Operative Therapie der weiblichen Harninkontinenz unter Berücksichtigung sexualitätsrelevanter Strukturen

Abstract

An evaluation of surgical treatment modalities for urinary incontinence shows that loop plasties are easy to use and with good short-term results with regard to achievement of urinary continence. However, in the light of reports of serious complications and the lack of long-term results, this indication must be reconsidered. In the framework of prolapse surgery Burch's colposuspension with sarcopexy and, possibly, rectopexy represents the standard therapy. Laparoscopic procedures are currently being evaluated. Experimental concepts such as, for example, tissue engineering for the reconstruction of a damaged sphincter apparatus or the use of hyaluronic acid as a bulking agent are potential procedures for the treatment of stress incontinence that need investigation, especially since these methods will probably not have visible negative impacts of the female patient's sexual function. What we need is an interdisciplinary project like that currently practiced in the German Centre for Pelvic Surgery. Objectives are the preservation and reattainment for female sexuality in the course of operations to achieve urinary continence and other pelvic interventions.