Zusammenfassung
Fragestellung: Urethrale Funktionsteste sind in Form von direkten urethralen Druckmessungen, Leak
Point Pressures und neu der urethralen Widerstandsmessung (URP) verfügbar. Ziel der
vorliegenden Arbeit ist, eine Literaturübersicht über die verfügbaren Tests sowie
eine kritische Bewertung zu geben. Material und Methode: Eine Medline-Suche mit den Suchbegriffen „urethra pressure profile“, „urethra function
test“, „leak point pressure“ und „urethral resistance pressure“ wurde von 1975 bis
2004 durchgeführt. Resultate: Die so identifizierten 86 Artikel geben eine Übersicht über die Methodik der Urethradruckprofile
mit ihren Varianten MUCP, funktionelle Urethralänge, Depressionskoeffizient, Leak
Point Pressures und urethrale Widerstandsmessung. Eine Korrelation mit dem Schweregrad
der Inkontinenz konnte nur der urethrale Retroresistenzdruck (URP) geben mit allerdings
bis anhin nur schwacher Datenlage. Diskussion: Es gibt bisher keinen urethralen Funktionstest, der eine urethrale Funktionsstörung
sicher von anderen Pathomechanismen als Ursache für eine Urininkontinenz abgrenzt.
Trotzdem können urethrale Funktionsteste Hinweise auf ein potenziell schlechteres
postoperatives Outcome bei hypotoner Urethra geben und sind für wissenschaftliche
Studien hilfreich.
Abstract
Introduction: Various urethral function tests are available such as direct urethral pressure measurement,
leak point pressure measurement and urethral resistance measurement. Aim of the study
was to give an overview and a critical review of the current literature. Method: A medline search was perfomed using the expressions “urethra pressure profile”, “urethra
function test”, “leak point pressure“ and “urethral resistance pressure” between 1975
and 2004. Results: 86 articles could be identified giving an overview of direct urethral pressure measurement,
functional urethral length, pressure transmission ratio, leak point pressure and urethral
resistance measurement. Only URP (urethral retro resistance pressure) correlated with
the severity of urodynamic stress incontinence but with one publication only. Discussion: There is no single urethral function test which is capable of distinguishing between
urethral dysfunction and other mechanisms. However, urethral function tests are useful
to predict postoperative outcome after incontinence procedures in patients with low
pressure urethra and in scientific studies.
Schlüsselwörter
Urininkontinenz - Urodynamik - urethrale Funktionsteste
Key words
Urinary in continence - urodynamics - urethral function tests
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Dr. Annette Kuhn Leiterin Urogynäkologie
Frauenklinik
Inselspital
Eftinger Str. 102
3010 Bern
Schweiz
Email: annette.kuhn@insel.ch
