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Neurogene Blasenfunktionsstörungen bei Patienten mit Meningomyelozele

S2k-Leitlinie zu Diagnostik und Therapie

Neurogenic bladder function disorders in patients with meningomyelocele

S2k guidelines on diagnostics and therapy

  • Leitlinien der DGU
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Zusammenfassung

Die Behandlung von Kindern und Jugendlichen mit Meningomyelozele hat in den letzten 30 Jahren einen deutlichen Wandel erfahren. Die Etablierung der Pharmakotherapie, des intermittierenden Einmalkatheterismus („clean intermittent catheterization“, CIC) und der Infektionsprophylaxe hat die Prognose der Patienten verbessert und zu neuen therapeutischen Strategien geführt. Die interdisziplinäre Zusammenarbeit von Neonatologen, Neurochirurgen, Neuropädiatern, Kinderurologen, pädiatrischen Nephrologen, Kinderorthopäden und Kinderchirurgen führt zu einer Optimierung der individuellen Therapie. In der vorliegenden Leitlinie werden Definitionen und Klassifikationen, Untersuchungen und Untersuchungszeitpunkte dargestellt und im Einzelnen erläutert. Die konservativen und operativen Therapieoptionen bei neurogener Blasenfunktionsstörung werden erläutert und anhand der aktuellen Literatur diskutiert. Der jeweils kurze Überblick soll für die behandelnden Ärzten eine Hilfe bei der Betreuung dieser Patientengruppe geben und die interdisziplinäre Zusammenarbeit erleichtern.

Abstract

The treatment of children and adolescents with meningomyelocele has experienced a clear change in the last 30 years. The establishment of pharmacotherapy, clean intermittent catheterization (CIC) and infection prophylaxis have improved the prognosis for patients and have led to new therapeutic strategies. The interdisciplinary cooperation between neonatologists, neurosurgeons, pediatric neurologists, pediatric urologists, pediatric nephrologists, pediatric orthopedists and pediatric surgeons leads to optimization of individualized therapy. These guidelines present definitions and classifications, investigations and timing which are described in detail. The conservative and operative therapy options for neurogenic bladder function disorders are described and discussed with reference to the current literature. The brief overview provides in each case assistance for the treating physician in the care of this patient group and facilitates the interdisciplinary cooperation.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. Unter http://www.awmf.org/uploads/tx_szleitlinien/043-047m_S2k_neurogenen_Blasenfunktionsst%C3%B6rungen_mit_Meningomyelocele_2013.pdf sind alle Interessenkonflikte gemäß den Richtlinien der AWMF abzurufen.

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Keines der Mitglieder ist durch seine berufliche oder außerberuflichen Tätigkeiten in der Erstellung der LL wesentlich beeinflusst worden.

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Authors and Affiliations

  1. Arbeitskreis Kinder- und Jugendurologie der deutschen Gesellschaft für Urologie, Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz, Langenbeck Straße 1, 55131, Mainz, Deutschland

    R. Stein, R. Beetz, M. Goepel, D. Rohrmann, I. Rübben, A. Schröder & J.W. Thüroff

  2. Arbeitsgemeinschaft Kinderurologie der Deutschen Gesellschaft für Kinderchirurgie, Mainz, Deutschland

    C. Assion, M. Bürst & B. Ludwikowski

  3. Arbeitsgemeinschaft Spina bifida und Hydrozephalus (ASbH), Hamburg, Deutschland

    R. Cremer, A. Ermert & H. Peters

  4. Arbeitskreis Urologische Funktionsdiagnostik und Urologie der Frau der deutschen Gesellschaft für Urologie, Düsseldorf, Deutschland

    M. Goepel & J. Pannek

  5. Gesellschaft für Neuropädiatrie, Berlin, Deutschland

    T. Michael & R. Trollmann

  6. Gesellschaft für pädiatrische Nephrologie, Bonn, Deutschland

    R. Beetz, R. Cremer & E. Kuwertz-Bröking

  7. Sektion Pädiatrische Neurochirurgie, Deutschen Gesellschaft für Neurochirurgie, Düsseldorf, Deutschland

    W. Wagner

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  1. R. Stein
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  2. C. Assion
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Correspondence to R. Stein.

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Der Artikel stellt eine verkürzte Form der von den oben genannten Gesellschaften erarbeiteten und seit Dezember 2013 bei der AWMF eingestellten S2k-Leitlinie dar.

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Stein, R., Assion, C., Beetz, R. et al. Neurogene Blasenfunktionsstörungen bei Patienten mit Meningomyelozele. Urologe 54, 239–253 (2015). https://doi.org/10.1007/s00120-013-3403-2

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