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Der Urologe, Ausgabe A

, Volume 43, Issue 5, pp 542–546 | Cite as

Urodynamische Phänomene der alternden Blase

  • T. M. Kessler
  • H. MadersbacherEmail author
Leitthema

Zusammenfassung

Symptome des unteren Harntraktes (LUTS) nehmen mit dem Alter bei beiden Geschlechtern zu und sind mit ihren medizinischen, psychischen und sozialen Konsequenzen ein zentrales Problem des alten Menschen. Meist sind im Alter die Blasenfunktionsstörungen multifaktoriell bedingt und können bis zu einem gewissen Grad alters- und/oder krankheitsbezogenen Veränderungen zugeordnet werden. Urodynamische Befunde sind stets im Kontext von Anamnese, Blasentagebuch, klinischer Untersuchung und anderen Befunden zu sehen. Mit zunehmendem Alter nehmen Miktionsvolumen und Harnstrahl ab, die Symptome der hyperaktiven Blase werden häufiger, und die Restharnmengen nehmen zu. Typische Befunde sind abnehmende maximale zystometrische Blasenkapazität, terminale Detrusorhyperaktivität und die Kombination von Detrusorhyperaktivität und Detrusorschwäche. Patienten mit terminaler Detrusorhyperaktivität profitieren von einem Toilettentraining, ggf. kombiniert mit einer anticholinergen Therapie. Dagegen sprechen Patienten mit phasischer Detrusorhyperaktivität mitunter gut auf eine nichtinvasive elektrische Neuromodulation an.

Schlüsselwörter

Alternde Blase Urodynamik Terminale Detrusorhyperaktivität Kombination von Detrusorhyperaktivität und Detrusorschwäche 

Urodynamic findings in the aging bladder

Abstract

Lower urinary tract symptoms increase with age in both sexes and are a major problem in the elderly due to the medical and bio-psycho-social consequences involved. Lower urinary tract dysfunctions in the elderly are generally multifactorial in origin and are classifiable to a large extent by age and pathology related changes. Urodynamic findings should never be interpreted without considering the medical history, bladder diary, clinical examination and other findings. Age related changes involve a decrease of voided volume and urinary flow and an increase in overactive bladder symptoms and post void residuals. Consequently, decreased maximum bladder capacity, terminal detrusor overactivity and detrusor overactivity with impaired contractile function are typically found in the elderly. Patients with terminal detrusor overactivity are well treated by bladder training and timed voiding, sometimes combined with anticholinergic drugs, whereas patients with phasic detrusor overactivity are often good candidates for non-invasive electrical neuromodulation.

Keywords

Aging bladder Urodynamics Terminal detrusor overactivity Detrusor overactivity with impaired contractile function 

Notes

Interessenkonflikt:

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Neuro-Urologische Ambulanz der Universitätsklinik Innsbruck
  2. 2.Neuro-Urologische Ambulanz der Universitätsklinik InnsbruckInnsbruckÖsterreich

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