Pathophysiologie der männlichen Harninkontinenz

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Zusammenfassung

Die Inkontinenz des Mannes wird vor allem durch eine Schädigung des Sphinktermechanismus im Rahmen von Behandlungen der Prostata verursacht. Die Prävalenz hängt stark von der Definition der Inkontinenz und der Methodik der Studien ab, zumeist werden 1–25 % genannt. Nach Operationen tritt die Inkontinenz sofort auf, nach Strahlentherapie typischerweise verzögert. Die Inkontinenzrate nach radikaler Prostatektomie ist bei allen Methoden ähnlich. Prostatachirurgie destabilisiert die anatomischen Strukturen, die den urethralen Sphinkter in seiner Lage im Beckenboden halten und seine Funktion gewährleisten. Insbesondere nach der radikalen Prostatektomie findet ein „männlicher Descensus“ statt. Verschiedene operative Techniken wie die Rocco-Naht oder Zügelplastiken zur Unterstützung der Anastomose sollen dem vorbeugen. Nach einer Strahlentherapie kann die Elastizität der Harnröhre und die muskuläre Funktion vermindert sein, was einen konzentrischen Verschluss der membranösen Harnröhre verhindert.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Universitätsklinikum BonnNeurourologieBonnDeutschland

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