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Diagnostik und operative Therapie der Postprostatektomie-Belastungsinkontinenz

Empfehlungen des Arbeitskreises Urologische Funktionsdiagnostik und Urologie der Frau

Diagnosis and surgical treatment of postprostatectomy stress incontinence

Recommendation of the working group Urologische Funktionsdiagnostik und Urologie der Frau

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Zusammenfassung

Für die operative Behandlung der Postprostatektomie-Belastungsinkontinenz stehen heute diverse Therapieoptionen zur Verfügung. Hierzu zählen adjustierbare und funktionelle Schlingensysteme, der künstliche Schließmuskel, „bulking agents“ und Ballonsysteme. Allerdings existiert keine im Alltag praktisch anwendbare Entscheidungshilfe für die gezielte Diagnostik und die nachfolgende Entscheidung zur differenzierten operativen Therapie der männlichen Belastungsinkontinenz. Ziel unserer Arbeit ist es Empfehlungen zu Diagnostik und operativen Therapie der Postprostatektomie-Belastungsinkontinenz zu geben, die im klinischen Alltag bei der Wahl der Therapie eine Unterstützung bieten. Dabei sollte die Auswahl der Methode in erster Linie nach den Kontraindikationen erfolgen. Allerdings zeigen die einzelnen Methoden breite Überschneidungen.

Abstract

Today, for the surgical treatment of postprostatectomy incontinence, several treatment options are available, e.g., adjustable and functional sling systems, artificial sphincter, bulking agents, and balloons. However, no recommendations in terms of specific diagnostic tools and differentiated treatment options for everyday life are available. Our aim is to provide some clinically relevant recommendations for the necessary diagnostic workup and different treatment options of postprostatetectomy incontinence to support clinical decisions in everyday life. Treatment selection should be based on contraindications. However, there is a broad overlap of the various surgical options.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. Bauer: AMS, Urotech [jeweils Beratung, Referententätigkeit, Drittmittel, Promedon (Beratung)], Hübner: Urotech, Promedon, Höfner: Advisory Board Lilly, Advisory Board GlaxoSmithKline, Advisory Board Aristo. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Urologische Klinik und Poliklinik, Klinikum der Universität München – Großhadern, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, München, Deutschland

    R.M. Bauer, C. Hampel, A. Haferkamp, K. Höfner & W. Hübner

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  1. R.M. Bauer
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  2. C. Hampel
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  3. A. Haferkamp
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  4. K. Höfner
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Für den Arbeitskreis „Urologische Funktionsdiagnostik und Urologie der Frau“ der Akademie der Deutschen Gesellschaft für Urologie

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Correspondence to R.M. Bauer.

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Bauer, R., Hampel, C., Haferkamp, A. et al. Diagnostik und operative Therapie der Postprostatektomie-Belastungsinkontinenz. Urologe 53, 847–853 (2014). https://doi.org/10.1007/s00120-014-3531-3

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