Zusammenfassung
Diese Arbeit gibt eine Übersicht über den derzeitigen Stand der konservativen Therapie der Belastungsharninkontinenz (SUI) und der überaktiven Blase (OAB). Bei der SUI finden die etablierten therapeutischen Möglichkeiten wie die Beckenbodengymnastik, die Elektrostimulationstherapie, das Biofeedbacktraining, das Vibrationstraining, die Östrogenisierung und die Pessartherapie ihre Anwendung. Aktuell ist mit Duloxetin das erste medikamentöse Therapeutikum zur Behandlung der SUI verfügbar. In der Therapie der überaktiven Blase sind aktuelle Anticholinergika mit einem günstigeren Nebenwirkungsprofil durch Solifenacin und das Darifenacin für die Patientinnen verfügbar. Daneben finden sich die konservativen Therapiestrategien, die sich in weiten Bereichen mit der Therapie bei der SUI decken. Bei der Anwendung der aktuellen Therapeutika ist trotz aller Weiterentwicklungen das Nebenwirkungsprofil sorgfältig zum Nutzen abzuwägen.
Abstract
This paper provides an overview of the current conservative treatment of female stress urinary incontinence (SUI) and the overactive bladder (OAB). The established treatment strategies for SUI are pelvic floor muscle exercises, electro-stimulation therapy, biofeedback training, oestrogen therapy and pessary therapy. Duloxetine is now available as the first drug therapy for the treatment of SUI. For the treatment of the overactive bladder, anticholinergic drugs are now available which, due to the use of solifenacin and darifenacin, result in fewer side effects for the patient. In addition, conservative treatment strategies can be applied which in many areas correspond with the treatment of SUI. Despite all newer developments, it is important, when applying new therapeutics, to carefully weigh the possible side effects against the benefits for the patient.
Schlüsselwörter
Harninkontinenz - Beckenboden - Trainingstherapie - Duloxetin - anticholinerge Medikamente - medikamentöse Therapie
Key words
Urinary incontinence - pelvic floor - exercise therapy - duloxetine - anticholinergic drug - drug therapy
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Dr. med. Sven Schiermeier
Frauenklinik der Universität Witten/Herdecke
Kontinenzzentrum der Deutschen Kontinenz Gesellschaft
Marienplatz 2
58452 Witten
Email: Dr.Schiermeier@gmx.de
