Quo vadis Urogynäkologie 2020 – innovative Behandlungskonzepte von Harninkontinenz und Genitalprolaps

Zusammenfassung

Die aktuelle Behandlung von Harninkontinenz und Genitalprolaps umfasst vielfältige innovative Möglichkeiten konservativer und operativer Therapien. Eine angepasste lokale Estrogenisierung und professionelle Techniken des passiven und aktiven Beckenbodentrainings mit Biofeedback, Rüttelplatte und verschiedenen Vaginaldevices stellen den Behandlungsbeginn bei Beckenbodenfunktionsstörungen dar. Methode der Wahl zur operativen Sanierung der Belastungsinkontinenz ist die Einlage einer suburethralen Schlinge. Die operative Behandlung des Genitalprolaps bietet verschiedene Methoden auf vaginalem oder abdominal/endoskopischem Weg unter Eigengewebsrekonstruktion oder Nutzung von alloplastischem Material. So gelingt eine individuelle optimale Rekonstruktion sowohl bei der jungen Frau mit zumeist postpartalen Schädigungen bis hin zur betagten Patientin in der letzten Lebensphase. Dazu gehört die Einschätzung des gesundheitlichen Zustandes der Patientin und dem bestehenden anästhesiologischen Risikoprofil. Wichtig ist die Ermittlung des realistischen Patientenwunsches nach Erläuterung eines individuellen Konzeptes und Darstellung auch alternativer operativer Möglichkeiten.

Schlüsselwörter

Belastungsinkontinenz - suburethrale Schlinge - Genitaldeszensus - Sakrokolpopexie - vaginale Uterusfixation

• References/Literatur

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