Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Obstetrics and Gynecology Reports
Erschienen in: Current Obstetrics and Gynecology Reports 3/2014

01.09.2014 | Pelvic Organ Prolapse (KL Noblett, Section Editor)

An Evidence-Based Approach to the Evaluation, Diagnostic Assessment, and Treatment of Fecal Incontinence in Women

verfasst von: Isuzu Meyer, Holly E. Richter

Erschienen in: Current Obstetrics and Gynecology Reports | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

Fecal incontinence (FI) is a debilitating disorder that negatively impacts quality of life. The etiology often is multifactorial and although most women with FI are able to be treated, many remain untreated because a significant proportion of women do not report their symptoms and seek care. The evaluation and treatment of FI also can be hindered by a lack of understanding of the mechanisms and current options. This article provides a review of the evidence-based evaluation and management for FI.
Literatur
1.
2.
Markland AD, Richter HE, Burgio KL, et al. Weight loss improves fecal incontinence severity in overweight and obese women with urinary incontinence. Int Urogynecol J. 2011;22(9):1151–7.PubMedCentralPubMedCrossRef
3.
4.
Lawrence JM, Lukacz ES, Nager CW, et al. Prevalence and co-occurrence of pelvic floor disorders in community-dwelling women. Obstet Gynecol. 2008;111:678–85.PubMedCrossRef
5.
Gleason JL, Markland AD, Greer WJ, et al. Anal sphincter repair for fecal incontinence: effect on symptom severity, quality of life, and anal sphincter squeeze pressures. Int Urogynecol J. 2011;22(12):1587–92.PubMedCentralPubMedCrossRef
6.
Varma MG, Brown JS, Creasman JM, et al. Fecal incontinence in females older than aged 40 years: who is at risk? Dis Colon Rectum. 2006;49:841.PubMedCentralPubMedCrossRef
7.
Markland AD, Goode PS, Burgio KL, et al. Incidence and risk factors for fecal incontinence in black and white older adults: a population-based study. J Am Geriatr Soc. 2010;58:1341.PubMedCentralPubMedCrossRef
8.
9.
Brown HW, Wexner SD, Segall MM, et al. Accidental bowel leakage in the mature women’s health study: prevalence and predictors. Int J Clin Pract. 2012;66(11):1101–8.PubMedCrossRef
10.
Landefeld CS, Bowers BJ, Feld AD, et al. National Institutes of Health state-of-the-science conference statement: prevention of fecal and urinary incontinence in adults. Ann Intern Med. 2008;148:449–58.10.PubMedCrossRef
11.
Brown HW, Wexner SD, Segall MM, et al. Quality of life impact in women with accidental bowel leakage. Int J Clin Pract. 2012;66(11):1109–16.PubMedCrossRef
12.
Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4.PubMed
13.
Rao SSC, Patel RS. How useful are manometric tests of anorectal function in the management of defecation disorders. Am J Gasteroenterol. 1997;92:469–75.
14.
Rao SSC. American College of Gastroenterology Practice Parameters Committee. Diagnosis and management of fecal incontinence Am J Gastroenterol. 2004;99:1585–604.CrossRef
15.
Watson NFS, Koshy A, Sagar PM. Anal bulking agents for faecal incontinence. Colorectal Dis. 2012;14(suppl3):29–33.PubMedCrossRef
16.
Thekkinkattil DK, Dunham RJ, O’Herlihy S, et al. Measurement of anal cushions in idiopathic faecal incontinence. Br J Surg. 2009;96:680–4.PubMedCrossRef
17.
Thekkinkattil DK, Lim M, Stojkovic SG, et al. A classification system for faecal incontinence based on anorectal investigations. Br J Surg. 2008;95:222–8.PubMedCrossRef
18.
Stojkovic SG, Lim M, Burke D, et al. Intra-anal collagen injection for the treatment of faecal incontinence. Br J Surg. 2006;93:1514–8.PubMedCrossRef
19.•
Hayden DM, Weiss EG. Fecal incontinence: etiology, evaluation, and treatment. Clin Colon Rectal Surg. 2011;24(1):64–70. This article provides a comprehensive review on current recommendations regarding evaluation and treatment of fecal incontinence from the colorectal surgery prospective.PubMedCentralPubMedCrossRef
20.
21.
Pretlove SJ, Thompson PJ, Toozs-Hobson PM, et al. Does the mode of delivery predispose women to anal incontinence in the first year postpartum? A comparative systematic review BJOG. 2008;115:421.
22.
Nelson RL, Furner SE, Westercamp M, Farquhar C. Cesarean delivery for the prevention of anal incontinence. Cochrane Database Syst Rev 2010;CD006756.
23.
Handa VL, Blomquist JL, Knoepp LR, et al. Pelvic floor disorders 5–10 years after vaginal or cesarean childbirth. Obstet Gynecol. 2011;118:777.PubMedCentralPubMed
24.
MacArthur C, Glazener C, Lancashire R, et al. Exclusive caesarean section delivery and subsequent urinary and faecal incontinence: a 12-year longitudinal study. BJOG. 2011;118:1001.PubMedCrossRef
25.•
Hehir MP, O’Connor HD, Higgins S, et al. Obstetric anal sphincter injury, risk factors and method of delivery - an 8-year analysis across two tertiary referral centers. J Matern Fetal Neonatal Med. 2013;26(15):1514–6. This prospective observational study from 2003 to 2010 compares the incident rates based on potential risk factors for obstetric anal sphincter injury (OASIS) and demonstrates that OASIS remains a significant cause of maternal morbidity.PubMedCrossRef
26.
Baumann P, Hammoud AO, McNeeley SG, et al. Factors associated with anal sphincter laceration in 40,923 primiparous women. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18:985.PubMedCrossRef
27.
Minaglia SM, Ozel B, Gatto NM, et al. Decreased rate of obstetrical anal sphincter laceration is associated with change in obstetric practice. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18:1399.PubMedCrossRef
28.
Sultan AH, Kamm MA, Hudson CN, et al. Third degree obstetric anal sphincter tears: risk factors and outcome of primary repair. BMJ. 1994;308(6933):887.PubMedCentralPubMedCrossRef
29.
Nager CW, Helliwell JP. Episiotomy increases perineal laceration length in primiparous women. Am J Obstet Gynecol. 2001;185:444.PubMedCrossRef
30.
Fenner DE, Genberg B, Brahma P, et al. Fecal and urinary incontinence after vaginal delivery with anal sphincter disruption in an obstetrics unit in the United States. Am J Obstet Gynecol. 2003;189:1543.PubMedCrossRef
31.
Sultan AH, Kamm MA, Hudson CN, et al. Anal sphincter disruption during vaginal delivery. New Engl J Med. 1993;329:1905–11.PubMedCrossRef
32.
Varma A, Gunn J, Gardiner A, et al. Obstetric anal sphincter injury: prospective evaluation of incidence. Dis Colon Rectum. 1999;42:1261–4.PubMedCrossRef
33.
Hannah ME, Whyte H, Hannah WJ, et al. Maternal outcomes at 2 years after planned cesarean section versus planned vaginal birth for breech presentation at term: the international randomized Term Breech Trial. Am J Obstet Gynecol. 2004;191:917.PubMedCrossRef
34.
Cesarean delivery on maternal request. Committee Opinion No 559. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2013;121:904–7
35.
Elfaghi I, Johansson-Ernste B, Rydhstroem H. Rupture of the sphincter ani: the recurrence rate in second delivery. BJOG. 2004;111:1361.PubMedCrossRef
36.
McKenna DS, Ester JB, Fischer JR. Elective cesarean delivery for women with a previous anal sphincter rupture. Am J Obstet Gynecol. 2003;189:1251.PubMedCrossRef
37.
Brink CA, Wells TJ, Sampselle CM, et al. A digital test for pelvic muscle strength in women with urinary incontinence. Nurs Res. 1994;43(6):352–6.PubMedCrossRef
38.
Coller JA. Clinical application of anorectal manometry. Gastroenterol Clin North Am. 1987;16:17.PubMed
39.
Orkin BA, Sinykin SB, Lloyd PC. The digital rectal examination scoring system (DRESS). Dis Colon Rectum. 2010;53:1656.PubMedCrossRef
40.
Felt-Bersma RJ, Klinkenberg-Knol EC, Meuwissen SGM. Investigation of anorectal function. Br J Surg. 1988;75:53–5.PubMedCrossRef
41.
Eckhardt VF, Kanzler G. How reliable is digital examination for the evaluation of anal sphincter tone? Int J Colorectal Dis. 1993;8:95–7.CrossRef
42.
Hill J, Corson RJ, Brandon H, et al. History and examination in the assessment of patients with idiopathic fecal incontinence. Dis Colon Rectum. 1994;37(5):473–7.PubMedCrossRef
43.
Rao SSC. Advances in diagnostic assessment of fecal incontinence and dyssynergic defecation. Gastroenterol Hepatol. 2008;2:323–5.
44.
Zutshi M, Salcedo L, Hammel J, et al. Anal physiologic testing in fecal incontinence: is it of any value? Int J Colorectal Dis. 2010;25(2):277–82.PubMedCrossRef
45.
Wexner SD, Jorge JM. Colorectal physiological tests: use or abuse of technology? Br J Surg. 1994;160:167–74.
46.
Keating JP, Stewart PJ, Eyers AA, et al. Are special investigations of value in the management of patients with fecal incontinence? Dis Colon Rectum. 1997;40:896.PubMedCrossRef
47.•
Costilla VC, Foxx-Orenstein AE, Mayer AP, et al. Office-based management of fecal incontinence. Gastroenterol Hepatol. 2013;9(7):423–33. This article attempts to provide an up-to-date comprehensive review of office-based management of fecal incontinence from the gastroenterology perspective.
48.
Barnett JL, Hasler WL, Camilleri M. American Gastroenterological Association medical position statement on anorectal testing techniques. American Gastroenterological Association Gastroenterology. 1999;116:732.
49.
Remes-Troche JM, Rao SSC. Neurophysiological testing in anorectal disorders. Gastroenterol Hepatol. 2008;2:323–35.
50.
Gurland B, Hull T. Transrectal ultrasound, manometry, and pudendal nerve terminal latency studies in the evaluation of sphincter injuries. Clin Colon Rectal Surg. 2008;21(3):157–66.PubMedCentralPubMedCrossRef
51.
Rao SSC, Sun WM. Current techniques of assessing defecation dynamics. Dig Dis. 1997;15(Suppl1):64–7.PubMedCrossRef
52.
Rao SSC, Hatfield R, Leistikow J, et al. Manometric tests of anorectal function in healthy humans. Am J Gastroenterol. 1999;116:735–60.
53.
Jones MP, Post J, Crowell MD. High-resolution manometry in the evaluation of anorectal disorders: A simultaneous comparison with water-perfused manometry. Am J Gastroenterol. 2007;102:850–5.PubMedCrossRef
54.
Law PJ, Kamm MA, Bartram CI. Anal endosonography in the investigation of faecal incontinence. Br J Surg. 1991;78:312–4.PubMedCrossRef
55.
Bartrum C. Radiological evaluation of anorectal disorders. In: Rao SCC, ed. Disorders of anorectum. Gastroenterol Clin North Am. W.B. Saunders, 2001;30(1):55–76
56.
Williams AB, Bartram CI, Halligan S, et al. Anal sphincter damage after vaginal delivery using three dimensional endosonography. Obstet Gynecol. 2001;97:770–5.PubMedCrossRef
57.
Sentovich SM, Wong WD, Blatchford GJ. Accuracy and reliability of transanal ultrasound for anterior anal sphincter injury. Dis Colon Rectum. 1998;41:1000–4.PubMedCrossRef
58.
Oberwalder M, Thaler K, Baig M, et al. Anal ultrasound and endo sonographic measurements of perineal body thickness: a new evaluation for fecal incontinence in females. Surg Endosc. 2004;18:650–4.PubMedCrossRef
59.
Rose S, Magnotta J, Kim R. Anorectal manometry pressures do not predict the results of endoanal ultrasound in patients with fecal incontinence (abstract). Gastroenterology. 1996;110:747.
60.
Voyvodic F, Rieger N, Skinner S, et al. Endosonographic imaging of anal sphincter injuries: does the size of the tear correlate with the degree of dysfunction? Dis Colon Rectum. 2003;46:735–41.PubMedCrossRef
61.
Dobben AC, Terra MP, Deutekom M, et al. Anal inspection and digital rectal examination compared to anorectal physiology tests and endoanal ultrasonography in evaluating fecal incontinence. Int J Colorectal Dis. 2007;22(7):783–90.PubMedCrossRef
62.•
Abdool Z, Sultan AH, Thakar R. Ultrasound imaging of the anal sphincter complex: a review. Br J Radiol. 2012;85(1015):865–75. The endoanal ultrasound is currently considered the gold standard for evaluating anal sphincter pathology in evaluation of anal incontinence. The article provides a comprehensive review of the different ultrasound modalities in evaluating anal sphincter integrity based on a MEDLINE literature search.PubMedCentralPubMedCrossRef
63.
Remes-Troche JM, Paulson J, Attaluri A, et al. A comprehensive assessment of the efferent motor pathways to the anorectum in humans. Neuorgastroenterol Motil. 2007;19:A330.
64.
65.
Hobday DI, Hobson AR, Sarkar S, et al. Cortical processing of human gut sensation: an evoked potential study. Am J Physiol Gastrointest Liver Physiol. 2002;283:335–9.
66.
Chan YK, Herkes GK, Badcock C, et al. Alterations in cerebral potentials evoked by rectal distension in irritable bowel syndrome. Am J Gastroenterol. 2001;96:2413–7.PubMedCrossRef
67.
Sinhamahaptra P, Saha SP, Chowdhury A, et al. Visceral afferent hypersensitivity in irritable bowel syndrome – evaluation by cerebral evoked potential after rectal stimulation. Am J Gastroenterol. 2001;96:2150–7.
68.
69.
Ehrenpreis ED, Chang D, Eichenwald E. Pharmacotherapy for fecal incontinence: Review. Dis Colon Rectum. 2006;50:641–9.CrossRef
70.
Read M, Read NW, Barber DC, Duthie HL. Effects of loperamide on anal sphincter function in patients complaining of chronic diarrhea with fecal incontinence and urgency. Dig Dis Sci. 1982;27:807.PubMedCrossRef
71.
Omar MI, Alexander CE. Drug treatment for faecal incontinence in adults. Cochrane Database Syst Rev. 2013;6, CD002116.PubMed
72.
Palmer KR, Corbett CL, Holdsworth CD. Double-blind cross-over study comparing loperamide, codeine and diphenoxylate in the treatment of chronic diarrhea. Gastroenterology. 1980;79:1272.PubMed
73.
NICHD Pelvic Floor Disorders Network. Controlling Anal Incontinence by Performing Anal Exercises with Biofeedback or Loperamide (CAPABLe). NCT02008565. Retrieved March 20, 2014, from clinicaltrials.gov.
74.
Cheetham MJ, Kamm MA, Phillips RK. Topical phenylephrine increases anal canal resting pressure in patients with faecal incontinence. Gut. 2001;48:356.PubMedCentralPubMedCrossRef
75.
Byrne CM, Solomon MJ, Young JM, et al. Biofeedback for fecal incontinence: short-term outcomes of 513 consecutive patients and predictors of successful treatment. Dis Colon Rectum. 2007;50:417.PubMedCrossRef
76.
Norton C. Cody, JD. Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults Cochrane Database Syst Rev. 2012;6, CD002111.
77.
Moscovitz I, Rotholtz NA, Baig MK, et al. Overlapping sphincteroplasty: does preservation of the scar influence immediate outcome? Colorectal Dis. 2002;4(4):275–9.PubMedCrossRef
78.•
Glasgow SC, Lowry AC. Long-term outcomes of anal sphincter repair for fecal incontinence: A systematic review. Dis Colon Rectum. 2012;55:482–90. A systematic review of long-term outcomes beyond 5 years of anal sphincter repair for fecal incontinence. Although continence deteriorated over the long-term (no patients remained continence at 10 year followup), patient QOL and satisfaction remained relatively high.PubMedCrossRef
79.
Oom DM, Gosselink MP, Schouten WR. Anterior sphincteroplasty for fecal incontinence: a single center experience in the era of sacral neuromodulation. Dis Colon Rectum. 2009;98:234–8.
80.
Tjandra JJ, Han WR. Goh J, et al. Direct repair vs overlapping sphincter repair: a randomized controlled trail Dis Colon Rectum. 2003;46(7):937–43.
81.
Garcia V, Rogers RG, Kim SS, et al. Primary repair of obstetric anal sphincter laceration: a randomized trial of two surgical techniques. Am J Obstet Gynecol. 2005;192(5):1697.PubMedCrossRef
82.
Farrell SA, Flowerdew G, Gilmour D, et al. Overlapping compared with end-to-end repair of complete third-degree or fourth-degree obstetric tears. Three-year follow-up of a randomized controlled trial Obstet Gynecol. 2012;120(4):803–8.
83.
Khaikin M, Wexner SD. Treatment strategies in obstructed defecation and fecal incontinence. World J Gastroenterol. 2006;12:3168.PubMedCentralPubMed
84.
Matzel KE. Sacral nerve stimulation for faecal incontinence: its role in the treatment algorithm. Colorectal Dis. 2011;13 Suppl 2:10–4.PubMedCrossRef
85.
Al-Sannan B, Banakhar M, Hassouna MM. The role of sacral nerve stimulation in female pelvic floor disorders. Curr Obstet Gynecol Rep. 2013;2:159–68.CrossRef
86.•
Patton V, Wiklendt L, Arkwright JW, et al. The effect of sacral nerve stimulation on distal colonic motility in patients with faecal incontinence. Br J Surg. 2013;100:959–68. This prospective double-blind randomized crossover trail compares distal colonic motility in patients with FI using SNS vs sham. The study suggests that SNS improves continence by modulating colonic motility in patients with urge FI.PubMedCrossRef
87.
Mowatt G, Glazener C, Jarrett M. Sacral nerve stimulation for fecal incontinence and constipation in adults: a short version Cochrane review. Neurourol Urodynam. 2008;27:155–61.CrossRef
88.
Bharucha AE, Rao SSC. An update on anorectal disorders for gastroenterologists. Gastroenterol. 2014;146:37–45.CrossRef
89.•
Wexner SD, Coller JA, Devroede G, et al. Sacral nerve stimulation for fecal incontinence: results of a 120-patient prospective multicenter study. Ann Surg. 2010;251:441–9. This multi-center (16 centers in North America and Australia), prospective trial investigated the safety and efficacy of SNS at 12 months post-implant compared with the baseline. The study reported a high degree of efficacy with a nominal and acceptable rate of morbidity.PubMedCrossRef
90.•
Hull T, Giese C, Wexner SD, et al. Long-term durability of sacral nerve stimulation therapy for chronic fecal incontinence. Dis Colon Rectum. 2013;56:234–45. This multicenter, prospective study included 67 patients to assess the long-term outcome (a minimum of 5 years) of SNS. The study showed the therapeutic effect and improved QOL was maintained > 5 years after SNS.PubMedCrossRef
91.
Chiarioni G, Palsson OS, Asteria CR, et al. Neuromodulation for fecal incontinence: an effective surgical intervention. World J Gastroenterol. 2013;19(41):7048–54.PubMedCentralPubMedCrossRef
92.•
Thin NN, Horrocks EJ, Hotouras A, et al. Systematic review of the clinical effectiveness of Neuromodulation in the treatment of faecal incontinence. Br J Surg. 2013;100:1430–47. This systematic review explored the current evidence on the clinical effectiveness of neuromodulation treatments for FI, including SNS, PTNS, and transcutaneous nerve stimulation(TTNS). The clinical effectiveness of PTNS is shown to be comparable to that of SNS at 12 months. There is currently a paucity of evidence available for the effectiveness of TTNS.PubMedCrossRef
93.•
Hotouras A, Murphy J, Walsh U, et al. Outcome of percutaneous tibial nerve stimulation (PTNS) for fecal incontinence: A prospective cohort study. Ann Surg. 2013;00:1–5. This prospective cohort study of 115 patients investigated the outcome of PTNS for FI. The study showed that PTNS is a well-tolerated treatment with high acceptability, with a sustained improvement with a median follow up of 26 months (up to 42).CrossRef
94.
Marti L. Comparison of Sacral Nerve Modulation and Pudendal Nerve Stimulation in Treatment of Fecal Incontinence. NCT 01069016. Retrieved March 28, 2014, from clinicaltrials.gov.
95.
Graf W, Mellgren A, Matzel KE, et al. Efficacy of dextranomer in stabilized hyaluronic acid for treatment of faecal incontinence: a randomized, sham-controlled trial. Lancet. 2011;377:997–1003.PubMedCrossRef
96.
Maeda Y, Laurberg S, Norton C. Perianal injectable bulking agents as treatment for faecal incontinence in adults. Cochrane Database Syst Rev. 2013;2, CD007959.PubMed
97.
Parisien CJ, Corman ML. The Sicca® procedure for the treatment of fecal incontinence: Definitive therapy or short-term solution. Clin in Colon Rectal Surg. 2005;18(1):371.CrossRef
98.
Takahashi-Monroy T, Morales M, et al. SECCA procedure for the treatment of fecal incontinence: Results of five-year follow-up. Dis Colon Rectum. 2008;51(3):355–9.PubMedCrossRef
99.
National Institute for Health and Clinical Excellence (NICE). Endoscopic radiofrequency therapy of the anal sphincter for faecal incontinence. Interventional Procedure Guidance 393. London, UK: NICE; May 2011. Retrieved March 22, 2014, from http://​www.​nice.​org.​uk
100.
Tan JJ, Chan M, Tjandra JJ. Evolving therapy for fecal incontinence. Dis Colon Rectum. 2007;50:1950.PubMedCrossRef
101.
Frudinger A, Kolle D, Schwaiger W, et al. Muscle-derived cell injection to treat anal incontinence due to obstetric trauma: pilot study with 1 year follow-up. Gut. 2010;59:55–61.PubMedCrossRef
102.
Autologous myoblast intrasphincteric injection for fecal incontinence (MIAS). NCT01523522. Retrieved March 20, 2014, from clinicaltrials.gov.
103.
Deutekom M, Dobben AC. Plugs for containing faecal incontinence. Cochrane Database Syst Rev. 2012;4, CD005086.PubMed
104.
Renew Medical. A study to evaluate the safety, tolerability, and effectiveness of the Renew Insert in treating accidental bowel leakage (REST). NCT01475474. Retrieved March 29, 2014, from clinicaltrials.gov.
105.
Lukacz ES, Segall MM, Wexner SD. A novel, convenient, and safe non surgical approach to the management of accidental bowel leakage. Abstract. American Urogynecologic Society/International Urogynecological Association 2014 Scientific Meeting. Presentation at the July 2014, Washington, DC
106.
Richter HE, Matthews CA, Varma M, et al. Clinical efficacy and safety evaluation of a vaginal bowel control (VBC) device for the treatment of fecal incontinence. Abstract. American Urogynecologic Society/International Urogynecological Association 2014 Scientific Meeting. Presentation at the July 2014, Washington, DC)
Metadaten
Titel
An Evidence-Based Approach to the Evaluation, Diagnostic Assessment, and Treatment of Fecal Incontinence in Women
verfasst von
Isuzu Meyer
Holly E. Richter
Publikationsdatum
01.09.2014
Verlag
Springer US
Erschienen in
Current Obstetrics and Gynecology Reports / Ausgabe 3/2014
Elektronische ISSN: 2161-3303
DOI
https://doi.org/10.1007/s13669-014-0085-8

Weitere Artikel der Ausgabe 3/2014

Current Obstetrics and Gynecology Reports 3/2014 Zur Ausgabe

Management of Uterine Fibroid (I Meinhold-Heerlein, Section Editor)

Update of Conservative Systemic Treatment of Uterine Fibroids

Management of Uterine Fibroid (I Meinhold-Heerlein, Section Editor)

Surgical Treatment of Fibroids

Erratum

Erratum to: Update of Conservative Systemic Treatment of Uterine Fibroids

Pelvic Organ Prolapse (KL Noblett, Section Editor)

Recent Developments in the Non-surgical Management of Pelvic Organ Prolapse

Pelvic Organ Prolapse (KL Noblett, Section Editor)

The Past, Present and Future of POP and Physical Therapy

Management of Uterine Fibroid (I Meinhold-Heerlein, Section Editor)

Etiology, Pathogenesis, and Malignant Potential of Uterine Leiomyoma – A Review

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

23.04.2024 Medikamente in Schwangerschaft und Stillzeit Nachrichten

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

23.04.2024 Depression antepartal oder postpartal Nachrichten

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

22.04.2024 DGIM 2024 Kongressbericht

Durch die Häufung nach der COVID-19-Pandemie sind Infektionen mit dem Respiratorischen Synzytial-Virus (RSV) in den Fokus gerückt. Fachgesellschaften empfehlen eine Impfung inzwischen nicht nur für Säuglinge und Kleinkinder.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen
Bildnachweise