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Belastungsinkontinenz

Diagnostik und Therapie

Stress incontinence

Diagnostics and therapy

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Die häufigste Form der weiblichen Harninkontinenz ist die Belastungsinkontinenz. Im Rahmen der Diagnostik sind Anamnese und klinische Untersuchung, sowie – falls notwendig – eine urodynamische Untersuchung wichtige Elemente. Auch die urogenitale Sonographie kann relevante Informationen liefern. Neben zahlreichen konservativen physiotherapeutischen, medikamtösen und Pessar-assoziierten Therapieoptionen, die grundsätzlich als „first-line-Therapie“ bezeichnet werden müssen, stehen unterschiedliche, immer weniger invasive, operative Therapieregime zur Verfügung. So wurde die Kolposuspension in vielen Kliniken durch die spannungsfreien Bänder abgelöst, die sich zum neuen Goldstandard etabliert haben. Da es sich um elektive Eingriffe handelt, die der Verbesserung der Lebensqualität dienen, ist eine genaue Aufklärung über mögliche konservative und operative Alternativen und ihre Erfolgsaussichten essentiell. Die Entscheidung, welcher Therapie man sich bedient, sollte gemeinsam mit der Patientin in Abhängigkeit ihres Leidensdrucks erfolgen.

Abstract

Urinary stress incontinence is the most common entity in the field of female urinary incontinence. Medical history and urogynecological examination are the key diagnostic elements. If necessary, urodynamic testing and urogenital sonography are helpful tools to determine the best choice of treatment. There are various conservative strategies available, such as physiotherapy, medicinal or pessary therapy, which should be defined as the first line treatment of urinary stress incontinence. However, surgical intervention might be required to cure the bothersome symptoms and to increase the quality of life. In many hospitals colposuspension has been replaced by newer, less invasive techniques, such as tension-free vaginal tape procedures and they have become established as the new gold standard. As surgical therapy has an elective character in order to improve quality of life, it is crucial to counsel patients regarding all conservative and operative alternatives. The decision on which therapeutic option is to be selected needs to be shared by both physician and patient.

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Interessenkonflikt

Die korrespondierende Autorin weist für sich und ihren Koautor auf folgende Beziehung/en hin: Referententätigkeit: Ethicon Gynecare, Astellas Pharma GmbH.

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Authors and Affiliations

  1. Universitäts-Frauenklinik, Calwerstr. 7, 72076, Tübingen, Deutschland

    C. Reisenauer & M. Hübner

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  1. C. Reisenauer
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  2. M. Hübner
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Correspondence to C. Reisenauer.

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Reisenauer, C., Hübner, M. Belastungsinkontinenz. Gynäkologe 46, 442–447 (2013). https://doi.org/10.1007/s00129-012-3121-7

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  • DOI: https://doi.org/10.1007/s00129-012-3121-7

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