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Die Urologie

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01.07.2005 | Weiterbildung • Zertifizierte Fortbildung

Fortentwickelte Konzepte zur weiblichen (In-)Kontinenz

Pathophysiologie, Diagnostik und operative Therapie

verfasst von: Dr. B. Liedl, I. Schorsch, C. Stief

Erschienen in: Die Urologie | Ausgabe 7/2005

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Zusammenfassung

Band- bzw. Fasziendefekte, die die Stützfunktion der Vagina beinträchtigen, können nach der Integraltheorie nicht nur Belastungsharninkontinenz, sondern auch Urgency und Blasenentleerungsstörungen verursachen. Im Folgenden werden die anatomischen und pathophysiologischen Grundlagen dieser Funktionsstörungen dargestellt, die durch Ersatz defekter Strukturen nach dem Prinzip „Rekonstruktion der Struktur ermöglicht Wiedererlangung der Funktion“ behandelt werden können. Wesentliche Elemente dieses therapeutischen Algorithmus sind suburethrale Bänder (retropubisch oder transobturatorisch); ferner ein posteriores Band, das durch die Fossa ischiorectales verläuft, den Scheidenabschluss in Höhe der sakrospinalen Ligamente dorsal hält und defekte sakrouterine Bänder ersetzt. Laterale und mediane Defekte bei Zystozele lassen sich durch ein vorderes Netz rekonstruieren, welches am Arcus tendineus fasciae pelvis durch seitliche transobturatorische Zügel fixiert wird. Bänder und Netze aus Polypropylen haben sich bewährt, da sie gut einheilen und durch Narbenbildung ein Neoligament bzw. eine Neofaszie erzeugen und dauerhaften Halt gewähren.

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Titel: Fortentwickelte Konzepte zur weiblichen (In-)Kontinenz
Pathophysiologie, Diagnostik und operative Therapie
verfasst von: Dr. B. Liedl
I. Schorsch
C. Stief
Publikationsdatum: 01.07.2005
Verlag: Springer-Verlag
Erschienen in: Die Urologie / Ausgabe 7/2005
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI: https://doi.org/10.1007/s00120-005-0875-8

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