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Erschienen in: Der Gynäkologe 3/2017

06.02.2017 | Botulinumtoxin | Leitthema

Therapie der Dranginkontinenz

verfasst von: Prof. Dr. Ursula Peschers

Erschienen in: Die Gynäkologie | Ausgabe 3/2017

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Zusammenfassung

Die konservative Therapie der nichtneurogenen überaktiven Blase umfasst die Änderung des Trink- und Miktionsverhaltens, die Physiotherapie, die lokale Östrogenisierung und die anticholinerge Medikation. Bei älteren und multimorbiden Patientinnen ist bei der Auswahl der Anticholinergika zu beachten, dass Anticholinergika zu einer kognitiven Beeinträchtigung führen können. Patientinnen mit Deszensus sollte eine Pessartherapie oder eine operative Behandlung angeboten werden. Die Injektion von Botulinumtoxin und die sakrale Neuromodulation erweitern das Behandlungsspektrum bei therapierefraktärer überaktiver Blase.
Literatur
1.
Zurück zum Zitat Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function. Neurourol Urodyn 21(2):167–178CrossRefPubMed Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function. Neurourol Urodyn 21(2):167–178CrossRefPubMed
2.
Zurück zum Zitat Amundsen CL, Richter HE, Menefee SA, Komesu YM, Arya LA, Gregory WT, Myers DL, Zyczynski HM, Vasavada S, Nolen TL, Wallace D, Meikle SF (2016) OnabotulinumtoxinA vs sacral neuromodulation on refractory urgency urinary incontinence in women: a randomized clinical trial. JAMA 316(13):1366–1374CrossRefPubMed Amundsen CL, Richter HE, Menefee SA, Komesu YM, Arya LA, Gregory WT, Myers DL, Zyczynski HM, Vasavada S, Nolen TL, Wallace D, Meikle SF (2016) OnabotulinumtoxinA vs sacral neuromodulation on refractory urgency urinary incontinence in women: a randomized clinical trial. JAMA 316(13):1366–1374CrossRefPubMed
3.
Zurück zum Zitat AWMF Register 015/007 (Leitlinie Stand 2010) Die überaktive Blase. S2K AWMF Register 015/007 (Leitlinie Stand 2010) Die überaktive Blase. S2K
4.
Zurück zum Zitat AWMF Register 015/055 (Leitlinie Stand 2013) Sonographie im Rahmen der urogynäkologisches Diagnostik. S2K AWMF Register 015/055 (Leitlinie Stand 2013) Sonographie im Rahmen der urogynäkologisches Diagnostik. S2K
5.
Zurück zum Zitat de Boer TA, Salvatore S, Cardozo L, Chapple C, Kelleher C, van Kerrebroeck P, Kirby MG, Koelbl H, Espuna-Pons M, Milsom I, Tubaro A, Wagg A, Vierhout ME (2010) Pelvic organ prolapse and overactive bladder. Neurourol Urodyn 29(1):30–39CrossRefPubMed de Boer TA, Salvatore S, Cardozo L, Chapple C, Kelleher C, van Kerrebroeck P, Kirby MG, Koelbl H, Espuna-Pons M, Milsom I, Tubaro A, Wagg A, Vierhout ME (2010) Pelvic organ prolapse and overactive bladder. Neurourol Urodyn 29(1):30–39CrossRefPubMed
6.
Zurück zum Zitat Boustani M, Campbell NL, Munger S, Maidment I, Fox GC (2008) Impact of anticholinergics on the aging brain: a review and practical application. Aging health 4:311–320CrossRef Boustani M, Campbell NL, Munger S, Maidment I, Fox GC (2008) Impact of anticholinergics on the aging brain: a review and practical application. Aging health 4:311–320CrossRef
8.
Zurück zum Zitat Brindley GS, Polkey CE, Rushton DN, Cardozo L (1986) Sacral anterior root stimulators for bladder control in paraplegia: the first 50 cases. J Neurol Neurosurg Psychiatr 49(10):1104–1114CrossRefPubMedPubMedCentral Brindley GS, Polkey CE, Rushton DN, Cardozo L (1986) Sacral anterior root stimulators for bladder control in paraplegia: the first 50 cases. J Neurol Neurosurg Psychiatr 49(10):1104–1114CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Burgio KL, Goode PS, Locher JL, Umlauf MG, Roth DL, Richter HE, Varner RE, Lloyd LK (2002) Behavioral training with and without biofeedback in the treatment of urge incontinence in older women: a randomized controlled trial. JAMA 288(18):2293–2299CrossRefPubMed Burgio KL, Goode PS, Locher JL, Umlauf MG, Roth DL, Richter HE, Varner RE, Lloyd LK (2002) Behavioral training with and without biofeedback in the treatment of urge incontinence in older women: a randomized controlled trial. JAMA 288(18):2293–2299CrossRefPubMed
10.
Zurück zum Zitat Campbell NL, Perkins AJ, Bradt P, Perk S, Wielage RC, Boustani MA, Ng DB (2016) Association of anticholinergic burden with cognitive impairment and health care utilization among a diverse ambulatory older adult population. Pharmacotherapy. doi:10.1002/phar.1843 Campbell NL, Perkins AJ, Bradt P, Perk S, Wielage RC, Boustani MA, Ng DB (2016) Association of anticholinergic burden with cognitive impairment and health care utilization among a diverse ambulatory older adult population. Pharmacotherapy. doi:10.​1002/​phar.​1843
11.
Zurück zum Zitat Chancellor MB, Staskin DR, Kay GG, Sandage BW, Oefelein MG, Tsao JW (2012) Blood-brain barrier permeation and efflux exclusion of anticholinergics used in the treatment of overactive bladder. Drugs Aging 29(4):259–273CrossRefPubMed Chancellor MB, Staskin DR, Kay GG, Sandage BW, Oefelein MG, Tsao JW (2012) Blood-brain barrier permeation and efflux exclusion of anticholinergics used in the treatment of overactive bladder. Drugs Aging 29(4):259–273CrossRefPubMed
12.
Zurück zum Zitat Cody JD, Jacobs ML, Richardson K, Moehrer B, Hextall AK (2012) Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev 17:10 Cody JD, Jacobs ML, Richardson K, Moehrer B, Hextall AK (2012) Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev 17:10
13.
Zurück zum Zitat Coyne KS, Sexton CC, Vats V et al (2011) National community prevalence of overactive bladder in the United States stratified by sex and age. Urology 77:1081CrossRefPubMed Coyne KS, Sexton CC, Vats V et al (2011) National community prevalence of overactive bladder in the United States stratified by sex and age. Urology 77:1081CrossRefPubMed
14.
Zurück zum Zitat Gormley EA, Lightner DJ, Society of Urodynamics, Vasavada SP (2015) Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol 193(5):1572–1580CrossRefPubMed Gormley EA, Lightner DJ, Society of Urodynamics, Vasavada SP (2015) Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol 193(5):1572–1580CrossRefPubMed
15.
Zurück zum Zitat Hay-Smith EJ, Herderschee R, Dumoulin C, Herbison GP (2011) Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev 7:12 Hay-Smith EJ, Herderschee R, Dumoulin C, Herbison GP (2011) Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev 7:12
16.
Zurück zum Zitat Hessdoerfer E, Jundt K, Peschers U (2011) Is a dipstick test sufficient to exclude urinary tract infection in women with overactive bladder? Int Urogynecol J 22(2):229–232CrossRefPubMed Hessdoerfer E, Jundt K, Peschers U (2011) Is a dipstick test sufficient to exclude urinary tract infection in women with overactive bladder? Int Urogynecol J 22(2):229–232CrossRefPubMed
17.
Zurück zum Zitat Milsom I, Coyne KS, Nicholson S, Kvasz M, Chen CI, Wein AJ (2013) Global prevalence and economic burden of urgency urinary incontinence: a systematic review. Eur Urol 65(1):79–95CrossRefPubMed Milsom I, Coyne KS, Nicholson S, Kvasz M, Chen CI, Wein AJ (2013) Global prevalence and economic burden of urgency urinary incontinence: a systematic review. Eur Urol 65(1):79–95CrossRefPubMed
18.
Zurück zum Zitat Miranne JM, Lopes V, Carberry CL, Sung VW (2013) The effect of pelvic organ prolapse severity on improvement in overactive bladder symptoms after pelvic reconstructive surgery. Int Urogynecol J 24(8):1303–1308CrossRefPubMed Miranne JM, Lopes V, Carberry CL, Sung VW (2013) The effect of pelvic organ prolapse severity on improvement in overactive bladder symptoms after pelvic reconstructive surgery. Int Urogynecol J 24(8):1303–1308CrossRefPubMed
19.
Zurück zum Zitat Nashold BS Jr, Friedman H, Grimes J (1981) Electrical stimulation of the conus medullaris to control the bladder in the paraplegic patient. A 10-year review. Appl Neurophysiol 44:225–232PubMed Nashold BS Jr, Friedman H, Grimes J (1981) Electrical stimulation of the conus medullaris to control the bladder in the paraplegic patient. A 10-year review. Appl Neurophysiol 44:225–232PubMed
20.
Zurück zum Zitat Onder G, Carpenter I, Finne-Soveri H, Gindin J, Frijters D, Henrard JC, Nikolaus T, Topinkova E, Tosato M, Liperoti R, Landi F, Bernabei R, SHELTER project (2012) Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study. BMC Health Serv Res 9(12):5CrossRef Onder G, Carpenter I, Finne-Soveri H, Gindin J, Frijters D, Henrard JC, Nikolaus T, Topinkova E, Tosato M, Liperoti R, Landi F, Bernabei R, SHELTER project (2012) Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study. BMC Health Serv Res 9(12):5CrossRef
21.
Zurück zum Zitat Osborn DJ, Kaufman MR, Mock S, Guan MJ, Dmochowski RR, Reynolds WS (2015) Urinary retention rates after intravesical onabotulinumtoxinA injection for idiopathic overactive bladder in clinical practice and predictors of this outcome. Neurourol Urodyn 34(7):675–678CrossRefPubMed Osborn DJ, Kaufman MR, Mock S, Guan MJ, Dmochowski RR, Reynolds WS (2015) Urinary retention rates after intravesical onabotulinumtoxinA injection for idiopathic overactive bladder in clinical practice and predictors of this outcome. Neurourol Urodyn 34(7):675–678CrossRefPubMed
22.
Zurück zum Zitat Peters KM, Killinger KA, Gilleran JP, Bartley J, Wolfert C, Boura JA (2015) Predictors of reoperation after sacral neuromodulation: A single institution evaluation of over 400 patients. Neurourol Urodyn. doi:10.1002/nau.22929 Peters KM, Killinger KA, Gilleran JP, Bartley J, Wolfert C, Boura JA (2015) Predictors of reoperation after sacral neuromodulation: A single institution evaluation of over 400 patients. Neurourol Urodyn. doi:10.​1002/​nau.​22929
23.
Zurück zum Zitat Resnick NM, Perera S, Tadic S, Organist L, Riley MA, Schaefer W, Griffiths D (2013) What predicts and what mediates the response of urge urinary incontinence to biofeedback? Neurourol Urodyn 32(5):408–415CrossRefPubMed Resnick NM, Perera S, Tadic S, Organist L, Riley MA, Schaefer W, Griffiths D (2013) What predicts and what mediates the response of urge urinary incontinence to biofeedback? Neurourol Urodyn 32(5):408–415CrossRefPubMed
24.
Zurück zum Zitat Schurch B, Schmid DM, Stöhrer M (2000) Treatment of neurogenic incontinence with botulinum toxin A. N Engl J Med 342(9):665CrossRefPubMed Schurch B, Schmid DM, Stöhrer M (2000) Treatment of neurogenic incontinence with botulinum toxin A. N Engl J Med 342(9):665CrossRefPubMed
25.
Zurück zum Zitat Siegel S, Noblett K, Mangel J, Griebling TL, Sutherland SE, Bird ET, Comiter C, Culkin D, Bennett J, Zylstra S, Kan F, Thiery E (2016) Three-year follow-up results of a prospective, multicenter study in overactive bladder subjects treated with sacral neuromodulation. Urology 94:57–63CrossRefPubMed Siegel S, Noblett K, Mangel J, Griebling TL, Sutherland SE, Bird ET, Comiter C, Culkin D, Bennett J, Zylstra S, Kan F, Thiery E (2016) Three-year follow-up results of a prospective, multicenter study in overactive bladder subjects treated with sacral neuromodulation. Urology 94:57–63CrossRefPubMed
26.
Zurück zum Zitat Sievert KD, Chapple C, Herschorn S, Joshi M, Zhou J, Nardo C, Nitti VW (2014) OnabotulinumtoxinA 100U provides significant improvements in overactive bladder symptoms in patients with urinary incontinence regardless of the number of anticholinergic therapies used or reason for inadequate management of overactive bladder. Int J Clin Pract 68(10):1246–1256CrossRefPubMedPubMedCentral Sievert KD, Chapple C, Herschorn S, Joshi M, Zhou J, Nardo C, Nitti VW (2014) OnabotulinumtoxinA 100U provides significant improvements in overactive bladder symptoms in patients with urinary incontinence regardless of the number of anticholinergic therapies used or reason for inadequate management of overactive bladder. Int J Clin Pract 68(10):1246–1256CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Spinelli M, Giardiello G, Gerber M, Arduini A, van den Hombergh U, Malaguti S (2003) New sacral neuromodulation lead for percutaneous implantation using local anesthesia: description and first experience. J Urol 170(5):1905–1907CrossRefPubMed Spinelli M, Giardiello G, Gerber M, Arduini A, van den Hombergh U, Malaguti S (2003) New sacral neuromodulation lead for percutaneous implantation using local anesthesia: description and first experience. J Urol 170(5):1905–1907CrossRefPubMed
29.
Zurück zum Zitat Tanagho EA (2012) Neuromodulation and neurostimulation: overview and future potential. Transl Androl Urol 1(1):44–49PubMedPubMedCentral Tanagho EA (2012) Neuromodulation and neurostimulation: overview and future potential. Transl Androl Urol 1(1):44–49PubMedPubMedCentral
30.
Zurück zum Zitat Tanagho EA, Schmidt RA, Orvis BR (1989) Neural stimulation for control of voiding dysfunction: a preliminary report in 22 patients with serious neuropathic voiding disorders. J Urol 142:340–345PubMed Tanagho EA, Schmidt RA, Orvis BR (1989) Neural stimulation for control of voiding dysfunction: a preliminary report in 22 patients with serious neuropathic voiding disorders. J Urol 142:340–345PubMed
31.
Zurück zum Zitat Wagg A, Compion G, Fahey A, Siddiqui E (2012) Persistence with prescribed antimuscarinic therapy for overactive bladder: a UK experience. BJU Int 110(11):1767–1774CrossRefPubMed Wagg A, Compion G, Fahey A, Siddiqui E (2012) Persistence with prescribed antimuscarinic therapy for overactive bladder: a UK experience. BJU Int 110(11):1767–1774CrossRefPubMed
32.
Zurück zum Zitat Warren K, Burden H, Abrams P (2016) Mirabegron in overactive bladder patients: efficacy review and upd, ate on drug safety. Ther Adv Drug Saf 7(5):204–216CrossRefPubMedPubMedCentral Warren K, Burden H, Abrams P (2016) Mirabegron in overactive bladder patients: efficacy review and upd, ate on drug safety. Ther Adv Drug Saf 7(5):204–216CrossRefPubMedPubMedCentral
Metadaten
Titel
Therapie der Dranginkontinenz
verfasst von
Prof. Dr. Ursula Peschers
Publikationsdatum
06.02.2017
Verlag
Springer Medizin
Erschienen in
Die Gynäkologie / Ausgabe 3/2017
Print ISSN: 2731-7102
Elektronische ISSN: 2731-7110
DOI
https://doi.org/10.1007/s00129-017-4031-5

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