospital in Bristol, UK, for one year.Healthcare Providers
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Complicated & Complex Pelvic Floor Disorders
