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Second-line-Therapie der idiopathisch überaktiven Blase

Sakrale Neuromodulation und Botulinumtoxin A

Second-line therapy of idiopathic detrusor overactivity

Sacral neuromodulation and botulinum toxin A

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Zusammenfassung

Das Syndrom der idiopathisch überaktiven Blase (I-OAB) beeinträchtigt das tägliche Leben vieler Menschen. Konservative Behandlungsformen wie Antimuskarinika sind nicht immer effektiv bzw. können Nebenwirkungen aufweisen, die zum Behandlungsabbruch führen. Minimal-invasive und reversible Verfahren wie die sakrale Neuromodulation (SNM) und die Injektion von Botulinumtoxin A in den Detrusor haben in den letzten Jahren zunehmend an Bedeutung gewonnen. Das einzige zur Behandlung der I-OAB zugelassene und von der „International Consultation on Incontinence“ empfohlene Verfahren ist die sakrale Neuromodulation mit der InterStim™-Therapie. Dieser Artikel gibt einen Überblick über die vorhandene klinische Evidenz für die Wirksamkeit und Sicherheit dieser beiden Verfahren sowie den gegenwärtigen Stellenwert der sakralen Neuromodulation und des Botulinumtoxin A in der Second-line-Therapie von Erwachsenen mit I-OAB.

Abstract

The syndrome of idiopathic overactive bladder (I-OAB) impairs quality of life for the affected individuals. Conservative treatment options such as antimuscarinics are not always effective, and resulting side effects can lead the patient to stop treatment. In recently years, minimally invasive and reversible sacral neuromodulation and botulinum toxin A have become available. Currently, the approved treatment option for I-OAB that is recommended by the International Consultation on Incontinence is sacral neuromodulation by InterStim therapy. This article gives an overview of the present clinical evidence on the effectiveness and reliability of these two treatment modalities as well as the current significance of sacral neuromodulation and botulinum toxin A for the second-line treatment of adult I-OAB.

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Interessenkonflikte

Der korrespondierende Autor weist auf folgende Beziehungen hin: Pfizer, Boehringer, Allergan: Vorträge; Allergan: Studienleiter; Medtronic: Studien, Vorträge. Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

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Authors and Affiliations

  1. Klinik für Urologie, Universitätsklinikum, Hoppe Seyler Straße 3, 72072, Tübingen, Deutschland

    B. Amend &  K.-D. Sievert

  2. Universitario de Canarias, Teneriffa, Spanien

    D. Castro-Diaz

  3. GH Pitié-Salpêtrière, Faculté Pierre et Marie Curie, Paris, Frankreich

    E. Chartier-Kastler

  4. University Hospitals KU Leuven, Leuven, Belgien

    D. De Ridder

  5. Ghent University Hospital, Ghent, Belgien

    K. Everaert

  6. Unità Spinale Unipolare, Azienda Ospedale Niguarda Cà Granda, Mailand, Italien

    M. Spinelli

  7. University Hospital Maastricht, Maastricht, Niederlande

    P. van Kereebroeck

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  1. B. Amend
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Correspondence to K.-D. Sievert.

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Amend, B., Castro-Diaz, D., Chartier-Kastler, E. et al. Second-line-Therapie der idiopathisch überaktiven Blase. Urologe 49, 245–252 (2010). https://doi.org/10.1007/s00120-009-2139-5

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