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Belastungsinkontinenz der Frau im Alter

Stress incontinence in elderly women

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Zusammenfassung

Die Belastungsinkontinenz ist eine der großen Aufgaben der Geriatrie. Mit dem demografischen Wandel unserer Bevölkerung tritt sie immer weiter in den Vordergrund unseres urologischen Klinikalltags. Die Versorgung und Therapie der Belastungsinkontinenz bedeutet bei der gealterten Frau ebenso wie bei der jungen Patientin eine gründliche Diagnostik mit einer ausgiebigen Erhebung von Risikofaktoren. Einflussgrößen wie Adipositas, der geänderte Hormonhaushalt, eine vorangegangene Operation im Beckenbereich und Geburten sind v. a. bei der älteren Frau vorhanden und tragen zu einer gehäuft auftretenden Belastungsinkontinenz bei. Das Behandlungskonzept der älteren Frau unterscheidet sich kaum von dem der jungen Frau. Die konservativen Behandlungsoptionen umfassen neben „Lifestyle-Modifikation“ und Gewichtsabnahme v. a. angeleitetes Beckenbodentraining, gegebenenfalls mit supportiver Begleitmedikation. Erst nach Ausschöpfen dieser Maßnahmen sollte über eine operative Therapie entschieden werden. Dabei stehen v. a. bei der älteren Frau eine Berücksichtigung der bestehenden Komorbiditäten und perioperativen Morbidität und Mortalität im Vordergrund. Minimal-invasive Operationsmethoden bieten v. a. bei diesen Patientinnen eine gute Herangehensweise.

Abstract

Stress incontinence is one of the major challenges in geriatric medicine. This is becoming more apparent in routine urology practice with the demographic changes in the population. A thorough diagnosis for a correct treatment of stress incontinence is as important in elderly women as it is in younger patients. This includes assessing the risk factors of incontinence and obesity, parturition, pelvic surgery and changes in hormone levels are risk factors usually found in elderly women. These are the main reasons why this patient group is most frequently affected. Treatment options do not differ significantly from these of younger women. Lifestyle modification, weight loss and supervised pelvic floor training are the mainstays of conservative therapy and surgical treatment should only be considered after these options have been exhausted. In these cases minimally invasive surgical techniques offer clear advantages especially for elderly often multimorbid women.

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  1. Klinik für Urologie und Kinderurologie, Westpfalz Klinikum Kaiserslautern, Helmut-Hartert-Straße 1, 67655, Kaiserslautern, Deutschland

    H. Loertzer & P. Schneider

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  1. H. Loertzer
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Loertzer, H., Schneider, P. Belastungsinkontinenz der Frau im Alter. Urologe 52, 813–820 (2013). https://doi.org/10.1007/s00120-013-3167-8

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