Pelvic floor weakness and urinary incontinence, also called bladder weakness, are among the most common complaints, especially in women after the change. Around 15 percent of postmenopausal women, but also some young patients, suffer from incontinence or sagging problems. Both are still a taboo subject. However, dysfunction of the bladder and descent of the bladder, uterus and rectum can be treated very effectively. My job as a surgeon is first of all to clarify and differentiate the complaints. In many cases, surgery can be avoided with pelvic floor exercises. Following the correct diagnosis, we develop an individual treatment plan for each patient. If an operation cannot be avoided, it can be carried out as a gentle, possibly interdisciplinary, minimally invasive procedure.