Abstract:
:Stress urinary incontinence in women is a common problem in Germany, with approx. 5 million women suffering from incontinence symptoms. These numbers are increasing, due to demographic changes; the suspected numbers are even higher. Prior to treatment, an extended diagnostic approach - including urodynamics and cystoscopy when necessary - is essential for optimal treatment selection.Primary treatment should be conservative, with pelvic floor training as an essential part of a multi-modal treatment concept. If conservative treatment fails, surgery is necessary and an increasing number of women are being treated with sub-urethral slings. The use of classical and well-known reconstructive surgeries - such as colposuspensions - is decreasing. An artificial urinary sphincter is a seldom indication in women, but a feasible option if the patient is physically and manually fit enough. The following article will summarise current diagnostic approaches and treatment options. :Die weibliche Belastungsinkontinenz stellt ein weit verbreitetes Problem dar. So sind in Deutschland etwa 4 – 5 Millionen Frauen davon betroffen. Die Zahl von Patientinnen wird aufgrund der demografischen Entwicklung in Zukunft weiter steigen. Auch muss aufgrund der Tabuisierung des Themas von einer hohen Dunkelziffer an betroffenen Patientinnen ausgegangen werden. Die weibliche Harninkontinenz wird von der International Continence Society (ICS) als jeder unwillkürliche Urinverlust bezeichnet, der objektiv nachweisbar ist und zudem zu sozialer Beeinträchtigung führt.Voraussetzung für eine erfolgreiche Behandlung ist eine gründliche urologische Untersuchung zur Evaluation der Art und der Ursache der Inkontinenz. Hierzu sind neben einer gezielten Anamnese der genauen Art der Inkontinenzsymptome und einer körperlichen Untersuchung des Genitalbereiches ggf. auch weiterführende Ultraschall- und Röntgenuntersuchungen der Blase notwendig. Ebenfalls können zur Evaluation der Blasenfunktion eine urodynamische Untersuchung sowie eine Zystoskopie zur Diagnostik notwendig sein. Die Therapieoptionen der Belastungsinkontinenz beinhalten zuerst konservative Maßnahmen wie eine Gewichtsreduktion und eine physiotherapeutische Beübung des Beckenbodens, weitere Möglichkeiten sind eine Elektrostimulation, Konus- sowie Pessar-Therapien und bei Bedarf eine lokale Östrogenisierung in der Postmenopause oder auch ein medikamentöser Therapieversuch mit Serotonin-Noradrenalin-Rezeptoren-Inhibitor (Duloxetin). Bei Versagen der konservativen Therapieoptionen sollte eine operative Therapie mit den Patientinnen besprochen werden.Neben aufwendigen offen-operativen Verfahren der früheren Jahrzehnte wie der Kolposuspension oder der Faszienzügelplastiken haben sich in den letzten Jahrzehnten zunehmend minimal-invasive Techniken etabliert, die einfach und schnell durchführbar sind sowie wenig belastend für die Patientinnen und die Belastungsinkontinenz zuverlässig und nachhaltig therapieren. Die spannungsfreien, mitturethralen Schlingen können mittlerweile als etablierte und weitverbreitete Techniken in der Behandlung der Belastungsinkontinenz bezeichnet werden. Die Implantation eines artifiziellen Sphinkters hat sich als sichere und verlässliche Methode zur Behandlung der weiblichen Belastungsinkontinenz höheren Grades und unterschiedlicher Ätiologie erwiesen, bleibt aktuell aber Spezialfällen vorbehalten.
journal_name
Aktuelle Uroljournal_title
Aktuelle Urologieauthors
Zugor V,Akbarov I,Karapanos L,Heidenreich Adoi
10.1055/s-0043-121479subject
Has Abstractpub_date
2018-02-01 00:00:00pages
78-82issue
1eissn
0001-7868issn
1438-8820journal_volume
49pub_type
杂志文章,评审abstract:PURPOSE:The optimal treatment options for lower pole stones with a diameter below 15 mm are controversially discussed. Extracorporeal shock wave lithotripsy (ESWL) is non-invasive but is hampered by low stone-free rates and a significant retreatment rate. Flexible ureterorenoscopy (URS) has been demonstrated to have hi...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0029-1224680
更新日期:2009-11-01 00:00:00
abstract::The medical profession is a particular health risk. Internal reasons for this are the common practice of self-diagnosis and self-therapy, presenteeism (work despite illness), and increased risks of addiction and suicide. External reasons include infectious diseases, violence against health professionals, the increasin...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/a-0854-5049
更新日期:2019-04-01 00:00:00
abstract::The treatment of a varicocele in childhood and adolescence is considered very controversial. In the past varicocele was often diagnosed during the medical examination for military purposes, but today varicocele is common in the J1 exam and is found rather frequently. However, we are still lacking evidence-based recomm...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/a-1075-1665
更新日期:2020-04-01 00:00:00
abstract::Testicular and paratesticular cystadenomas arise from an oviduct-like structure, which, morphologically, is almost identical with the ovarian surface epithelium. These are very rare benign tumours of adults. They present as asymptomatic cystic lesions. Bilateral paratesticular cystadenomas are associated with the Von-...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0043-101214
更新日期:2018-06-01 00:00:00
abstract::Between 15 and 20 % of patients diagnosed with renal cell carcinoma suffer from metastatic disease by the time of diagnosis. In addition to systemic therapy, there are various surgical strategies to treat the primary tumour, e. g. cytoreductive nephrectomy (CN) or palliative nephrectomy (PN). In the immunotherapy era,...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/a-0658-0832
更新日期:2018-09-01 00:00:00
abstract:PURPOSE:Hematogenous spread of BCG after intravesical instillation against bladder cancer is rare, but may result in systemic infection and hypersensitivity reaction. We investigated fluoroquinolones and steroids in an animal model to improve the therapeutic options in local and systemic BCG infection. Furthermore, we ...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2004-818541
更新日期:2004-09-01 00:00:00
abstract:PURPOSE:Gap junctions are intercellular contacts important for the synchronization of muscle cell activity through electrical coupling. Since the role of gap junctions for the function of smooth bladder muscle is still a matter of debate, we investigated the occurrence of gap junctions and the gap junctional protein co...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2003-42001
更新日期:2003-09-01 00:00:00
abstract::Pain is a cardinal symptom in 70 % of cancer patients. Even in developed countries, 30 to 80 % of these patients are inadequately treated. The main cause for this lack of care is not pain refractory to treatment but inadequate or incorrect use of analgesic drugs. A sufficient treatment of pain requires knowledge of th...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2004-830208
更新日期:2005-06-01 00:00:00
abstract::The precise identification and detection of bladder tumours is a prerequisite for complete transurethral resection and, thus, the reduction of recurrence. White-light cystoscopy remains the gold standard and has been further improved by the introduction of digital HD techniques. New digital techniques such as narrow-b...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/a-0731-0008
更新日期:2019-02-01 00:00:00
abstract::c-Met plays a significant role in multiple cellular processes. Being encoded by a proto-oncogene, tyrosine kinase supports aggressive tumour behaviour such as tumour invasiveness and formation of metastases. For some subtypes of renal cell carcinoma studies have shown a association between c-Met expression and clinica...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-115401
更新日期:2016-12-01 00:00:00
abstract::A 19-year-old man complaining of anuria for 1 day was presented. A ureteral stent was indwelled 3 months ago for preventing ureteral obstruction and protecting kidney function. Abdominopelvic computed tomography (CT) scan revealed a solitary pelvic ectopic kidney (PEK) and severe hydronephrosis. And the ureteral stent...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/a-1018-1449
更新日期:2020-03-05 00:00:00
abstract:PURPOSE:Germ cell differentiation, DNA synthesis, and apoptosis can be evaluated quantitatively. On the other hand, an interstitial lesion is difficult to examine. We have focused on the quantitative analysis of testicular interstitial fibrosis after vasectomy. MATERIALS AND METHODS:Forty testicular biopsy specimens f...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2003-41612
更新日期:2003-07-01 00:00:00
abstract::Alpha1-receptor blockers (alfuzosin, doxazosin, tamsulosin and terazosin), 5alpha-reductase inhibitors (dutasteride and finasteride) and combinations thereof are used in the drug treatment of benign prostatic syndrome. As before, there is still no evidence supporting the use of plant extracts, the use of anticholinerg...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-2006-944297
更新日期:2006-09-01 00:00:00
abstract::The field of urogynaecology represents an interdisciplinary subspecialty which is dedicated to qualified diagnostics and effective treatment of functional, static, endocrine and urological pelvic floor disorders. Core areas of the surgical uro-gynaecology are pelvic floor reconstruction for the treatment of urinary an...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0031-1271571
更新日期:2011-07-01 00:00:00
abstract::Patients with metastatic renal cell carcinoma have a life-limiting prognosis. Therefore, the aim of therapy is normally palliative care. Nevertheless, substantial achievements have been made in the past years. Cytokines as long-term standard therapy have been more and more replaced by new targeted therapies. Sunitinib...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1363228
更新日期:2014-01-01 00:00:00
abstract:INTRODUCTION:Nephron-sparing surgery (NSS) is mandatory for patients with renal tumors in both kidneys or in a solitary kidney in order to preserve renal function (imperative indication). NSS has also become the gold standard (elective indication) for small unilateral renal tumors (< 4 cm) with a normal contralateral k...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0029-1224649
更新日期:2010-01-01 00:00:00
abstract::The online marketing of physicians must be measured against the same advertising regulations as conventional marketing. In this context, the Medical Professional Code of Conduct, the Medical Products Advertising Act ("Heilmittelwerbegesetz") and the Law against Unfair Competition are particularly relevant. In addition...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/a-0893-6315
更新日期:2019-08-01 00:00:00
abstract:PURPOSE:Throughout the past years, several studies have shown that fluorescence cystoscopy with ALA (5-aminolevulinic acid) improves the detection rate of superficial bladder tumors by approximately 20 % compared to standard white light cystoscopy. These results suggest a reduced rate of residual/recurrent tumors with ...
journal_title:Aktuelle Urologie
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1055/s-2004-818544
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Behavioral interventions are part of the standard therapy for the overactive bladder syndrome although its impact still is unclear. METHODS:A systematic review according to the key words "overactive bladder" and "behavioral therapy" was undertaken. Original studies dealing with adults and with an English ab...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1550037
更新日期:2015-09-01 00:00:00
abstract::Tomatoes are discussed to have an important role in the prevention of and therapy for prostate cancer (PCA). Whether or not they are also useful in the primary and secondary prevention of benign prostate hyperplasia (BPH) is not clear. This review summarises the results of original contributions with a focus on interv...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1077031
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Hydrocephalus as a complication of tuberculous orchiepididymitis is extremely rare. In this reported case, hydrocephalus was the consequence of a disseminated tuberculous process. CASE REPORT:A 28-year-old man was treated for a left-sided orchiepididymitis. He developed the signs of increased intracranial...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2004-830255
更新日期:2006-01-01 00:00:00
abstract::Faced with the dilemma of choosing between the extremes of standard whole gland therapy and active surveillance, those affected by prostate cancer have recently been on the lookout for less invasive alternatives. Particularly the question of whether it would be possible in low risk cancer to treat only the tumour itse...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1396803
更新日期:2015-01-01 00:00:00
abstract:PURPOSE:The range of maximum bladder smooth muscle tension in the published literature varies between 1.3 and 59 N/cm (2) depending on the experimental setup. Based on own animal trials, we attempted to determine bladder wall tension during detrusor contraction in physiological and obstructed voiding and during detruso...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2003-37558
更新日期:2003-01-01 00:00:00
abstract::Abiraterone acetate (in combination with prednisone/prednisolone (abiraterone/P)), enzalutamide or docetaxel may all be used for the first-line treatment of asymptomatic or mildly symptomatic mCRPC. As treatment with docetaxel can result in the emergence of considerable adverse events, the less toxic substances abirat...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/a-1036-1568
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:Testicular trauma can be classified into blunt or penetrating injury. While every case of penetrating trauma is subjected to surgical treatment, the decision between surgery and conservative treatment must be made for each case of blunt injury. Inspection, palpation and duplex sonography may be helpful in ...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2003-40234
更新日期:2003-05-01 00:00:00
abstract::Prostate cancer (PCa) with distant metastasis at diagnosis (M1) is associated with an unfavourable prognosis. Therefore, according to current treatment guidelines, local treatment (radical prostatectomy or irradiation of the prostate gland) is not recommended in men with M1 disease. However, M1 patients inevitably dev...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-113547
更新日期:2016-09-01 00:00:00
abstract:INTRODUCTION: Virtual reality (VR) is an artificially simulated environment permitting interaction. On the other hand, augmented reality (AR) is an enhanced version of reality created by the use of technology to overlay digital information on an image of something being viewed through a device. Both technologies have p...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/a-0759-0029
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVES:We evaluated children with pelvic kidney and their follow-up according to initial renal function and the appearance of concomitant urological pathologies. PATIENTS AND METHODS:In a retrospective analysis of our case notes, we studied 17 children (8 female, 9 male) who had been referred to our department for...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2005-915621
更新日期:2006-07-01 00:00:00
abstract:PURPOSE:In order to assess the efficacy and toxicity of oral estramustine phosphate (EMP) administration, low-dose EMP monotherapy (study 1) and very low-dose EMP therapy with luteinizing hormone-releasing hormone (LH-RH) agonist (study 2) were conducted in previously untreated prostate cancer and long-term outcomes we...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0029-1224657
更新日期:2010-01-01 00:00:00
abstract::Leiomyomas are benign neoplasms arising from smooth muscle cells. We describe the case of a 17-year-old boy admitted with progressive severe obstructive voiding symptoms. Retrograde urethrography showed a bulbous urethral stricture which was resected with primary urethral anastomosis. Histopathological examination con...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2007-993038
更新日期:2008-03-01 00:00:00