Skip to main content
Log in

Vom Beckenbodentraining bis zu Medikamenten

Harninkontinenz im Alter: Für jede Form die passende Therapie

Urinary incontinence — Diagnostic and therapy options in the elderly

  • FORTBILDUNG . SCHWERPUNKT
  • Published:
MMW - Fortschritte der Medizin Aims and scope

Die Prävalenz der Harninkontinenz nimmt mit dem Alter zu. Frauen sind häufiger von einer Belastungs- und gemischten, Männer häufiger von einer Dranginkontinenz betroffen. Über den Stellenwert von Verhaltens-, Physio- und Pharmakotherapie bei den verschiedenen Harninkontinenz-Formen informiert Sie der nachfolgende Beitrag.

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

Literatur

  1. Abrams P, Andersson KE, Birder L et al (2017) 6th International Consultation on Incontinence. Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse and faecal incontinence. 6th International Consultation on Incontinence, Chapter 11 Incontinence in frail older persons, Tokyo.

  2. Abrams P, Cardozo L, Fall M et al. (2002) The standardisation of terminology of lower urinary tract function: Report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21: 167–178.

    Article  Google Scholar 

  3. Agrawal MS, Yadav A, Yadav H, Singh AK, Lavania P, Jaiman R. A prospective randomized study comparing alfuzosin and tamsulosin in the management of patients suffering from acute urinary retention caused by benign prostatic hyperplasia. Indian J Urol 2009 October;25(4):474–8.

    Article  Google Scholar 

  4. Ancelin ML, Artero S, Portet F, Dupuy AM, Touchon J, Ritchie K. Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. BMJ 2006 February 25;332(7539):455–9.

    Article  Google Scholar 

  5. Becher K, Bojack B, Büntig N, Ege S, Hatzinger M, Kirschner-Hermanns R, Wiedemann A, S2e-Leitlinie Harninkontinenz bei geriatrischen Patienten, Diagnostik und Therapie, (2017), AWMF-Register Nr. 084/001; Stand 30.04.2016.

  6. Bhomi KK, Bhattachan CL. Factors predicting the success of a trial without catheter in acute urinary retention secondary to benign prostatic hyperplasia. Nepal Med Coll J 2011 September;13(3):178–81.

    CAS  PubMed  Google Scholar 

  7. Brown JS, Vittinghoff E, Wyman JF et al. (2000) Urinary incontinence: does it increase risk for falls and fractures? Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc 48(7): 721 to 725.

    Article  Google Scholar 

  8. Cantrell MA, Bream-Rouwenhorst HR, Steffensmeier A, Hemerson P, Rogers M, Stamper B. Intraoperative floppy iris syndrome associated with alpha1-adrenergic receptor antagonists. Ann Pharmacother 2008 April;42(4):558–63.

    Article  CAS  Google Scholar 

  9. Chang DF, Braga-Mele R, Mamalis N, Masket S, Miller KM, Nichamin LD et al. Clinical experience with intraoperative floppy-iris syndrome. Results of the 2008 ASCRS member survey. J Cataract Refract Surg 2008 July;34(7):1201–9.

    Article  Google Scholar 

  10. Chapple CR, Kaplan SA, Mitcheson D, Klecka J, Cummings J, Drogendijk T et al. Randomized double-blind, active-controlled phase 3 study to assess 12-month safety and efficacy of mirabegron, a beta(3)-adrenoceptoragonist in overactive bladder. Eur Urol 2013 February;63(2):296–305.

    Article  CAS  Google Scholar 

  11. Chapple CR, Khullar V, Gabriel Z et al (2008) The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis. Eur Urol 54:543–562.

    Article  CAS  Google Scholar 

  12. Cody JD, Richardson K, Moehrer B et al (2009) Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev:CD001405.

  13. Dmochowski RR, Miklos JR, Norton PA, Zinner NR, Yalcin I, Bump RC. Duloxetine versus placebo for the treatment of North American women with stress urinary incontinence. J Urol 2003 October;170(4 Pt 1):1259–63.

    Article  CAS  Google Scholar 

  14. DuBeau CE, Kraus SR, Griebling TL, Newman DK, Wyman JF, Johnson TM 2nd, Ouslander JG, Sun F, Gong J, Bavendam T. Effect of fesoterodine in vulnerable elderly subjects with urgency incontinence: a double-blind, placebo controlled trial. J Urol. 2014;191:395–404.

    Article  CAS  Google Scholar 

  15. Ghoniem GM, Van Leeuwen JS, Elser DM, Freeman RM, Zhao YD, Yalcin I et al. A randomized controlled trial of duloxetine alone, pelvic floor muscle training alone, combined treatment and no active treatment in women with stress urinary incontinence. J Urol 2005 May;173(5):1647–53.

    Article  CAS  Google Scholar 

  16. Goepel M, Hoffmann JA, Piro M, Rübgen H, Michal MC, Prevalence and Physician awareness of symptoms of urinary bladder dysfunction. Eur Urol 2002; 41:234–9.

    Article  Google Scholar 

  17. Harvey MA, Baker K, Wells GA. Tolterodine versus oxybutynin in the treatment of urge urinary incontinence: a meta-analysis. Am J Obstet Gynecol 2001 July;185(1):56–61.

    Article  CAS  Google Scholar 

  18. Kay G, Crook T, Rekeda L et al (2006) Differential effects of the antimuscarinic agents darifenacin and oxybutynin ER on memory in older subjects. Eur Urol 50:317–326

    Article  CAS  Google Scholar 

  19. Khullar V, Amarenco G, Angulo JC et al (2013) Efficacy and tolerability of mirabegron, a β(3)-adrenoceptor agonist, in patients with overactive bladder: results from a randomised European-Australian phase 3 trial. Eur Urol 63:283–295.

    Article  CAS  Google Scholar 

  20. Khullar V, Cambronero J, Angulo JC, Wooning M, Blauwet MB, Dorrepaal C et al. Efficacy of mirabegron in patients with and without prior antimuscarinic therapy for overactive bladder: a post hoc analysis of a randomized European-Australian Phase 3 trial. BMC Urol 2013;13:45.

    Article  Google Scholar 

  21. Kim HL, Kim JC, Benson DA, Bales GT, Gerber GS. Results of treatment with tamsulosin in men with acute urinary retention. Tech Urol 2001 December;7(4):256–60.

    CAS  PubMed  Google Scholar 

  22. Lucas MG, Bosch RJL, Burkhard FC et al (2012) EAU guidelines on assessment and nonsurgical management of urinary incontinence. Eur Urol 62:1130–1142.

    Article  Google Scholar 

  23. Lucas MG, Stephenson TP, Nargund V. Tamsulosin in the management of patients in acute urinary retention from benign prostatic hyperplasia. BJU Int 2005 February;95(3):354–7.

    Article  CAS  Google Scholar 

  24. Nitti VW, Chapple CR, Walters C, Blauwet MB, Herschorn S, Milsom I et al. Safety and tolerability of the beta3 -adrenoceptor agonist mirabegron, for the treatment of overactive bladder: results of a prospective pooled analysis of three 12-week randomised Phase III trials and of a 1-year randomised Phase III trial. Int J Clin Pract 2014 August;68(8):972–85.

    Article  CAS  Google Scholar 

  25. Nitti VW, Dmochowski R, Herschorn S et al (2013) OnabotulinumtoxinA for the treatment of patients with overactive bladder and urinary incontinence: results of a phase 3, randomized, placebo controlled trial. J Urol 189:2186–2193.

    Article  CAS  Google Scholar 

  26. Nitti VW, Rosenberg S, Mitcheson DH, He W, Fakhoury A, Martin NE. Urodynamics and safety of the beta(3)-adrenoceptor agonist mirabegron in males with lower urinary tract symptoms and bladder outlet obstruction. J Urol 2013 October;190(4):1320–7.

    Article  CAS  Google Scholar 

  27. Nomiya M, Yamaguchi O (2003) A quantitative analysis of mRNA expression of alpha 1 and beta-adrenoceptor subtypes and their functional roles in human normal and obstructed bladders. J Urol 170:649–653.

    Article  CAS  Google Scholar 

  28. Norton PA, Zinner NR, Yalcin I, Bump RC. Duloxetine versus placebo in the treatment of stress urinary incontinence. Am J Obstet Gynecol 2002 July;187(1):40–8.

    Article  CAS  Google Scholar 

  29. Novack GD, Lewis RA, Vogel R, Sheth N, Swearingen D, Rasmussen S et al. Randomized, double-masked, placebo-controlled study to assess the ocular safety of mirabegron in healthy volunteers. J Ocul Pharmacol Ther 2013 September;29(7):674–80.

    Article  CAS  Google Scholar 

  30. Oelke M, Becher K, Castro-Diaz D, Chartier-Kastler E, Kirby M, Wagg A, Wehling M, (2015), Appropriateness of oral drugs for long-term treatment of lower urinary tract symptoms in older persons: results of a systematic literature review and international consensus validation process (LUTS-FORTA 2014) Age Ageing, doi: 10.1093/ageing/afv077.

    Article  Google Scholar 

  31. Patel-Gadhia R, Bhal K, Patil P: Retrospective audit on tolerability and efficacy of duloxetine for stress urinary incontinence, J Obstet Gynaecol 2011;31(3):258–9.

    Article  CAS  Google Scholar 

  32. Resnick N.M., Urinary incontinence in the elderly, Medical Ground Rounds, 1984. 3: p. 281–290.

    Google Scholar 

  33. Seif C, Boy S, Wefer B et al (2008) Botulinumtoxin in der Therapie der überaktiven Blase — ein Überblick. Urologe 47:46–53.

    Article  CAS  Google Scholar 

  34. Staskin D, Kay G, Tannenbaum C et al (2010) Trospium chloride is undetectable in the older human central nervous system. J Am Geriatr Soc 58:1618–1619.

    Article  Google Scholar 

  35. Tufan HA, Gencer B, Kara S, Comez AT, Kurt HA, Alan C. Alterations in Iris Structure and Pupil Size Related to Alpha-1 Adrenergic Receptor Antagonists Use: Implications for Floppy Iris Syndrome. J Ocul Pharmacol Ther 2012 December 5.

  36. van Kerrebroeck P, Abrams P, Lange R, Slack M, Wyndaele JJ, Yalcin I et al. Duloxetine versus placebo in the treatment of European and Canadian women with stress urinary incontinence. BJOG 2004 March;111(3):249–57.

    Article  CAS  Google Scholar 

  37. Vinsnes AG, Helbostad JL, Nyronning S et al (2012) Effect of physical training on urinary incontinence: a randomized parallel group trial in nursing homes. Clin Interv Aging 7:45–50.

    Article  Google Scholar 

  38. Wagg A, Cardozo L, Nitti VW, Castro-Diaz D, Auerbach S, Blauwet MB et al. The efficacy and tolerability of the beta3-adrenoceptor agonist mirabegron for the treatment of symptoms of overactive bladder in older patients. Age Ageing 2014 Sep;43(5): 666–75.

    Article  Google Scholar 

  39. Welz-Barth A: Inkontinenz im Alter, ein soziales und ökonomisches Problem, Urologe 2007;46:363–4.

    Article  CAS  Google Scholar 

  40. Wolff GF, Kuchel GA, Smith PhP. Overactive bladder in the vulnerable elderly, Res Rep Urol 2014: 6; 131–138.

    PubMed  PubMed Central  Google Scholar 

  41. Zeif HJ, Subramonian K. Alpha blockers prior to removal of a catheter for acute urinary retention in adult men. Cochrane Database Syst Rev 2009;(4):CD006744.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Klaus Friedrich Becher MHBA.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Becher, K.F. Harninkontinenz im Alter: Für jede Form die passende Therapie. MMW - Fortschritte der Medizin 161, 37–42 (2019). https://doi.org/10.1007/s15006-019-0130-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15006-019-0130-7

Keywords

Navigation