Zusammenfassung
Harninkontinenz ist das Unvermögen, die Blasenentleerung willentlich zu kontrollieren.
Belastungsinkontinenz ist die häufigste Art der Inkontinenz bei Frauen. Zurzeit stehen
keine akzeptierten oder zugelassenen Medikamente zur Behandlung der Belastungsinkontinenz
zur Verfügung. Eine Vielzahl von Studien sehen eine Verbindung zwischen den Neurotransmittern
Serotonin und Noradrenalin in der Kontrolle des unteren Harntrakts. Auf der Basis
dieser Eigenschaften gibt es mit Duloxetin, einem kombinierten Serotonin-/Noradrenalinwiederaufnahmehemmer,
einen neuen therapeutischen Ansatz. Duloxetin scheint am präsynaptischen Neuron im
Onuf-Nukleus zu wirken. Die Wirkungsweise von Duloxetin wurde in tierexperimentellen
Studien untersucht. In einer doppelblinden, randomisierten, plazebokontrollierten
Studie bei Frauen mit Belastungsinkontinenz zeigte sich eine signifikante und klinisch
relevante Senkung der Harninkontinenzepisoden unter Duloxetin. Als häufigste Nebenwirkung
trat Übelkeit auf. Diese Ergebnisse deuten darauf hin, dass der Einsatz von Duloxetin
in der Behandlung der Belastungsinkontinenz viel versprechend ist und die Lebensqualität
der Frauen verbessern kann.
Abstract
Urinary incontinence is the inability to willingly control bladder voiding. Stress
urinary incontinence (SUI) is the most frequently occurring type of incontinence in
women. No specific and approved medication is yet available to treat stress urinary
incontinence. Numerous studies have implicated the neurotransmitters, serotonin and
noradrenaline in the central neural control of the lower urinary tract function. On
the basis of these characteristics, duloxetine, a combined serotonin/norepinephrine
reuptake inhibitor, may be a good therapeutic alternative. Duloxetine appears to act
on the presynaptic neuron of the Onuf nucleus. The effectiveness of duloxetine was
studied in animal experiments. In a double-blind, randomized placebo-controlled clinical
trial in women with stress urinary incontinence there was a significant reduction
in urinary incontinence episodes under duloxetine treatment. The most frequent adverse
effect observed was nausea. In summary, these results indicate that duloxetine may
prove to be an effective treatment for stress urinary incontinence in women and help
improve their quality of life.
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Prof. Dr. med. Wolfgang Jost
Fachbereich Neurologie und Klinische Neurophysiologie · Deutsche Klinik für Diagnostik
Aukammallee 33
65191 Wiesbaden
eMail: jost.neuro@dkd-wiesbaden.de
