[Urinary incontinence and urodynamics]

Urologe A. 2006 Sep:45 Suppl 4:106-21. doi: 10.1007/s00120-006-1192-6.
[Article in German]

Abstract

Incontinence can be the result of impaired functioning of the detrusor muscle and/or the sphincter mechanism. For this reason, the pathomorphology and the pathophysiology should be documented before surgery, so that if it is not successful it is possible to deduce what alterations have been caused by an operation and the reason why the treatment has not been successful. Vaginal reconstruction of the pelvic floor following vaginal prolapse is a safe, effective surgical procedure, particularly for older women. Abdominal fixation of the vaginal stump through open or laparoscopic sacrocolpopexy gives long-lasting and anatomically favourable results especially for younger women who are sexually active, but is associated with a higher mortality rate. Incontinence treatment in men is itself gradually becoming accepted as a subspecialty. Pharmacological treatment that is used for urge incontinence takes the form of substances that relax or desensitize the detrusor (antimuscarinics, oestrogens, alpha-blockers, beta-mimetics, botulinum toxin A, resiniferatoxin, vinpocetin), while stress incontinence requires stimulation of the sphincter and pelvic floor (alpha-mimetics, oestrogens, duloxetin). Bladder function disturbances in children can be classified by noninvasive methods, but the therapy remains a difficult endurance test for the children, their parents and the doctor, often extending over years.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Adult
  • Aged
  • Animals
  • Botulinum Toxins, Type A / therapeutic use
  • Child
  • Disease Models, Animal
  • Estrogen Replacement Therapy
  • Female
  • Humans
  • Male
  • Medication Adherence
  • Muscarinic Antagonists / therapeutic use
  • Treatment Outcome
  • Urinary Incontinence / classification
  • Urinary Incontinence / drug therapy
  • Urinary Incontinence / physiopathology*
  • Urinary Incontinence / surgery*
  • Urodynamics / drug effects
  • Urodynamics / physiology*

Substances

  • Muscarinic Antagonists
  • Botulinum Toxins, Type A