Urethrale Funktionsteste: Was bringen sie uns wirklich?

Zusammenfassung

Fragestellung: Urethrale Funktionsteste sind in Form von direkten urethralen Druckmessungen, Leak Point Pressures und neu der urethralen Widerstandsmessung (URP) verfügbar. Ziel der vorliegenden Arbeit ist, eine Literaturübersicht über die verfügbaren Tests sowie eine kritische Bewertung zu geben. Material und Methode: Eine Medline-Suche mit den Suchbegriffen „urethra pressure profile“, „urethra function test“, „leak point pressure“ und „urethral resistance pressure“ wurde von 1975 bis 2004 durchgeführt. Resultate: Die so identifizierten 86 Artikel geben eine Übersicht über die Methodik der Urethradruckprofile mit ihren Varianten MUCP, funktionelle Urethralänge, Depressionskoeffizient, Leak Point Pressures und urethrale Widerstandsmessung. Eine Korrelation mit dem Schweregrad der Inkontinenz konnte nur der urethrale Retroresistenzdruck (URP) geben mit allerdings bis anhin nur schwacher Datenlage. Diskussion: Es gibt bisher keinen urethralen Funktionstest, der eine urethrale Funktionsstörung sicher von anderen Pathomechanismen als Ursache für eine Urininkontinenz abgrenzt. Trotzdem können urethrale Funktionsteste Hinweise auf ein potenziell schlechteres postoperatives Outcome bei hypotoner Urethra geben und sind für wissenschaftliche Studien hilfreich.

Abstract

Introduction: Various urethral function tests are available such as direct urethral pressure measurement, leak point pressure measurement and urethral resistance measurement. Aim of the study was to give an overview and a critical review of the current literature. Method: A medline search was perfomed using the expressions “urethra pressure profile”, “urethra function test”, “leak point pressure“ and “urethral resistance pressure” between 1975 and 2004. Results: 86 articles could be identified giving an overview of direct urethral pressure measurement, functional urethral length, pressure transmission ratio, leak point pressure and urethral resistance measurement. Only URP (urethral retro resistance pressure) correlated with the severity of urodynamic stress incontinence but with one publication only. Discussion: There is no single urethral function test which is capable of distinguishing between urethral dysfunction and other mechanisms. However, urethral function tests are useful to predict postoperative outcome after incontinence procedures in patients with low pressure urethra and in scientific studies.

Schlüsselwörter

Urininkontinenz - Urodynamik - urethrale Funktionsteste

Key words

Urinary in continence - urodynamics - urethral function tests

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