Skip to main content
Log in

Behandlung der weiblichen Belastungsinkontinenz

Stellenwert klassischer Inkontinenzoperationen

Treatment of female stress urinary incontinence

Value of classical incontinence operations

  • Leitthema
  • Published:
Der Urologe Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Faszienzügelplastiken und die Kolposuspensionsplastiken galten bis Mitte der 1990er Jahre als Standardoperationen in der Therapie der Belastungsinkontinenz der Frau. Neue operative Verfahren wurden mit diesen Operationstechniken bezüglich Heilungsrate und Langzeitergebnissen verglichen.

Ergebnisse

Während die Faszienzügelplastik heute nur noch einen historischen Stellenwert einnimmt, wurde auch die Kolposuspension, trotz teils vergleichbarer Ergebnisse, durch die spannungsfreien Bänder als neuer Goldstandard abgelöst. Dies ist weniger einer geringeren Effektivität als vielmehr einem geringeren operativen Trauma, einer unkomplizierten Anwendung und schnellen Rekonvaleszenz geschuldet. Insbesondere aber im Rezidivfall und in der kombinierten Therapie des Deszensus bzw. Prolaps kann die Kolposuspension weiterhin ihre Anwendung finden.

Abstract

Background

Fascial sling and the colposuspension were considered standard operations in the therapy of female stress urinary incontinence until the mid-1990s. New surgical procedures were compared with these techniques in regard to cure rate and long-term results.

Results

Nowadays fascial slings are rarely performed. Colposuspension – despite comparable results – was replaced by tension-free tapes as the new gold standard. This is not due to lower efficacy, but predominantly due to reduced surgical trauma, simple use, and rapid convalescence. However, in cases of recurrence and the combined treatment of prolapse, colposuspension is still used.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. Petros PE, Ulmsten UI (1990) An integral theory of female urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynecol Scand 153(Suppl):7–31

    Article  CAS  Google Scholar 

  2. Varga Z (2014) Spannungsfreie mitturethrale Vaginalschlingen. In: Hofmann R, Wagner U (Hrsg) Inkontinenz- und Deszensuschirurgie der Frau. Springer, Berlin Heidelberg New York, S 81

  3. Ulmsten U, Petros P (1995) Intravaginal slingplasty (IVS): an ambulatory surgical procedure for treatment of female urinary incontinence. Scand J Urol Nephrol 29(1):75–82

    Article  CAS  PubMed  Google Scholar 

  4. Kalder M (2014) Kolpopexie. In: Hofmann R, Wagner U (Hrsg) Inkontinenz- und Deszensuschirurgie der Frau. Springer, Berlin Heidelberg New York, S 177

  5. Albo ME, Richter HE, Brubaker L et al (2007) Urinary incontinent treatment network. Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med 356:2143–2155

    Article  CAS  PubMed  Google Scholar 

  6. Lapitan MC, Cody JD (2012) Open retropubic colposuspension for urinary 6-incontinence in women. Cochrane Database Syst Rev 6

  7. Lucas MG, Bosch RJ, Burkhard FC et al (2013) EAU guidelines on surgical treatment of urinary incontinence. European Association of Urology. Actas Urol Esp 37:459–472

    CAS  PubMed  Google Scholar 

  8. Rehman H, Bezerra CC, Bruschini H et al (2011) Traditional suburethral sling operations for urinary incontinence in women. Cochrane Database Syst Rev 19

  9. Baumann K (2014) Abdominale Kolposuspensionsverfahren. In: Hofmann R, Wagner U (Hrsg) Inkontinenz- und Deszensuschirurgie der Frau. Springer, Berlin Heidelberg New York, S 95 ff

  10. Ward K, Hilton P (2002) Prospective multicentre randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence. BMJ 325:67–70

    Article  PubMed Central  PubMed  Google Scholar 

  11. Maher C, Feiner B, Baessler K et al (2013) Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev

  12. Brubaker L, Cundiff GW, Fine P et al (2006) Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence. N Engl J Med 354:1557–1566

    Article  CAS  PubMed  Google Scholar 

  13. Costantini E, Lazzeri M, Bini V et al (2010) Pelvic organ prolapse repair with and without prophylactic concomitant Burch colposuspension in continent women: a randomized, controlled trial with 8-year followup. J Urol 185:2236–2240

    Article  Google Scholar 

  14. Agur W, Riad M, Secco S et al (2013) Surgical treatment of recurrent stress urinary incontinence in women: a systematic review and meta-analysis of randomised controlled trials. Eur Urol 64:323–336

    Article  PubMed  Google Scholar 

  15. Abdel-Fattah M, Ramsay I, Pringle S et al (2011) Evaluation of transobturator tension-free vaginal tapes in management of women with recurrent stress urinary incontinence. Urology 77:1070–1075

    Article  PubMed  Google Scholar 

  16. Stav K, Dwyer PL, Rosamilia A et al (2010) Repeat synthetic mid urethral sling procedure for women with recurrent stress urinary incontinence. J Urol 183:241–246

    Article  PubMed  Google Scholar 

  17. Sharifiaghdas F, Mortazavi N (2008) Tension-free vaginal tape and autologous rectus fascia pubovaginal sling for the treatment of urinary stress incontinence: a medium-term follow-up. Med Princ Pract 17:209–214

    Article  PubMed  Google Scholar 

  18. Nitahara KS, Aboseif S, Tanagho EA (1999) Long-term results of colpocystourethropexy for persistent or recurrent stress urinary incontinence. J Urol 162:138–141

    Article  CAS  PubMed  Google Scholar 

  19. Diana M, Zoppe C, Mastrangeli B (2000) Treatment of vaginal vault prolapse with abdominal sacral colpopexy using prolene mesh. Am J Surg 179:126–128

    Article  CAS  PubMed  Google Scholar 

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Frohme und R. Hofmann geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Frohme.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Frohme, C., Hofmann, R. Behandlung der weiblichen Belastungsinkontinenz. Urologe 54, 342–348 (2015). https://doi.org/10.1007/s00120-014-3682-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00120-014-3682-2

Schlüsselwörter

Keywords

Navigation