Urininkontinenz

Urin- und Stuhlinkontinenz nehmen mit dem Alter zu und reduzieren Alltagskompetenz und Lebensqualität. Sie werden oft nicht erkannt, da die Betroffenen ihre Beschwerden nicht äußern, aber auch wenn die Diagnose gestellt wurde, bleibt die Versorgung oft unzureichend. Zielsetzung des Beitrags ist, Arten der Inkontinenz und deren Behandlungsmöglichkeiten für ein Höchstmaß an Kontinenz entsprechend der etablierten Kontinenz-Profile zu kennen.

Abstract

Prevalence and incidence of both urinary and fecal incontinence increase with age. They reduce everyday competence and quality of life in all age groups. It is often not recognized because those affected do not express their complaints, but even if the diagnosis has been made, therapy and care often remains inadequate. The aim of the article is to know types of incontinence and their treatment options for a maximum of continence according to the established continence profiles. In older, especially multimorbid frail people, urinary incontinence is not primarily to be seen as a symptom of a disease, but as a “geriatric syndrome”. In the interplay of multimorbidity, environmental factors and other contextual factors that can influence each other, this must be taken into account in diagnostics and therapy. Incontinence itself leads to increased immobility, thus to falls in the elderly and to mental impairments.

Schlüsselwörter

Urininkontinenz - überaktive Blase - Therapie - ältere Patienten

Key worsd

urinary incontinence - overactive bladder - therapy - elderly patients

Publikationsverlauf

Artikel online veröffentlicht:
22. Juli 2022

• Literatur

• 1 Welz-Barth A. Inkontinenz im Alter, ein soziales und ökonomisches Problem. Urologe 2007; 46: 363-364
• 2 Goepel M, Hoffmann JA, Piro M. et al. Prevalence and Physician awareness of symptoms of urinary bladder dysfunction. Eur Urol 2002; 41 (03) 234-239
• 3 Diokno AC, Estanol MVC, Ibrahim IA. et al. Prevalence of urinary incontinence in community dwelling men: a cross sectional nationwide epidemiology survey. Int Urol Nephrol 2007; 39 (01) 129-136
• 4 Markland AD, Goode PS, Redden DT. et al. Prevalence of urinary incontinence in men: results from the national health and nutrition examination survey. J Urol 2010; 184 (03) 1022-1027
• 5 Hirasing RA, van Leerdam FJ, Bolk-Bennink L. et al. Enuresis nocturna in adults. Scand J Urol Nephrol 1997; 31 (06) 533-536
• 6 Nelson R, Furner S, Jesudason V. Fecal incontinence in Wisconsin nursing homes: prevalence and associations. Dis Colon Rectum 1998; 41: 1226-1229
• 7 EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2021. ISBN: 978-94-92671-13-4
• 8 Moon S, Chung HS, Kim YJ. et al. The impact of urinary incontinence on falls: A systematic review and meta-analysis. PLoS One 2021; 16 (05) e0251711
• 9 Beele H, Smet S, Van Damme N. et al. Incontinence-Associated Dermatitis: Pathogenesis, Contributing Factors, Prevention and Management Options. Drugs Aging 2018; 35 (01) 1-10
• 10 Hannestad YS, Rortveit G, Daltveit AK. et al. Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. BJOG 2003; 110 (03) 247-254
• 11 Doumouchtsis SK, Loganathan J, Pergialiotis V. The role of obesity on urinary incontinence and anal incontinence in women: a review. BJOG 2022; 129 (01) 162-170
• 12 Ege S. Management der Harninkontinenz in einer geriatrischen Rehabilitationsklinik. Z Gerontol Geriat 2018; 51: 301-313
• 13 Becher K, Oelke M, Grass-Kapanke B. et al. Improving the health care of geriatric patients: management of urinary incontinence: a position paper. Z Gerontol Geriatr 2013; 46 (05) 456-464
• 14 Vinsnes AG, Helbostad JL, Nyronning S. et al. Effect of physical training on urinary incontinence: a randomized parallel group trial in nursing homes. Clin Interv Aging 2012; 7: 45-50
• 15 Sahin N, Yesil H, Gorcan B. The effect of pelvic floor exercises performed with EMG biofeedback or a vaginal cone on incontinence severity, pelvic floor muscle strength, and quality of life in women with stress urinary incontinence: a randomized, 6-month follow-up study. Int Urogynecol J 2022;
• 16 Welk B, McArthur E, Fraser LA. et al. The risk of fall and fracture with the initiation of a prostate-selective α-Antagonist: a population based cohort study. BMJ 2015; 351: h5398
• 17 Agost-González A, Escobio-Prieto I, Pareja-Leal AM. et al. Percutaneous versus Transcutaneous Electrical Stimulation of the Posterior Tibial Nerve in Idiopathic Overactive Bladder Syndrome with Urinary Incontinence in Adults: A Systematic Review. Healthcare (Basel) 2021; 9 (07) 879
• 18 Nitti VW, Rosenberg S, Mitcheson DH. et al. Urodynamics and safety of the beta 3-adrenoceptor agonist mirabegron in males with lower urinary tract symptoms and bladder outlet obstruction. J Urol 2013; 190 (04) 1320-1327
• 19 Khullar V, Amarenco G, Angulo JC. et al. Efficacy and tolerability of mirabegron, a β(3)-adrenoceptor agonist, in patients with overactive bladder: results from a randomised European-Australian phase 3 trial. Eur Urol 2013; 63: 283-295
• 20 DuBeau CE, Kraus SR, Griebling TL. et al. Effect of fesoterodine in vulnerable elderly subjects with urgency incontinence: a double-blind, placebo controlled trial. J Urol 2014; 191: 395-404
• 21 Ancelin ML, Artero S, Portet F. et al. Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. BMJ 2006; 332: 455-459
• 22 Lucas MG, Bosch RJL, Burkhard FC. et al. EAU guidelines on assessment and nonsurgical management of urinary incontinence. Eur Urol 2012; 62: 1130-1142
• 23 Cody JD, Richardson K, Moehrer B. et al. Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev 2012; CD001405
• 24 Butea-Bocu M, Foller S, Gleisner J. et al S2k-Leitlinie Hilfsmittelberatung. AWMF-Registernummer 043-054. Stand: 01.07.2020. Im Internet (Stand: 08.04.2022): https://www.awmf.org/uploads/tx_szleitlinien/043-054l_S2k_Hilfsmittelberatung_2020-10_1.pdf