Evidenzbasierte Medizin in der weiblichen Stressinkontinenzchirurgie

Zusammenfassung

Gerade im letzten Jahrzehnt kam es zu einer rasanten Weiterentwicklung neuer Operationsverfahren zur Behandlung der weiblichen Stressharninkontinenz. In einer Zeit der evidenzbasierten Medizin ist aber die Zahl prospektiv randomisierter Untersuchungen zur Überprüfung dieser Verfahren, vor allem unter dem Einsatz subtiler prä- und postoperativer Untersuchungen, gering. In dieser Übersicht werden bislang erhobene Erfahrungen und Daten verschiedener Operationstechniken zur Behebung der weiblichen Stressharninkontinenz dargestellt und Anforderungen zur noch ausstehenden Überprüfung dieser neuen Methoden erhoben. Heute stellen die Urethraschlingen, insbesondere die TVT-Schlingentechnik, eine echte Innovation in der Inkontinenzchirurgie dar und befinden sich aufgrund der bislang vorhandenen, publizierten Datenlage auf dem besten Weg, als etablierte Behandlungsmaßnahme anerkannt zu werden.

Abstract

In the last decade, a rapidly growing number of novel surgical procedures has been introduced into daily clinical practice to cure female stress urinary incontinence. However, in times of an increasing demand for evidence-based medicine, there is a striking dearth of prospective randomised trials dealing with stress-incontinence surgery, especially using subtle pre- and postoperative evaluation. Experiences and data of various surgical techniques to treat stress incontinence are presented in this review article, as well as the lack of current information for novel methods, essential for routine application, is defined. The recently developed urethral slings, especially TVT (tension-free vaginal tape), represent an important innovation in the field of stress-incontinence surgery, and due to the published data available so far, are on the way of acceptance as an established surgical procedure.

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