The investigation and treatment of female pelvic floor dysfunction.

Abstract:

BACKGROUND:25% of all women report involuntary loss of urine, and 7% may require treatment. METHODS:This review is based on a selection of pertinent literature, including guidelines and Cochrane reviews. RESULTS:The assessment of pelvic floor dysfunction in women begins with a basic evaluation that is followed by special diagnostic tests if indicated. The physician taking the clinical history should inquire about the patient's behavior, personality, social and other stressors, and eating and drinking habits, as well as any mental disorders that may be present, including anxiety disorders, depression, somatization disorders, and disorders of adaptation. Conservative treatment consists mainly of lifestyle changes, physiotherapy, and medication. Stress incontinence is most commonly treated with pelvic floor exercises, with a documented success rate of 56.1% vs. 6% without such treatment (relative risk 8.38, 95% confidence interval 3.67-19.07). If incontinence persists, surgery may be indicated ( implantation of suburethral tension-free slings, or colposuspension). Feedback and biofeedback training can be used to treat an overactive bladder. If these techniques and drug therapy are unsuccessful, botulinum toxin injections can be considered. CONCLUSION:Well-validated treatments for pelvic floor dysfunction are available. Psychosomatic factors must be taken into account and can have a major effect on treatment outcomes.

journal_name

Dtsch Arztebl Int

authors

Jundt K,Peschers U,Kentenich H

doi

10.3238/arztebl.2015.0564

subject

Has Abstract

pub_date

2015-08-17 00:00:00

pages

564-74

issue

33-34

issn

1866-0452

pii

arztebl.2015.0564

journal_volume

112

pub_type

杂志文章,评审
  • Inflammatory Bowel Disease.

    abstract:BACKGROUND:Inflammatory bowel diseases are common in Europe, with prevalences as high as 1 in 198 persons (ulcerative colitis) and 1 in 310 persons (Crohn's disease). METHODS:This review is based on pertinent articles retrieved by a search in PubMed and in German and European guidelines and Cochrane reviews of control...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2016.0072

    authors: Wehkamp J,Götz M,Herrlinger K,Steurer W,Stange EF

    更新日期:2016-02-05 00:00:00

  • The Efficacy and Evidence-Based Use of Biologics in Children and Adolescents: Using Monoclonal Antibodies and Fusion Proteins as Treatments.

    abstract:BACKGROUND:Monoclonal antibodies (mAb) and fusion proteins (FP) are increasingly being used in children and adolescents. In this review, we analyze the evidence for their safety and efficacy in the treatment of the most common chronic inflammatory diseases. METHODS:We systematically searched PubMed, AWMF.org, and othe...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2019.0703

    authors: Niehues T,Özgür TT

    更新日期:2019-10-18 00:00:00

  • Intrauterine surgery--choices and limitations.

    abstract:BACKGROUND:The past decade has seen much progress in intrauterine surgery. Randomized trials have documented the benefit of some procedures of this type for the unborn child. METHOD:Selective literature review RESULTS:Randomized trials have demonstrated the benefit of fetoscopic laser coagulation of placental anastom...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2012.0603

    authors: Diemert A,Diehl W,Glosemeyer P,Deprest J,Hecher K

    更新日期:2012-09-01 00:00:00

  • The Association of Climatic Factors with Rates of Surgical Site Infections: 17 Years' Data From Hospital Infection Surveillance.

    abstract:BACKGROUND:Surgical site infections (SSI) are among the most common healthcare- associated infections. The aim of our explorative study was to determine how selected climatic factors are associated with SSI rates. METHODS:SSI rates were calculated for operative procedures included in the surgi- cal site infection surv...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2019.0529

    authors: Aghdassi SJS,Schwab F,Hoffmann P,Gastmeier P

    更新日期:2019-08-05 00:00:00

  • Antipsychotic prescription in children and adolescents: an analysis of data from a German statutory health insurance company from 2005 to 2012.

    abstract:BACKGROUND:Despite sparse documentation of their long-term therapeutic effects and side effects, antipsychotic drugs have come to be prescribed more frequently for children and adolescents in recent years, both in the USA and in Europe. No current data are available about antipsychotic prescriptions for this age group ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2014.0025

    authors: Bachmann CJ,Lempp T,Glaeske G,Hoffmann F

    更新日期:2014-01-17 00:00:00

  • The diagnosis of fetal alcohol syndrome.

    abstract:BACKGROUND:The estimated prevalence of fetal alcohol syndrome (FAS) is 8 for every 1000 live births. FAS has serious, lifelong consequences for the affected children and their families. A variety of professionals deal with persons who have FAS, including pediatricians, general practitioners, neurologists, gynecologists...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2013.0703

    authors: Landgraf MN,Nothacker M,Kopp IB,Heinen F

    更新日期:2013-10-01 00:00:00

  • Exercise as stroke prophylaxis.

    abstract:BACKGROUND:Stroke is the third most common cause of death in industrialized countries, accounting for more than 10% of deaths over age 65. Most strokes are due to arteriosclerosis. Regular physical activity lowers arterial blood pressure and body weight and improves glucose and lipid metabolism, thereby slowing the dev...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztbl.2009.0715

    authors: Reimers CD,Knapp G,Reimers AK

    更新日期:2009-10-01 00:00:00

  • Photodermatoses: diagnosis and treatment.

    abstract:BACKGROUND:Sunlight induces a wide variety of dermatoses. Their differential diagnosis is problematic not only because of similar phenotypes, but also because of confusing nomenclature and classification. METHODS:We selectively reviewed the literature of the past 20 years and describe the modern nosology of photoderma...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0135

    authors: Lehmann P,Schwarz T

    更新日期:2011-03-01 00:00:00

  • Interdisciplinary Risk Management in the Treatment of Multiple Sclerosis.

    abstract:BACKGROUND:Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system. There are at least 150 000 persons with MS in Germany. Recent years have seen the approval of new drugs against. METHODS:This article is based on pertinent literature retrieved by a selective search in PubMed as wel...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2016.0879

    authors: Havla J,Warnke C,Derfuss T,Kappos L,Hartung HP,Hohlfeld R

    更新日期:2016-12-26 00:00:00

  • Aggression and violence against primary care physicians—a nationwide questionnaire survey.

    abstract:BACKGROUND:International studies show that aggressive behavior against primary care physicians is not an uncommon occurrence. There has been no systematic study to date of the nature and frequency of such occurrences in Germany. METHODS:A four-page questionnaire was sent to a nationwide random sample of 1500 primary c...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2015.0159

    authors: Vorderwülbecke F,Feistle M,Mehring M,Schneider A,Linde K

    更新日期:2015-03-06 00:00:00

  • Indicated prevention of schizophrenia.

    abstract:INTRODUCTION:Despite recent advances in their treatment, schizophrenic disorders are still among the diseases that most severely impair patients' quality of life. For this reason, centers for the early recognition of schizophrenic disorders have come into existence worldwide. In these centers, much effort is devoted to...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2008.0532

    authors: Klosterkötter J

    更新日期:2008-07-01 00:00:00

  • Preventing the spread of multidrug-resistant gram-negative pathogens: recommendations of an expert panel of the German Society For Hygiene and Microbiology.

    abstract:BACKGROUND:Infections with multidrug-resistant gram-negative bacteria are hard to treat and cause high morbidity and mortality. The direct transmission of such pathogens is well documented, and measures to protect other patients would seem indicated. Nonetheless, evidence-based recommendations are not yet available bec...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2012.0039

    authors: Mattner F,Bange FC,Meyer E,Seifert H,Wichelhaus TA,Chaberny IF

    更新日期:2012-01-01 00:00:00

  • The Interdisciplinary Diagnosis and Treatment of Intraocular Tumors.

    abstract:BACKGROUND:Recent years have seen major changes in the diagnosis and treatment of solid intraocular tumors, mainly owing to an improved molecular biological understanding of their pathogenesis, new therapeutic approaches for the local treatment of tumors in children, and long-term follow-up observations in clinical tri...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2018.0106

    authors: Bornfeld N,Biewald E,Bauer S,Temming P,Lohmann D,Zeschnigk M

    更新日期:2018-02-16 00:00:00

  • QTc prolongation by psychotropic drugs and the risk of Torsade de Pointes.

    abstract:INTRODUCTION:Many psychotropic drugs can delay cardiac repolarization and thereby prolong the rate-corrected QT interval (QTc). A prolonged QTc often arouses concern in clinical practice, as it can be followed, in rare cases, by the life-threatening polymorphic ventricular tachyarrhythmia called torsade de pointes (TdP...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0687

    authors: Wenzel-Seifert K,Wittmann M,Haen E

    更新日期:2011-10-01 00:00:00

  • Adjuvant therapy for women over age 65 with breast cancer.

    abstract:BACKGROUND:Women over age 65 with breast cancer are often not treated in accordance with current guidelines as far as adjuvant therapy is concerned, because of the lack of adequate scientific evidence. METHODS:This article is based on a selective review of pertinent literature retrieved by a PubMed search, as well as ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0365

    authors: Sautter-Bihl ML,Souchon R,Gerber B

    更新日期:2011-05-01 00:00:00

  • Cardioversion in Non-Valvular Atrial Fibrillation.

    abstract:BACKGROUND:Atrial fibrillation is the most common type of cardiac arrhythmia and is associated with elevated rates of stroke, heart failure, hospital admission, and death. Its prevalence in the overall population is 1.5% to 2%. To convert atrial fibrillation to sinus rhythm, cardioversion is needed. METHODS:This revie...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2015.0856

    authors: Klein HH,Trappe HJ

    更新日期:2015-12-11 00:00:00

  • Visual loss following intraocular gas injection.

    abstract:INTRODUCTION:The range of indications for vitreoretinal surgery has widened in recent years, and intraocular gas application is frequently performed as part of retinal surgery, with the aim of achieving long-acting tamponade. METHODS:Selective literature review. RESULTS:An intraocular gas bubble containing perfluorop...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2008.0108

    authors: Silvanus MT,Moldzio P,Bornfeld N,Peters J

    更新日期:2008-02-01 00:00:00

  • The management of psychiatric emergencies.

    abstract:BACKGROUND:Psychiatric emergencies such as acute psychomotor agitation or suicidality often arise in non-psychiatric settings such as general hospitals, emergency services, or doctors' offices and give rise to stress for all persons involved. They may be life-threatening and must therefore be treated at once. In this a...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0222

    authors: Mavrogiorgou P,Brüne M,Juckel G

    更新日期:2011-04-01 00:00:00

  • The First Aid and Hospital Treatment of Gunshot and Blast Injuries.

    abstract:BACKGROUND:When gunshot and blast injuries affect only a single person, first aid can always be delivered in conformity with the relevant guidelines. In contrast, when there is a dynamic casualty situation affecting many persons, such as after a terrorist attack, treatment may need to be focused on immediately life-thr...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2017.0237

    authors: Franke A,Bieler D,Friemert B,Schwab R,Kollig E,Güsgen C

    更新日期:2017-04-07 00:00:00

  • The Range and Scientific Value of Randomized Trials.

    abstract:BACKGROUND:The randomized, controlled trial (RCT) is the gold standard of scientific evidence for the attribution of clinical effects (benefits and harms) to medical interventions. Many different designs for RCTs have been developed in order to counter legitimate critical objections and to better adapt the trials to th...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2017.0635

    authors: Lange S,Sauerland S,Lauterberg J,Windeler J

    更新日期:2017-09-22 00:00:00

  • The Diagnosis and Treatment of Peripheral Arterial Vascular Disease.

    abstract:BACKGROUND:In peripheral arterial occlusive disease (PAOD), arterial stenosis or occlusion impairs perfusion in the territory of the distal portion of the aorta and the iliac and leg arteries. In Germany, the prevalence of PAOD rises with age, reaching 20% among persons over age 70. METHODS:This guideline was prepared...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,实务指引

    doi:10.3238/arztebl.2016.0729

    authors: Lawall H,Huppert P,Espinola-Klein C,Rümenapf G

    更新日期:2016-10-28 00:00:00

  • Smoking and passive smoking exposure in young people: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS).

    abstract:INTRODUCTION:This study analyzes the prevalence and associated factors for smoking and passive smoking among young people. METHODS:The data are derived from a subsample of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), carried out by the Robert Koch Institute between May 2003 ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2008.0265

    authors: Lampert T

    更新日期:2008-04-01 00:00:00

  • Treatment in a center for geriatric traumatology.

    abstract:BACKGROUND:Although the number of elderly patients with fractures is increasing, there have been only a few studies to date of the efficacy of collaborative treatment by trauma surgeons and geriatricians. METHODS:Data on patients over age 75 with femoral neck, trochanteric, proximal humeral, and pelvic ring fractures ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2015.0113

    authors: Grund S,Roos M,Duchene W,Schuler M

    更新日期:2015-02-13 00:00:00

  • Isolated non-compaction cardiomyopathy.

    abstract:BACKGROUND:Isolated non-compaction cardiomyopathy (NCCM) was first described in 1984. This disorder, a primary genetic cardiomyopathy, is now attracting increased attention. METHOD:The current state of the epidemiology, pathogenesis, pathophysiology, clinical features, diagnosis, treatment, and prognosis of NCCM are d...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2010.0206

    authors: Engberding R,Stöllberger C,Ong P,Yelbuz TM,Gerecke BJ,Breithardt G

    更新日期:2010-03-01 00:00:00

  • Ultrasonographic screening for the detection of abdominal aortic aneurysms.

    abstract:BACKGROUND:The prevalence of abdominal aortic aneurysms (AAA) with a maximal diameter of 3 cm or more is age-dependent; among persons over age 65, it lies between 4% and 8% in men and between 0.5% and 1.5% in women. About 10% of all AAAs have a maximum diameter of 5 cm or more. The prognosis of ruptured AAA (rAAA) is d...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2009.0657

    authors: Eckstein HH,Böckler D,Flessenkämper I,Schmitz-Rixen T,Debus S,Lang W

    更新日期:2009-10-01 00:00:00

  • Diagnostics of cerebral gliomas with radiolabeled amino acids.

    abstract:INTRODUCTION:Magnetic resonance tomography (MRT) is the investigation of choice for diagnosing cerebral glioma, but its capacity to differentiate tumor tissue from non-specific tissue changes is limited. Positron emission tomography (PET) and single photon emission computerized tomography (SPECT) using radiolabeled ami...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2008.0055

    authors: Langen KJ,Tatsch K,Grosu AL,Jacobs AH,Weckesser M,Sabri O

    更新日期:2008-01-01 00:00:00

  • Patient safety and error management: what causes adverse events and how can they be prevented?

    abstract:BACKGROUND:Even in industrialized countries, health care is not as safe as it should be. The term "patient safety" denotes the non-occurrence of adverse events and the presence of measures to prevent them. METHODS:The literature was selectively reviewed to obtain information on the epidemiology and causes of preventab...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2010.0092

    authors: Hoffmann B,Rohe J

    更新日期:2010-02-01 00:00:00

  • Rehabilitation in Patients With Coronary Heart Disease: Participation and Its Effect on Prognosis.

    abstract:BACKGROUND:In Germany, rehabilitation is considered to be indicated after an acute hospital stay for the treatment of a severe cardiac condition. In comparative studies, at least 51% of German hospital patients with coronary heart disease (CHD) who were entitled to rehabilitative measures actually took part n rehabilit...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2015.0527

    authors: Schlitt A,Wischmann P,Wienke A,Hoepfner F,Noack F,Silber RE,Werdan K

    更新日期:2015-08-03 00:00:00

  • Ovarian cancer: diagnosis and treatment.

    abstract:BACKGROUND:Patients with ovarian cancer usually present to a family physician with nonspecific symptoms, most often abdominal pain. The outcome depends above all on the stage of the disease when it is diagnosed and on the quality of treatment. METHODS:This article is based on a review of selected publications from 200...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0635

    authors: Burges A,Schmalfeldt B

    更新日期:2011-09-01 00:00:00

  • The impact of arterial hypertension on polytrauma and traumatic brain injury.

    abstract:BACKGROUND:Pre-hospital hypotension in trauma patients is associated with high mortality. Especially for patients with severe traumatic brain injury (TBI), arterial normotension or even hypertension (AHT) is considered an important mechanism for sustaining adequate cerebral perfusion pressure. The effect of pre-hospita...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2012.0849

    authors: Sellmann T,Miersch D,Kienbaum P,Flohé S,Schneppendahl J,Lefering R,DGU Trauma Registry.

    更新日期:2012-12-01 00:00:00