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Descensus genitalis

Genital prolapse

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Die Erkrankungen und Funktionsstörungen des weiblichen Beckenbodens gewinnen aufgrund der demographischen Entwicklung und der steigenden Lebenserwartung der Frau einerseits und aufgrund der Ansprüche an die Erhaltung der Lebensqualität in jedem Alter andererseits stetig an Bedeutung. Die Prävalenz des Descensus genitalis wird in einer schwedischen Studie in einer Subgruppe von Frauen zwischen 20 und 59 Jahren mit 31 % angegeben, die Prävalenz bei Frauen zwischen 50- und 79 Jahren steigt auf bis zu 41 %. Die AGUB (Arbeitsgemeinschaft für Urogynäkologie und plastische Beckenbodenrekonstruktion) hat in den letzten Jahren gemeinsam mit Kollegen aus Österreich und der Schweiz für alle relevanten Erkrankungen des Beckenbodens hochkarätige Leitlinien für den gesamten deutschsprachigen Raum Europas entwickelt. Dargestellt werden die wesentlichen Schritte der Diagnostik sowie die konservative und operative Therapie. Besonders wird dabei auf die unterschiedlichen Zugangswege von vaginal, abdominal und minimal-invasiv per Laparoskopie eingegangen sowie auf die uteruserhaltenden Operationsverfahren. Abschließend erfolgt eine Bewertung der alloplastischen Netzmaterialen im Spiegel der aktuellen Literatur.

Abstract

Diseases and functional disorders of the female pelvic floor are continuously gaining in importance due to the demographic developments with the increasing life expectations of women and the demands on the preservation of the quality of life at all ages. In a Swedish study the prevalence of genital prolapse in a subgroup of women between 20 and 59 years old was given as 31% and the prevalence in women between 50 and 79 years old increased up to 41%. In recent years the German working group for urogynecology and plastic surgical pelvic floor reconstruction (AGUB) together with colleagues from Austria and Switzerland has developed high-quality guidelines for all relevant diseases and for all German-speaking regions in Europe. The principal steps of the diagnostics as well as the conservative and surgical treatment are presented. Special emphasis is placed on the various vaginal, abdominal and minimally invasive access routes by laparoscopy as well as uterus-preserving surgical procedures. Finally, an assessment of alloplastic mesh materials is carried out as reflected in the currently available literature.

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Authors and Affiliations

  1. Frauenklinik, Klinikum Kassel, Mönchebergstr. 41, 34125, Kassel, Deutschland

    T. Dimpfl, A.-K. von Hobe & C. Schiffner

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  1. T. Dimpfl
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  2. A.-K. von Hobe
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  3. C. Schiffner
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Correspondence to T. Dimpfl.

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Interessenkonflikt

T. Dimpfl, A.-K. von Hobe und C. Schiffner geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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T. Dimpfl, Kassel

Teile des Artikels sind entnommen aus: Dimpfl T, Kohlschein B, Schiffner C, Spanknebel B (2017) Therapie des Descensus genitalis. In: Gynäkologe 50:204–212 https://doi.org/10.1007/s00129-016-4005-z.

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Dimpfl, T., von Hobe, AK. & Schiffner, C. Descensus genitalis. Gynäkologe 52, 202–211 (2019). https://doi.org/10.1007/s00129-018-4370-x

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  • DOI: https://doi.org/10.1007/s00129-018-4370-x

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