Abstract:
:As a key area of gynaecology, urogynaecology has undergone impressive changes in the past few years. Together with the high prevalence of functional pelvic floor disorders, modern anaesthesia procedures and the introduction of new, innovative minimally invasive operation techniques have led to a dramatic increase in the number of operations for incontinence and prolapses. The increasingly subtle diagnostic options, such as, e. g., 2D and 3D sonography of the pelvic floor provide unambiguous findings and facilitate decision making. Tension-free vaginal slings in retro-pubic, trans-obturator or single-incision techniques show a high success rate with few complications and have almost completely replaced the more invasive abdominal surgical techniques for the operative management of stress incontinence. Especially for recurrent prolapse the use of alloplastic nets leads to a markedly improved anatomic and functional outcome. In spite of the euphoria about modern operation techniques and novel net materials, in-depth knowledge of pelvic floor anatomy, sufficient surgical experience and unequivocal guideline-conform indications are mandatory for satisfactory treatment outcomes. The afflicted women must be informed in detail about alternative procedures and more emphasis should be placed on conservative therapy. Novel surgical techniques should be monitored by registers or clinical trials. The professional society is called upon to improve the training curricula for pelvic floor surgery. ZUSAMMENFASSUNG:Die Urogynäkologie hat sich als große Säule unseres Faches in den letzten Jahren eindrucksvoll verändert. Bei einer hohen Prävalenz an Beckenboden-Funktionsstörungen ist es durch moderne sichere Anästhesieverfahren und Einführung neuer innovativer minimalinvasiver OP-Verfahren zu einem rasanten Zuwachs an Inkontinenz- und Senkungsoperationen gekommen. Immer subtilere diagnostische Möglichkeiten wie z.B. die 2-D- und 3-D-Beckenbodensonografie erbringen klare Befunde zur besseren Entscheidungsfindung. Spannungsfreie Vaginalschlingen in retropubischer, transobturatorischer oder Single-Incision-Technik zeigen hohe Erfolgsraten bei geringen Komplikationen und haben die invasiveren abdominalen Techniken bei der operativen Behandlung der Belastungsinkontinenz weitestgehend abgelöst. Der Einsatz von alloplastischen Meshes führt gerade beim Rezidivprolaps zu einer deutlichen Verbesserung des anatomischen und funktionellen Outcomes. Bei aller Euphorie über moderne Operationstechniken und neue Netzmaterialien sind die profunde Kenntnis der Beckenbodenanatomie, eine ausreichende operative Expertise und eine klare leitliniengerechte Indikationsstellung unverzichtbar für einen zufriedenstellenden Behandlungserfolg. Betroffene Frauen müssen umfassender auch über alternative Verfahren aufgeklärt werden und der konservativen Therapie muss ein größerer Stellenwert gegeben werden. Neue Operationstechniken sollten durch Studien oder Register überwacht werden. Die Fachgesellschaft ist aufgerufen, die Ausbildung des Beckenbodenchirurgen zu verbessern.
journal_name
Geburtshilfe Frauenheilkdjournal_title
Geburtshilfe und Frauenheilkundeauthors
Naumann G,Kölbl Hdoi
10.1055/s-0031-1298335subject
Has Abstractpub_date
2012-03-01 00:00:00pages
202-210issue
3eissn
0016-5751issn
1438-8804journal_volume
72pub_type
杂志文章abstract::In invasive carcinoma of the cervix stage 1B our investigations showed 19% lymph node metastases (n = 47) which were verified by operation and microscopic examination. In all of these patients no lympographic evidence of metastases was observed. The value of lymphography in stage 1B invasive carcinoma of the cervix is...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-04-01 00:00:00
abstract::Tuberculosis in a case of non-puerperal mastitis is a rare clinical finding. A special case of a 28-year old Thai patient was diagnosed and successfully treated with an antituberculous chemotherapy. The most important diagnostic procedure was the microbiological and histological investigation to enable the diagnosis t...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1023638
更新日期:1993-01-01 00:00:00
abstract::According to a judgement by the German Federal Court of 17 December 1991 the surgeon is legally bound to inform the patient before hand of the risk of a possible homologous blood transfusion during surgery. If the transfusion probability exceeds 5%, this obligation is really relevant, 228 patients with primary breast ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1023526
更新日期:1995-10-01 00:00:00
abstract::In a retrospective study the mode of delivery by 565 pregnant women who had previously undergone Caesarean section, was explored on the basis of their medical records. Particular attention was paid to the problem of PDA. Primary Caesarean section was performed in about 25% of the cases and secondary Caesarean section ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036868
更新日期:1984-03-01 00:00:00
abstract::In a prospective study 265 patients with threatened abortions were divided into 2 groups. One group of 134 patients received treatment with Oestradiol benzoat and hydroxyprogesterone capronat. The other group of 131 patients received no hormonal treatment. Of the group treated with hormones 40.7% of the women had an a...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 临床试验,杂志文章
doi:
更新日期:1977-02-01 00:00:00
abstract::Subcutaneous mastectomy was performed in 335 patients between 1974 and 1982. In 265 of these, original mammographies were available which were analysed retrospectively and compared with the final histological finding of the subcutaneous mastectomy preparation. The rate of newly discovered non-invasive carcinomas in th...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036377
更新日期:1985-09-01 00:00:00
abstract::Introduction: Defects of the levator ani muscle complex could represent a pathophysiological link between vaginal birth trauma and urogynecological symptoms many years later. The aim of our study was to determine the prevalence of levator ani muscle defects using 3D or 4D ultrasound and palpation in urogynecological p...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0034-1396180
更新日期:2015-01-01 00:00:00
abstract::Malignant tumours can be differentiated from the benign ones by their vascular blood supply. We employed three methods to analyse the blood flow: the angiodynograph, the duplex system, and the continuous-wave Doppler method, and measured the blood flow in 151 patients on the preoperative day. Histology revealed a mali...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1023775
更新日期:1992-07-01 00:00:00
abstract::A team of experts from the fields of gynaecology and obstetrics, diabetology, internal medicine, paediatrics and midwifery from Germany, Austria and Switzerland produced a new version of the existing S3 guideline on gestational diabetes. It replaces the recommendations of the German Association for Gynaecology and Obs...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/a-0659-2596
更新日期:2018-12-01 00:00:00
abstract::Clinical reports on successful hormonal treatment of climacteric or menopausal sexual dysfunctions are in contradiction with the lack of oestrous phenomena in humans as well as with the results of double-blind studies finding no objective proof for the alleged hormonal influence. A review of recent studies on the topi...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2007-1023732
更新日期:1993-11-01 00:00:00
abstract::In four cases of one twin pregnancy and three triplet pregnancies, efforts were made to prolong the pregnancy after the death of one foetus between 15th and 26th weeks of gestation. Two patients had a history of spontaneous abortion, three patients had undergone infertility treatment. In a further three cases the memb...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1022944
更新日期:1992-01-01 00:00:00
abstract::The results of 196 cases after operation for cerclage are reported. In 133 patients the operation was performed because of cervical incompetence with opening of the cervical canal without contractions. In 63 patients a prophylactic operation was performed for anamnestic reasons. In the group of cervical incompetence t...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036953
更新日期:1981-09-01 00:00:00
abstract::Contaminants exercise an influence on different levels of reproduction, resulting in disturbances of the cycle, abortion and diverse complications during pregnancy among women, whereas, in the case of men, alterations of the spermiogram have been observed. Numerous unfavourable influences on reproduction are known fro...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2007-1023171
更新日期:1992-09-01 00:00:00
abstract::To evaluate their physical efficiency, 14 healthy untrained women were examined during pregnancy weeks 16-20, 25-29 and 34-38 and 5 to 10 weeks post partum, by spiroergometry at various exercise levels on the bicycle ergometer. Besides the spiroergometric values, circulatory parameters were measured and serum analyses...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036184
更新日期:1986-03-01 00:00:00
abstract::Three million out of 4.5 million foreigners in Germany are from countries, where sickle cell anaemia is found. Today, this disease occurs in Germany with sufficient frequency and this makes it imperative for every physician to be familiar with it. Most of the sickle cell patients today attain the reproductive age. Dur...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1026275
更新日期:1990-06-01 00:00:00
abstract::The influence of electric acupuncture on the sphincter of the femal urethra was checked on 15 patients with stressincontinence without gross anatomic variation recognized by means of simultaneous cystourethrometry. After 30 minutes of electric stimulation through acupuncture-needles, which were placed into the skin of...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 临床试验,杂志文章
doi:
更新日期:1975-09-01 00:00:00
abstract::In 1959 Rauscher and Spurny questioned the advantages of routine lymphadenectomy in radical Wertheim operations compared to selective lymphadenectomies. Our present review disagrees with the above mentioned doubts. Rauscher and Spurny base their results on clinical staging of cancer of the cervix in cases from 1947 to...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1976-06-01 00:00:00
abstract::Marriage according to religious denomination is no longer important because of the philosophical changes in recent times. Reproductive behaviour is no longer dependant on religion for the same reasons. Faith in the naturalness and ordainment by God of the roles of the sexes is no longer prevalent. From 1960--1976 the ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-06-01 00:00:00
abstract::133 patients attending the colposcopy-laser outpatient consultations were examined simultaneously by cytology, colposcopy and punch biopsy. A cone biopsy was taken 25 patients and one patient was hysterectomised later. A comparison between cytology and histology revealed 17.1% false negative smear results. Cytology an...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1022864
更新日期:1994-07-01 00:00:00
abstract::A 65 year old woman, who had vaginal hysterectomy 24 years ago, was admitted to the hospital because of a lower abdominal tumor. When laparotomy was performed a retroperitoneal myoma with a weight of 1,8 kg and 22 cm in diameter was found. ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1037345
更新日期:1980-04-01 00:00:00
abstract::In multiple pregnancy, an intense supervision of the fetal condition is indicated during pregnancy and delivery. With the aid of a recently developed actocardiograph originally described by Maeda, it is possible to monitor the fetal heart rate (FHR) and fetal movements (FM) of twins simultaneously on one tracing by 2 ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1026227
更新日期:1991-11-01 00:00:00
abstract::Seasonal fluctuations in the sex ratio of new borns are investigated. The largest predominance of male deliveries over female deliveries was found to be during the conception months May-June with an almost constant number of deliveries. The highest value was in June. Seasonal maximum of the male to female sex ratio is...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00
abstract::Therapeutic results in advanced cervical cancer have not been showing any progress for more than 30 years. Only by means of systemic therapy does it seem possible, that further treatment results may be obtained similar to those in squamous cell carcinoma of the head and neck. Therefore, between 1985 and 1990 we tried ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1026177
更新日期:1991-06-01 00:00:00
abstract::The special anatomic approach and difficult cell collecting from all parts of the corpus uteri have so far prevented the development of an ideal instrument for an early detection of endometrial adenocarcinoma. During the past 9 years we examined several methods; this is a report of a long-term study on 2,500 smears wi...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036489
更新日期:1985-12-01 00:00:00
abstract::Aim: Nodal status remains one of the most important prognostic factors in breast cancer. The cellular and molecular reasons for the spread of tumor cells to the lymph nodes are not well understood and there are only few predictors in addition to tumor size and multifocality that give an insight into additional mechani...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0032-1328291
更新日期:2013-02-01 00:00:00
abstract::A study of the side effects of epidural anesthesia for painless delivery in 100 patients showed that 90% of the post partum patients were very satisfied with the analgesia and did not consider symptoms post partum to be very debilitating and did not blame the epidural anesthesia for the symptoms. Severe pain in the oc...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 临床试验,杂志文章
doi:10.1055/s-2008-1036870
更新日期:1984-03-01 00:00:00
abstract::As a part of the Central European Study a long-term study of the pubertal development of 687 Hungarian girls was undertaken and the findings compared with those of a cross-sectional study of a group of girls from Münster. In addition to assessment of the breast and pubic hair according to Tanner's classification, the ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1026624
更新日期:1988-11-01 00:00:00
abstract::Relevant correlations between the level of the IQ and the reactions to gynaecological interventions and changes in the female reproductive system were detected. These are important in medical practice. The findings are based on psychometric studies in 400 to 500 women. First: Puberty and menarche are experienced in co...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1978-08-01 00:00:00
abstract::Epidemiological data have demonstrated, that the progestogen component of oral contraceptives is involved in the development of hypertension, ischaemic heart diseases and stroke. It had been suggested, that atherosclerotic lesions due to the unfavourable effect on lipid metabolism of progestogens with androgenic prope...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2007-1026140
更新日期:1992-11-01 00:00:00
abstract::The results of the course of birth in 71 intrauterine cases of foetal death are presented. There were spontaneous deliveries in 82% of the cases and in 4% a vacuum extraction was performed. The relatively high rate (14%) of Caesarean sections was in most cases, due to maternal indication. The introduction of prostagla...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1022962
更新日期:1992-02-01 00:00:00