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Aktuelle Urol 2021; 52(03): 237-244
DOI: 10.1055/a-1492-5287
Übersicht

Diagnostik der weiblichen Harninkontinenz: Dos and Dontʼs

Diagnostic testing of female urinary incontinence: dos and dontʼs
Anke K. Jaekel
Universitätsklinikum Bonn, Klinik und Poliklinik für Urologie und Kinderurologie, Abteilung Neuro-Urologie, Bonn
,
Ruth Kirschner-Hermanns
Universitätsklinikum Bonn, Klinik und Poliklinik für Urologie und Kinderurologie, Abteilung Neuro-Urologie, Bonn
,
Stephanie C. Knüpfer
Universitätsklinikum Bonn, Klinik und Poliklinik für Urologie und Kinderurologie, Abteilung Neuro-Urologie, Bonn
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Zusammenfassung

Die Harninkontinenz schränkt die physische und psychische Gesundheit sowie die Lebensqualität der Betroffenen stark ein. Sie stellt eine weitverbreitete chronische Erkrankung dar, aktuell sind über 200 Mio. Menschen weltweit betroffen. Frauen sind deutlich häufiger harninkontinent als Männer. Es existieren derzeit eine Vielzahl an konservativen und operativen Therapiemaßnahmen zur Behandlung der weiblichen Harninkontinenz. Zum effektiven und erfolgreichen Einsatz dieser Maßnahmen ist die umfassende Diagnostik der zugrundeliegenden anatomischen und funktionellen Veränderungen unerlässlich. Die vorliegende Arbeit stellt die diagnostischen Möglichkeiten der weiblichen Harninkontinenz von der nicht-invasiven bis hin zur invasiven Untersuchung vor. Es werden mögliche Fallstricke und Verbesserungsmöglichkeiten der einzelnen Verfahren beschrieben.

Abstract

Urinary incontinence causes significant limitations in quality of life and reduces mental and physical health. It is a widespread and chronic disease. About 200 million people are affected by urinary incontinence worldwide. Females are more often affected than males. For the therapy of female urinary incontinence various conservative and surgical treatment measures are available. A comprehensive diagnostic work-up is crucial for effective and successful use of those therapeutical measures. The current paper gives a review of diagnostic options for female urinary incontinence: from non-invasive up to invasive investigations. It presents potential pitfalls and possibilities for improving the diagnostic work-up.

Schlüsselwörter

weibliche Harninkontinenz - Urogynäkologie - Diagnostik

Keywords

female urinary incontinence - Urogynecology - diagnostics


Publication History

Article published online:
21 May 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Referenzen

  • 1 Milsom I. et al. Effect of bothersome overactive bladder symptoms on health-related quality of life, anxiety, depression, and treatment seeking in the United States: results from EpiLUTS. Urology 2012; 80: 90
    CrossrefPubMedGoogle Scholar
  • 2 Felde G. et al. Anxiety and depression associated with urinary incontinence. A 10-year follow-up study from the Norwegian HUNT study (EPINCONT). Neurourol Urodyn 2017; 36: 322
    CrossrefPubMedGoogle Scholar
  • 3 Coyne KS. et al. The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study. BJU Int 2009; 104: 352
    CrossrefPubMedGoogle Scholar
  • 4 Barakat B, Franke K, Schakaki S. et al. Stem cell applications in regenerative medicine for stress urinary incontinence: A review of effectiveness based on clinical trials. Arab J Urol 2020; 194-205 DOI: 10.1080/2090598X.2020.1750864.
    CrossrefPubMedGoogle Scholar
  • 5 Abrams P, Cardozo L, Fall M. et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 2003; 61: 37-49
    CrossrefPubMedGoogle Scholar
  • 6 Coyne KS, Wein AJ, Tubaro A. et al. The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS. BJU Int 2009; 103 Suppl 3: 4-11 DOI: 10.1111/j.1464-410X.2009.08371.x.
    CrossrefPubMedGoogle Scholar
  • 7 Irwin DE, Milsom I, Kopp Z. et al. Impact of overactive bladder symptoms on employment, social interactions and emotional well-being in six European countries. BJU Int 2006; 97: 96-100 DOI: 10.1111/j.1464-410X.2005.05889.x.
    CrossrefPubMedGoogle Scholar
  • 8 Klotz T, Brüggenjürgen B, Burkart M. et al. The economic costs of overactive bladder in Germany. Eur Urol 2007; 51: 1654-62 discussion 1662-3 DOI: 10.1016/j.eururo.2006.11.040.
    CrossrefPubMedGoogle Scholar
  • 9 Ganz ML, Smalarz AM, Krupski TL. et al. Economic costs of overactive bladder in the United States. Urology 2010; 75: 526-532.e1 DOI: 10.1016/j.urology.2009.06.096.
    CrossrefPubMedGoogle Scholar
  • 10 Beutel ME, Hessel A, Schwarz R. et al. Prävalenz der Urininkontinenz in der deutschen Bevölkerung. Komorbidität, Lebensqualität, Einflussgrössen. Urologe A 2005; 44: 232-238 DOI: 10.1007/s00120-005-0791-y.
    CrossrefPubMedGoogle Scholar
  • 11 Hunskaar S, lose G, Sykes D. et al. The prevalence of urinary incontince in women in four european contries. BJU international 2004; 93: 324-330
    CrossrefPubMedGoogle Scholar
  • 12 Schreiber Pedersen L, Lose G, Høybye MT. et al. Prevalence of urinary incontinence among women and analysis of potential risk factors in Germany and Denmark. Acta Obstet Gynecol Scand 2017; 939-948 DOI: 10.1111/aogs.13149.
    CrossrefPubMedGoogle Scholar
  • 13 Kirschner-Hermanns R, Anding R, Wiedemann A. Urologie. Willkomm M. Praktische Geriatrie. Klinik - Diagnostik - Interdisziplinäre Therapie. Stuttgart, New York : Georg Thieme Verlag; 2017. 2. 451-465
    Google Scholar
  • 14 Nambiar AK, Lemack GE, Chapple CR. et al. European Association of Urology. The Role of Urodynamics in the Evaluation of Urinary Incontinence: The European Association of Urology Recommendations in 2016. Eur Urol 2017; 71: 501-503
    CrossrefPubMedGoogle Scholar
  • 15 Gormley EA, Lightner DJ, Burgio KL. et al. American Urological Association; Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. J Urol 2012; 188: 2455-2463 DOI: 10.1016/j.juro.2012.09.079.
    CrossrefPubMedGoogle Scholar
  • 16 EAU Guidelines on management of non-neurogenic female lower urinary tract symptoms (LUTS). https://uroweb.org/guideline/non-neurogenic-female-luts
    PubMedGoogle Scholar
  • 17 Blok B. et al. EAU Guidelines on Neuro-urology. Edn presented at the 36th Annual Congress, Milan, 2021. EAU Guidelines Office, Arnhem, The Netherlands.
    PubMedGoogle Scholar
  • 18 Bonkat G. et al. EAU Guidelines on Urological Infections. Edn presented at the 36th Annual Congress, Milan, 2021. EAU Guidelines Office, Arnhem, The Netherlands.
    PubMedGoogle Scholar
  • 19 Engeler D. et al. EAU Guidelines on Chronic Pelvic Pain. Edn presented at the 36th Annual Congress, Milan, 2021. EAU Guidelines Office, Arnhem, The Netherlands.
    PubMedGoogle Scholar
  • 20 Burgio KL. et al. Behavioral vs drug treatment for urge urinary incontinence in older women: arandomized controlled trial. JAMA 1998; 280: 1995
    CrossrefPubMedGoogle Scholar
  • 21 Yap TL. et al. A systematic review of the reliability of frequency-volume charts in urological research and its implications for the optimum chart duration. BJU Int 2007; 99: 9
    CrossrefPubMedGoogle Scholar
  • 22 Haylen BT. et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic floor surgery. Neurourol Urodyn 2011; 30: 2
    CrossrefPubMedGoogle Scholar
  • 23 Bright E. et al. Developing and validating the International Consultation on Incontinence Questionnaire bladder diary. Eur Urol 2014; 66: 294
    CrossrefPubMedGoogle Scholar
  • 24 Jimenez-Cidre MA. et al. The 3-day bladder diary is a feasible, reliable and valid tool to evaluate the lower urinary tract symptoms in women. Neurourol Urodyn 2015; 34: 128
    CrossrefPubMedGoogle Scholar
  • 25 Farrell SA. et al. Women’s ability to assess their urinary incontinence type using the QUID as an educational tool. Int Urogynecol J 2013; 24: 759
    CrossrefPubMedGoogle Scholar
  • 26 ICIQ Development Group. International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ-FLUTS) ICIQ Project. 2014
    PubMedGoogle Scholar
  • 27 Chan SS. et al. Responsiveness of the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire in women undergoing treatment for pelvic floor disorders. Int Urogynecol J 2013; 24: 213
    CrossrefPubMedGoogle Scholar
  • 28 Toozs-Hobson P, Freeman R, Barber M. et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for reporting outcomes of surgical procedures für pelvic organ prolapse. Int Urogynecol J 2012; 23: 527-535
    CrossrefPubMedGoogle Scholar
  • 29 Dietz HP, Moegni F, Shek KL. Diagnosis of levator avulsion injury:a comparison of three methods. Ultrasound Obstet Gynecol 2012; 40: 693-698
    CrossrefPubMedGoogle Scholar
  • 30 Isherwood PJ, Rane A. Comparative assessment of pelvic floor strength using a pernieometer ans digital examination. Bjog 2000; 107: 1007-1011
    CrossrefPubMedGoogle Scholar
  • 31 Messelink B, Benson T, Berghmans B. et al. Standardization of terminology of pelvic floor muscle function and dysfunction.report from the pelvic floor clinical assessment group oft he International Continence Society. Neurourol Urodyn 2005; 24: 374-380
    CrossrefPubMedGoogle Scholar
  • 32 Guralnick ML. et al. ICS Educational Module: Cough stress test in the evaluation of female urinary´incontinence: Introducing the ICS-Uniform Cough Stress Test. Neurourol Urodyn 2018; 37: 1849
    CrossrefPubMedGoogle Scholar
  • 33 Patnam R. et al. Standing Vs Supine; Does it Matter in Cough Stress Testing?. Female Pelvic Med Reconstr Surg 2017; 23: 315
    CrossrefPubMedGoogle Scholar
  • 34 Reena C, Kekre AN, Kekre N. Occult stress incontinence in women with pelvic organ prolapse. Int J Gynaecol Obstet 2007; 97: 31-4
    CrossrefPubMedGoogle Scholar
  • 35 Sinha D, Arunkalaivanan AS. Prevalence of occult stress incontinence in continent women with severe genital prolapse. J Obstet Gynaecol 2007; 27: 174-6
    CrossrefPubMedGoogle Scholar
  • 36 Santoro GA, Wieczorek AP, Dietz HP. et al. State of the art: an integrated approach to pelvic floor ultrasonography. Ultrasound Obset Gynecol 2011; 37: 381-396
    CrossrefPubMedGoogle Scholar
  • 37 Dietz HP. Ultrasound in the assessment of pelvic organ prolapse. Best Pract Res Clin Obstet Gynaecol 2019; 54: 12-30
    CrossrefPubMedGoogle Scholar
  • 38 Naumann G. Urogynäkologische Diagnostik – Update 2019. Gynäkologe 2019; 52: 183-187
    CrossrefPubMedGoogle Scholar
  • 39 Wong V, Shek K, Rane A. et al. Is levator avulsion a predictor of cystocele recurrence following anterior vaginal mesh placement?. Ultrasound Obstet Gynecol 2013; 42: 230-234
    CrossrefPubMedGoogle Scholar
  • 40 Dietz HP. Mesh in prolapse surgery: an imaging perpective. Ultrasound Obstet gynecol 2012; 40: 495-503
    CrossrefPubMedGoogle Scholar
  • 41 Gillor M, Dietz HP. Translabial ultrasound imaging of urethral diverticula. Ultrasound Obstet Gynecol 2019; 54: 552-556
    CrossrefPubMedGoogle Scholar
  • 42 Greiman AK, Rolef J, Rovner ES. Urethral diverticulum: a systematic review. Arab J Urol 2019; 17: 49-57
    CrossrefPubMedGoogle Scholar
  • 43 Arinzon Z. et al. Clinical presentation of urinary tract infection (UTI) differs with aging in women. Arch Gerontol Geriatr 2012; 55: 145
    CrossrefPubMedGoogle Scholar
  • 44 Ouslander JG. et al. Does eradicating bacteriuria affect the severity of chronic urinary incontinence in nursing home residents?. Ann Intern Med 1995; 122: 749
    CrossrefPubMedGoogle Scholar
  • 45 Painter V. et al. Does patient activity level affect 24-hr pad test results in stress-incontinent women?. Neurourol Urodyn 2012; 31: 143
    CrossrefPubMedGoogle Scholar
  • 46 Rosier PFWM. et al. Committee 6. Urodynamic testing. Abrams P, Cardozo L, Wagg A, Wein A. Incontinence, 6th Edn. Bristol, UK: 2017
    Google Scholar
  • 47 Vakili B, Chesson RR, Kyle BL. et al. The incidence of urinary tract injury during hysterectomy: a prospective analysis nased on universal cystoscopy. Am J Obstet Gynecol 2005; 192: 1599-1604
    CrossrefPubMedGoogle Scholar
  • 48 Rosier P. et al. International Continence Society Good Urodynamic Practices and Terms 2016: Urodynamics, uroflowmetry, cystometry, and pressure-flow study. Neurourol Urodyn 2017; 36: 1243
    CrossrefPubMedGoogle Scholar
  • 49 Abrams P. et al. United Kingdom Continence Society: Minimum standards for urodynamic studies, 2018. Neurourol Urodyn 2019; 38: 838
    CrossrefPubMedGoogle Scholar
  • 50 Nager CW, Brubaker L, Litman HJ. et al. Urinary Incontinence Treatment Network. A randomized trial of urodynamic testing before stress-incontinence surgery. N Engl J Med 2012; 366: 1987-1997
    CrossrefPubMedGoogle Scholar
  • 51 Glazener CM, Lapitan MC. Urodynamic studies for management of urinary incontinence in children and adults. Cochrane Database Syst Rev 2012; 1: CD003195
    PubMedGoogle Scholar