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Bildgebung bei Harninkontinenz

Imaging for urinary incontinence

  • Leitthema
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Zusammenfassung

Hintergrund

Die nicht-invasiven und strahlungsfreien bildgebenden Verfahren wie Ultraschall und Magnetresonanztomographie (MRT) werden aktuell sowohl für die klinischen als auch wissenschaftlichen Fragestellungen bei Inkontinenz der Frau und des Mannes breit angewendet. Der zunehmende Einsatz und die Verbesserung der Techniken dieser Verfahren sind mit einer raschen Entwicklung der minimal-invasiven Therapiemöglichkeiten der Inkontinenz bei Frau und Mann sowie einem besseren Verständnis des Kontinenzmechanismus eng verbunden. Während die Sonographie eine kostengünstige und gut verfügbare diagnostische Methode für eine routinemäßige Anwendung darstellt, ist die kostspieligere dynamische funktionelle MRT aufgrund einer präziseren Visualisierung der funktionellen Verhältnisse des Beckenbodens neben der anatomisch-räumlichen Darstellung für komplexe diagnostische Zwecke und die Forschung geeignet.

Methodik

Sowohl die Sonographie als auch die dynamische funktionelle MRT sind für die Beurteilung des weiblichen Beckenbodens bereits gut etabliert. Die zunehmende Entwicklung und der Einsatz der perinealen Sonographie und dynamischen funktionellen MRT in den letzten Jahren sind auch in der Evaluation des männlichen Beckenbodens und insbesondere bei Postprostatektomieinkontinenz zu beobachten.

Schlussfolgerung

Die weitere Entwicklung der Sonographie und MRT kann neben den neuen Erkenntnissen des Kontinenzmechanismus die operative Technik der Prostatektomie und minimal-invasiver Therapie der Inkontinenz bei Frau und Mann in Zukunft erheblich verbessern.

Abstract

Background

Ultrasonography and functional cine magnetic resonance imaging (MRI) are noninvasive and x-ray free tools, which are currently widely used in clinical diagnostics and scientific research of male and female urinary incontinence. The increasing use and improving techniques of modern imaging tools are closely linked to rapid development of minimally invasive surgery in patients with urinary incontinence and insights gained in continence mechanisms.

Methods

Whereas ultrasonography is a cost-efficient and readily available diagnostic tool for a routine use, the more expensive functional MRI, as a tool with more precise visualization of functional interactions and spatial representation of anatomical structures of the pelvic floor, is suitable for complex diagnostic purposes and scientific research. Both tools are already well established for evaluations of the female pelvic floor. For evaluation of the male pelvic floor, and in particular postprostatectomy incontinence, perineal ultrasonography and functional cine MRI are becoming increasingly evident.

Conclusion

Further development of both imaging tools will contribute to new insights into the continence mechanism and improve the techniques of radical prostatectomy and minimally invasive surgery of male and female urinary incontinence in the future.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. K. Brocker weist auf Vortragshonorare von Serag Wiessner GmbH&Co KG hin. I. Soljanik, O. Solyanik, C.G. Stief, R. Anding und R. Kirschner-Hermanns geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Neuro-Urologie, Klinik für Paraplegiologie, Department für Orthopädie, Unfallchirurgie und Paraplegiologie, Universität Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Deutschland

    I. Soljanik

  2. Klinik für Gynäkologie und Geburtshilfe, Universität Heidelberg, Heidelberg, Deutschland

    K. Brocker

  3. Institut für diagnostische und interventionelle Neuroradiologie, Medizinische Hochschule Hannover, Hannover, Deutschland

    O. Solyanik

  4. Urologische Klinik und Poliklinik, Klinikum der Universität München-Großhadern, Ludwig-Maximilians-Universität München, München, Deutschland

    C.G. Stief

  5. Neuro-Urologie/Urologische Klinik, Universitätsklinikum Rheinische Friedrich-Wilhelms-Universität, Bonn und Neurologisches Rehabilitationszentrum‚ Godeshöhe e.V., Bonn, Deutschland

    R. Anding & R. Kirschner-Hermanns

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  1. I. Soljanik
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  2. K. Brocker
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Correspondence to I. Soljanik.

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Soljanik, I., Brocker, K., Solyanik, O. et al. Bildgebung bei Harninkontinenz. Urologe 54, 963–971 (2015). https://doi.org/10.1007/s00120-015-3872-6

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