Zusammenfassung
Die Stressharninkontinenz ist in der überwiegenden Zahl der Fälle durch Veränderungen der Halte- und Stützstrukturen um Blasenhals und Urethra verursacht. Klinisches Kennzeichen dieser Art von Inkontinenz ist die Hypermobilität der entsprechenden anatomischen Strukturen. Bei plözlichen intraabdominellen Drucksteigerungen übersteigt der Blasen-druck den Harnrörendruck und es kommt zum unwillkürlichen Ab-gang von Urin. Der Urethralverschlussdruck in Ruhe (UVD max.) liegt bei diesen Patientinnen im Normbereich. Bei einer wesentlich kleineren Gruppe von Patientinnen ist primär der Verschlussmechanismus der Harnröhre gestört. Ursachlich sind Denervierung, Fibrosierung und Atrophisierung der Harnröhrenmuskulatur. Der Urethralverschlussdruck in Ruhe ist bei diesen Patientinnen deutlich niedriger als bei altersent-sprechenden gesunden Frauen (<20cm H2O). Die sogenannte funktio-nelle Urethralänge ist meist verkürzt. Die proximale Urethra ist auch in Ruhe trichterformig zur Blase hin geöffnet. Im Gegensatz zur ersten Gruppe kann bei der seltenen „reinen“ Form einer hypotonen Urethra der Blasenhals funktionell anatomisch stabil sein. Mischformen sind je-doch häufig.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Literatur
Alcalay M, Monga A, Stanton SL (1995) Burch colposuspension: a 10–20 year follow up. Br J Obstet Gynaec 102:740–745
Bergman A, Ballard Da, Konnings PP (1989) Comparison of three different surgical procedures for genuine stress incontinence: Prospective randomized study. Am J Obstet Gynecol 16:1102–1106
Bergman A, Elia G (1995) Three surgical procedures for genuine stress incontinence: Five year follow up of a prospective randomized study. Am J Obstet Gynecol 173:66–71
Buller JL, Cundiff GW (2000) Laparoscopic surgeries for urinary incontinence. Clin Obstet Gynecol 43:604–618
Burch JC (1961) Urethrovaginal fixation to Cooper’s ligament for the correction of stress incontinence, cystocele and prolapse. Am J Obstet Gynecol 88:281–290
Burch JC (1968) Cooper’s ligament urethrovesical suspension for stress incontinence. Am J Obstet Gynecol 100:764–772
Burton G (1993) A randomized comparison of laparoscopic and open colposuspension. Neurourol Urodyn 13:497–498
Burton G (1997) A three year prospective randomized urodynamic study comparing open and laparoscopic colposuspension. Neurol Urodyn 16:353–354
Cowan W, Morgan HR (1979) A simplified retropubic urethropexy in the treatment of primary and recurrent urinary stress incontinence in the female. Am J Obstet gynecol 134:295–298
Cutner A, Smith ARB (2001) Laparoscopic colposuspension. Current Opinion Obstet Gynec 13:533–537
Das S (1999) Laparoscopic surgery for female urinary incontinence: prudence shall prevail. JSLS 3:273–277
Demirci F, Petri E (2000) Perioperative complications of Burch colposuspension. Int Urogynecol J 11:170–175
Drouin J, Tessier J, Bertrand PE, Schick E (1999) Burch colposuspension: Long-term results and review of published reports. Urology 54:808–814
Eberhard J (1988) Die Integration der Urodynamik im Diagnostik-und Therapie-konzept der Stressinkontinenz der Frau. Habilitationsschrift, Zurich
Fatthy H, El lHao M, Samaha I, Abdallah K (2001) Modified Burch colposuspension: laparoscopy versus laparotomy. J Am Assoc Gynecol Laparosc 8:99–106
Gunn GC, Cooper RP, Gordon NS, Gragnon L (1994) Use of a new device for endoscopic suturing in the laparoscopic Burch procedure. J Am Assoc Gynecol Laparosc 2:65–70
Ingelman-Sundberg A (1951) Urinary incontinence in women excluding fistulas. Acta Obstet Gynecol Scand 31:266–291
Jarvis G (1994) Surgery for genuine stress incontinence. Br J Obst et Gynaec 101
Lam AM, Jenkins GJ, Hyslop RS (1995) Laparoscopic Burch colposuspension for stress incontinence: preliminary results. Med J Aust 162:18–22
Langebrekke A, Dahistrom B, Eraker R, Urnes A (1995) The laparoscopic Burch procedure: a preliminary report. Acta Obstet Gynecol Scand 74:153–156
Lavin JM, Lewis GJ, Foote AJ et al (1998) Laparoscopic Burch colposuspension: A minimum of 2 years follow up and comparison with open colposuspension. Gynaecol Endosc 7:251–258
Lee C, Yen C, Wang C et al (1998) Extraperitoneoscopic colposuspension using CO2 distension method. Int Surg 83:262–264
Liu C, Paek W (1993) Laparoscopic retropubic colposuspension (Burch procedure). J Am Assoc Gynecol Laparosc 1:31–35
Liu C (1994) Laparoscopic treatment of genuine urinary stress incontinence. Clin Obstet Gynecol 8:789–798
Mashall VF, Marchetti AA, Krantz KE (1949) The correction of stress incontinence by simple vesicourethral suspension. Surg Gynecol Obstet 88:509–516
Me Dougall EM (2001) Laparoscopic management of female urinary incontinence Urol Clin North Am 28:145–149
Meeks GR (2000) Advanced laparoscopic gynecologic surgery. Surg Clin North Am 80:1443–1464
Miklos JR, Kohli N (2000) Laparoscopic paravaginal repair plus burch colposuspension: review and descriptive technique. Urology 56(Suppl6a):64–69
Nezhat CH, Nezhat F, Netzhat CR et al (1994) Laparoscopic retropubic cystocolpo-suspension, J Am Assoc Gynecol laparosc 1:339–349
Persson J, Wolner-Hanssen P (2000) Laparoscopic Burch colposuspension for stress urinary incontinence: a randomized comparison of one or two sutures on each side of the urethra. Obstet Gynecol 95:151–155
Polascik TJ, Moore RG, Rosenberg MT et al (1995) Comparison of laparoscopic and open retropubic urethropexy for treatment of stress urinary incontinence. Urology 45:647–652
Raz S (1981) Modified bladder neck suspension for female stress incontinence. Urology 17:82–85
Richardson DA (1991) The evaluation of different surgical procedures. In Oster-gard DR, Blut E: Urogynecology and Urodynamics. Theory and Practice. Williams and Wilkins, Baltimore
Ross JW (1995) Laparoscopic Burch repair compared to laparotomy Burch for cure of urinary stress incontinence. Int Urogynecol 6:323–328
Ross JW (1996) Two techniques of laparoscopic Burch repair for stress incontinence — a prospective randomized study. J Am Assoc Gynecol Laparosc 3:351–357
Saidi MH, Gallagker MS, Skop IP et al (1998) Extraperitoneal laparoscopic colpo-suspension: Short term cure rates, complications and duration of hospital stay in comparison with Burch colposuspension. Obstet Gynecol 92:619–621
Speights SE, Moore RD, Miklos JR (2000) Frequency of lower urinary tract injury at laparoscopic Burch and paravaginal repair. J Am Assoc Gynecol Laparosc 7:515–518
Stanton SL, Cardozo LD (1979) Results of the colposuspension operation for incontinence and prolapse. Br J Obstet Gynaec 86:L693–697
Stanton SL (1990) Surgical management of urethral sphincter incompetence. Clin Obstet Gynecol 33:346–357
Su TH, Wang KG, Hsu CY et al (1997) Prospective comparison of laparoscopic and traditional colposuspension in the treatment of genuine stress incontinence. Acta Obstet Gynecol Scand 76:576–582
Schmidt EH, De Wilde RL (1998) Standardverfahren der minimalinvasiven Chi-rurgie in der Frauenheilkunde. Thieme, Stuttgart
Tanagho EA (1976) Colpocystourethropexy: the way we do it. J Urol 116:751–753
Vancaillie TG, Schiissler W (1991) Laparoscopic bladder-neck suspension. J Lapar-oendosc Surg 1:169–173
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2002 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Schmidt, E.H., Frank, V., DeWilde, R.L. (2002). Endoskopische versus konventionelle Kolposuspension. In: Malik, E., Diedrich, K. (eds) Gynäkologische Endoskopie pro und contra. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-57440-5_6
Download citation
DOI: https://doi.org/10.1007/978-3-642-57440-5_6
Publisher Name: Steinkopff, Heidelberg
Print ISBN: 978-3-642-63264-8
Online ISBN: 978-3-642-57440-5
eBook Packages: Springer Book Archive