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Endoskopische versus konventionelle Kolposuspension

  • E. H. Schmidt
  • V. Frank
  • R. L. DeWilde
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Zusammenfassung

Die Stressharninkontinenz ist in der überwiegenden Zahl der Fälle durch Veränderungen der Halte- und Stützstrukturen um Blasenhals und Urethra verursacht. Klinisches Kennzeichen dieser Art von Inkontinenz ist die Hypermobilität der entsprechenden anatomischen Strukturen. Bei plözlichen intraabdominellen Drucksteigerungen übersteigt der Blasen-druck den Harnrörendruck und es kommt zum unwillkürlichen Ab-gang von Urin. Der Urethralverschlussdruck in Ruhe (UVD max.) liegt bei diesen Patientinnen im Normbereich. Bei einer wesentlich kleineren Gruppe von Patientinnen ist primär der Verschlussmechanismus der Harnröhre gestört. Ursachlich sind Denervierung, Fibrosierung und Atrophisierung der Harnröhrenmuskulatur. Der Urethralverschlussdruck in Ruhe ist bei diesen Patientinnen deutlich niedriger als bei altersent-sprechenden gesunden Frauen (<20cm H2O). Die sogenannte funktio-nelle Urethralänge ist meist verkürzt. Die proximale Urethra ist auch in Ruhe trichterformig zur Blase hin geöffnet. Im Gegensatz zur ersten Gruppe kann bei der seltenen „reinen“ Form einer hypotonen Urethra der Blasenhals funktionell anatomisch stabil sein. Mischformen sind je-doch häufig.

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© Springer-Verlag Berlin Heidelberg 2002

Authors and Affiliations

  • E. H. Schmidt
  • V. Frank
  • R. L. DeWilde

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