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Frauenheilkunde up2date 2024; 18(02): 149-163
DOI: 10.1055/a-2040-9942
Operative Gynäkologie

Netzchirurgie in der Gynäkologie

Markus Hübner
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Die Verwendung alloplastischer Materialien in der Gynäkologie ist ein kontrovers diskutiertes Thema. Die Einführung des TVT (Tension-free Vaginal Tape) durch Ulf Ulmsten 1996 [1] kann vor allem in den deutschsprachigen Ländern bis heute als Erfolgsgeschichte angesehen werden. Dagegen stellt die vaginale netzunterstützte Deszensuschirurgie nach wie vor eine große Herausforderung dar, die einer differenzierten Auseinandersetzung bedarf.
Kernaussagen

  • Alloplastische Materialien, d. h. „Netze“, haben in der Urogynäkologie ihren festen Stellenwert.

  • Vor allem bei der Therapie der Belastungsharninkontinenz ist das TVT nach wie vor Goldstandard. Alternativen sind bei gleichem Erfolg aufwendiger.

  • Im Bereich der Deszensuschirurgie sollte zwischen vaginalen und endoskopischen Verfahren unterschieden werden.

  • Bei der vaginalen Netzeinlage ist Vorsicht geboten und sie sollte gemäß Leitlinie eher der Rezidivsituation oder einem komplexen Deszensus vorbehalten sein.

  • Die endoskopische Netzeinlage ist dank guter Datenlage als sicher und erfolgreich zu bezeichnen.

  • Essenziell sind die kritische, individuelle Indikationsstellung sowie eine umfassende Aufklärung der Patientinnen.

Schlüsselwörter

alloplastische Materialien - Descensus genitalis - Belastungsharninkontinenz


Publication History

Article published online:
28 March 2024

© 2024. Thieme. All rights reserved.

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