AkupunkturPraxis 2023; 04(03): 124-135
DOI: 10.1055/a-2068-2700
CME-Fortbildung

Harninkontinenz

Uwe Zimmermann

Ein unwillkürlicher Urinverlust ist für die Betroffenen ein großes hygienisches und psychosoziales Problem. Alterungsprozesse und Erkrankungen führen bei beiden Geschlechtern zu Veränderungen der Anatomie und Funktion des unteren Harntrakts und der Beckenbodenstrukturen, in deren Folge eine Harninkontinenz auftreten kann. Dieser Artikel gibt einen Überblick über die häufigsten Störungsmechanismen, welche die Blase und die Funktion des Beckenbodens und des darin eingebetteten Sphinktersystems beeinflussen, sowie, wie diese diagnostiziert und therapiert werden können.



Publication History

Article published online:
17 August 2023

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  • Literatur

  • 1 Shamliyan TA. et al. Male urinary incontinence: prevalence, risk factors, and preventive interventions. Rev Urol 2009; 11: 145-165
  • 2 Markland AD. et al. Prevalence of urinary incontinence in men: results from the national health and nutrition examination survey. J Urol 2010; 184: 1022-1027
  • 3 Langa KM, Fultz NH, Saint S. et al. Informal caregiving time and costs for urinary incontinence in older individuals in the United States. J Am Geriatr Soc 2002; 50: 733-737
  • 4 www.awmf.org/leitlinien
  • 5 https://uroweb.org/guidelines
  • 6 Schultz-Lampel D. Die neue Leitlinie „Harninkontinenz der Frau“. AWMF-Register Nr: 015-091 – Das sollten Sie wissen. Urologie 2023; 62: 141-152
  • 7 Panicker JN. et al. Lower urinary tract dysfunction in the neurological patient: clinical assessment and management. Lancet Neurol 2015; 14: 720
  • 8 Petros PE, Ulmsten UI. An integral theory and its method for the diagnosis and management of female urinary incontinence. Scand J Urol Nephrol Suppl 1993; 153: 1-93
  • 9 Abrams P. et al. The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 2003; 61: 37-49
  • 10 Ingelheim-Sundbergn A. Urinary inkontinence in women, excluding fistulas. Acta Obstes Gynecol Sand 1952; 31: 266
  • 11 Stamey TA. Endoscopic suspension of the vesicle neck for surgically curable urinary incontinence in the female. Monogrf Urol 1981; 2: 65
  • 12 Sutherst J, Brown M, Schawer M. Assessing the severity of urinary incontinence in women by weighing perineal pads. Lancet 1981; 1: 1128-1130
  • 13 Klaskov P, Hald T. Reproducible and reliability of urinary incontinence assessment with a 60 minute test. Scand J Unroll Nephron 1984; 18: 293-298
  • 14 Hahn I, Fall M. Objective quantification of urinary stress incontinence: a short, reproducible, provocative pad-test. Neurourol Urodynam 1991; 10: 475-481
  • 15 www.ics.org/
  • 16 Anding R. Pathophysiologie der männlichen Harninkontinenz. In: Michel M, Thüroff J, Janetschek G et al. Die Urologie. Heidelberg: Springer; 2016
  • 17 Frohme C. Klassifikation und Pathophysiologie der weiblichen Harninkontinenz. In: Michel M, Thüroff J, Janetschek G et al. Die Urologie. Heidelberg: Springer; 2016
  • 18 Avery K, Donovan J, Peters T. et al. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn 2004; 23: 322-330
  • 19 Gaudenz M. Der Inkontinenz-Fragebogen mit einem neuen Urge-Score und Stress-Score. Geburtshilfe Frauenheilkd 1979; 39: 784-792
  • 20 Artibani W, Cerruto MA. The role of imaging in urinary incontinence. BJU Int 2005; 95: 699-703
  • 21 Prasad SR, Menias CO, Narra VR. et al. Cross-sectional imaging of the female urethra: technique and results. Radiographics 2005; 25: 749-761
  • 22 Buyse G, Waldeck K, Verpoorten C. et al. Intravesical oxybutynin for neurogenic bladder dysfunction: less systemic side effects due to reduced first pass metabolism. J Urol 1998; 160: 892-896
  • 23 Nitti VW. et al. Onabotulinumtoxin A for the treatment of patients with overactive bladder and urinary incontinence: results of a phase 3, randomized, placebo controlled trial. J Urol 2013; 189: 2186-2193
  • 24 Nitti VW. et al. Results of a randomized phase III trial of mirabegron in patients with overactive bladder. J Urol 2013; 189: 1388-1395
  • 25 Duloxetine UI Study Group. Millard RJ. et al. Duloxetine vs placebo in the treatment of stress urinary incontinence: a four-continent randomized clinical trial. BJU Int 2004; 93: 311-318
  • 26 Filocamo MT. et al. Pharmacologic treatment in postprostatectomy stress urinary incontinence. Eur Urol 2007; 51: 1559
  • 27 Alan C. et al. Efficacy of Duloxetine in the Early Management of Urinary Continence after Radical Prostatectomy. Curr Urol 2015; 8: 43
  • 28 Berghmans B. et al. Electrical stimulation with non-implanted electrodes for urinary incontinence in men. Cochrane Database Syst Rev 2013; 6: CD001202
  • 29 Shi H, Zhao L, Cui L. et al. A Critical Overview of Systematic Reviews and Meta-Analyses of Acupuncture for Female Stress Urinary Incontinence. Pain Res Manag 2022; 2022: 5887862
  • 30 Imamoglu MA. et al. The comparison of artificial urinary sphincter implantation and endourethral macroplastique injection for the treatment of postprostatectomy incontinence. Eur Urol 2005; 47: 209-213
  • 31 Lightner DJ. et al. Cystoscopic injections of dextranomer hyaluronic acid into proximal urethra for urethral incompetence: efficacy and adverse outcomes. Urology 2010; 75: 1310-1314
  • 32 Ormaechea M. et al. A biocompatible, synthetic, non-biodegradable, easy-to-inject bulking substance. Evaluation of local tissular reaction, localized migration and long-distance migration. Arch Esp Urol 2008; 61: 263-268
  • 33 Tiguert R. et al. Collagen injection in the management of post-radical prostatectomy intrinsic sphincteric deficiency. Neurourol Urodyn 1999; 18: 653-658
  • 34 Hegele A, Varga Z, Hofmann R. et al. Therapie der weiblichen Harninkontinenz. In: Michel M, Thüroff J, Janetschek G et al. Die Urologie. Heidelberg: Springer; 2016
  • 35 Werther M. et al. Stress urinary incontinence after radical prostatectomy: long term effects of endoscopic injection with dextranomer/hylauronic acid copolymer. Neurourol Urodyn 2009; 8 www.ics.org/Abstracts/Publish/47/000643.pdf
  • 36 Kirchin V. et al. Urethral injection therapy for urinary incontinence in women. Cochrane Database of Systematic Reviews 2007; 7
  • 37 Thüroff JW, Hohenfellner M, Schultz-Lampel D. Die Harninkontinenz des Mannes. Faszienzügelplastik zur Therapie der Streßinkontinenz. Aktuelle Urol 1992; 23: 149-157
  • 38 Raz S, McGuire EJ, Ehrlich RM. et al. Fascial sling to correct male neurogenic sphincter incompetence: the McGuire/Raz approach. J Urol 1988; 139: 528-531
  • 39 Zoedler D, Boeminghaus H. On indication and technique of suspension plastic surgery. Z Urol Nephrol 1965; 58: 459-462
  • 40 Schaeffer AJ, Clemens JQ, Ferrari M, Stamey TA. The male bulbourethral sling procedure for post-radical prostatectomy incontinence. J Urol 1998; 159: 1510-1515
  • 41 Delorme E. La bandelette trans-obturatrice: un procédé mini-invasif pour traiter l’incontinence urinaire d’effort de la femme. Prog Urol 2001; 11: 1306-1313
  • 42 Karmakar D, Mostafa A, Abdel-Fattah M. Long-term outcomes of transobturator tapes in women with stress urinary incontinence: E-TOT randomised controlled trial. BJOG 2017; 124: 973-981
  • 43 Nilsson CG, Palva K, Aarnio R. et al. Seventeen years’ follow-up of the tension-free vaginal tape procedure for female stress urinary incontinence. Int Urogynecol J 2013; 24: 1265-1269
  • 44 Svenningsen R, Staff AC, Schiøtz HA. et al. Long-term follow-up of the retropubic tension-free vaginal tape procedure. Int Urogynecol J 2013; 24: 1271-1278
  • 45 Burch JC. Urethrovaginal fixation to Cooper’s ligament for correction of stress incontinence, cystocele, and prolapse. Am J Obstet Gynecol 1961; 81: 281-290
  • 46 Stern JA, Clemens JQ, Tiplitsky SI. et al. Long-term results of the bulbourethral sling procedure. J Urol 2005; 173: 1654-1656
  • 47 EAU Guideline Urinary Incontinence. www.uroweb.org/guideline/urinary-incontinence
  • 48 Rehder P, Gozzi C. Transobturator sling suspension for male urinary incontinence including post-radical prostatectomy. Eur Urol 2007; 52: 860-866
  • 49 Rehder P, Haab F, Cornu JN. et al. Treatment of postprostatectomy male urinary incontinence with the transobturator retroluminal repositioning sling suspension: 3-year follow-up. Eur Urol 2012; 62: 140-145
  • 50 Guimarães M, Oliveira R, Pinto R. et al. Intermediate-term results, up to 4 years, of a bone-anchored male perineal sling for treating male stress urinary incontinence after prostate surgery. BJU Int 2009; 103: 500-504
  • 51 Carmel M, Hage B, Hanna S. et al. Long-term efficacy of the bone-anchored male sling for moderate and severe stress urinary incontinence. BJU Int 2010; 106: 1012-1016
  • 52 Hübner WA, Schlarp OM. Treatment of incontinence after prostatectomy using a new minimally invasive device: adjustable continence therapy. BJU Int 2005; 96: 587-594
  • 53 Dalpiaz O, Knopf HJ, Orth S. et al. Mid-term complications after placement of the male adjustable suburethral sling: a single center experience. J Urol 2011; 186: 604-609
  • 54 Seweryn J, Bauer W, Ponholzer A, Schramek P. Initial experience and results with a new adjustable transobturator male system for the treatment of stress urinary incontinence. J Urol 2012; 187: 956-961
  • 55 Kim SP, Sarmast Z, Daignault S. et al. Long-term durability and functional outcomes among patients with artificial urinary sphincters: a 10-year retrospective review from the University of Michigan. J Urol 2008; 179: 1912-1916
  • 56 Cruz F, Herschorn S, Aliotta P. et al. Efficacy and safety of onabotulinumtoxinA in patients with urinary incontinence due to neurogenic detrusor overactivity: a randomised, double-blind, placebo-controlled trial. Eur Urol 2011; 60: 742-750
  • 57 Ginsberg D, Gousse A, Keppenne V. et al. Phase 3 efficacy and tolerability study of onabotulinumtoxinA for urinary incontinence from neurogenic detrusor overactivity. J Urol 2012; 187: 2131-2139
  • 58 www.verwaltung.awmf.org/leitlinien/detail/ll/043-053.html