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Aktuelle Urol 2013; 44(03): 189-195
DOI: 10.1055/s-0033-1337935
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Geriatrische Urologie: Besonderheiten der palliativen Harnblasenlangzeitdrainage im Kontext der „Geriatrischen I’s“

Geriatric Urology: Special Features of Palliative Long-Term Urinary Bladder Drainage in the Context of the Geriatric I’s
A. Wiedemann
1   Urologische Abteilung, Evangelisches Krankenhaus Witten gGmbH
2   Lehrstuhl für Geriatrie der Universität Witten/Herdecke
,
I. Füsgen
2   Lehrstuhl für Geriatrie der Universität Witten/Herdecke
› Author Affiliations
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Publication History

Publication Date:
27 May 2013 (online)

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Zusammenfassung

An der Schnittstelle von Urologie und Geriatrie rückt in der Situation der Palliativversorgung einer Harninkontinenz oder einer Blasenentleerungsstörung der geriatrische Patient mit seinen Besonderheiten in den Mittelpunkt. Einflussfaktoren, die der operativ tätige Urologen berücksichtigen muss, sind hierbei nicht nur das hohe Alter und die damit verbundene Vulnerabilität des geriatrischen Patienten, sondern auch Aspekte wie Patientenwunsch, Vorstellungen der pflegenden Angehörigen und die Geschlechtersituation. In diesem Licht ist die strenge und individuelle Indikationsstellung zu einer palliativen Katheteranlage obligat. Es sollten im Vorfeld alle anderen Behandlungsoptionen ausgelotet werden, bei der Anlage besonders schonende und risikoarme Verfahren wie die SPK-Anlage in Nephrostomie-Technik Anwendung finden und nach der Anlage eines Katheters eine besonders aufmerksame und sorgsame Pflege der Ableitung zur Vermeidung von Komplikationen und Folgekrankheiten verpflichtend sein.

Abstract

In situations at the interface of urology and geriatric medicine the palliative management of geriatric patients with urinary incontinence of voiding dysfunction occupies a central position. Influencing factors that need to be considered by the surgically active urologist are not only the high age and the thus associated vulnerability of the geriatric patient but also other aspects such as the patient’s wishes, the expectations of care-giving relatives and the sexual situation. In this light a strict and individually adapted indication for placing a palliative indwelling catheter is mandatory. First of all, all other treatment options should be explored, for the placement itself particularly sparing and low-risk procedures such as suprapubic catheter placement in nephrostomy technique should be employed. After placement of the catheter special attention must be paid to the hygienic care of the deviation in order to avoid complications and subsequent diseases.

Schlüsselwörter

Harninkontinenz - ältere Patienten - Diabetes - Harnblasenlangzeitdrainage - transurethraler ­Dauer­katheter - suprapubischer Katheter

Key words

urinary incontinence - elderly patients - diabetes - long-term urinary drainage - Foley catheter - suprapubic catheter

Editorial Comment zur Übersicht

 

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