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Urodynamik vor operativer Inkontinenztherapie

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Urodynamic studies prior to urinary incontinence surgery

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Zusammenfassung

Bei Vorliegen einer Harninkontinenz ist nach Versagen konservativer Maßnahmen oft eine operative Therapie notwendig. In den Leitlinien wird vor operativen Maßnahmen eine urodynamische Diagnostik empfohlen. Nichtinvasive (Uroflowmetrie) und invasive Methoden (Zystometrie und Druck-Fluss-Studie, gegebenenfalls in Kombination mit einer Durchleuchtung [Videourodynamik] sowie Urethradruckprofil) werden unterschieden. Alle Untersuchungen dienen der Objektivierung und Quantifizierung des jeweiligen Beschwerdebildes, der korrekten Zuordnung von Symptomen zur Pathophysiologie und Anatomie sowie der Identifikation von Risikofaktoren, die oft einen wesentlichen Einfluss auf den Erfolg der Therapie haben. Komplikationen und oft nicht unwesentliche, die Lebensqualität und auch -dauer betreffende Folgeerscheinungen einer Blasenfunktionsstörung können, entsprechende Erfahrung vorausgesetzt, erkannt werden. Urodynamische Untersuchungen werden durchgeführt, um Diagnosen einzugrenzen, therapeutische Strategien zu entwickeln und prognostische Parameter zu erhalten. Hierbei soll der nachstehende Artikel Hilfe bieten.

Abstract

Surgery is often necessary after failure of conservative therapy for urinary incontinence. Guidelines recommend urodynamic studies before surgery. A distinction is made between non-invasive (uroflowmetry) and invasive methods (cystometry and pressure-flow study, if necessary as combined videourodynamics, as well as urethral pressure profile). All examinations serve to objectify and quantify the symptoms, to correctly assign symptoms to the pathophysiology and anatomy as well as to identify risk factors, which often have a significant influence on the success of surgical therapy. Given appropriate experience, complications and often significant sequelae of bladder dysfunction affecting the patient’s quality of life and life expectancy can be recognized. Urodynamic studies are performed to help narrow down potential diagnoses, to develop therapeutic strategies, and to obtain prognostic parameters. The following article is intended to provide some support.

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Correspondence to Dr. A. Kaufmann.

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A. Kaufmann gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Kaufmann, A. Urodynamik vor operativer Inkontinenztherapie. Urologe 56, 1539–1547 (2017). https://doi.org/10.1007/s00120-017-0530-1

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Schlüsselwörter

  • Belastungsinkontinenz
  • Blasenfunktionsstörung
  • Post-Prostatektomie
  • Miktionsstörung
  • Prolaps

Keywords

  • Urinary incontinence, stress
  • Urinary bladder diseases
  • Post-Prostatectomy
  • Urination disorders
  • Prolapse