[Urinary stress incontinence in women].
The integral theory of Petros and Ulmsten has profoundly changed our understanding of the female pelvic floor. Anatomic laxity of the vaginal wall caused by pelvic floor defects induced at different damage zones is frequently not only responsible for stress urinary incontinence but also for pollakisuria, urgency, post-void residual and pelvic pain. A number of minimally invasive techniques have been developed to correct these defects. Applying a tension-free polypropylene tape around the mid-urethra has become an established method to correct the anterior ligaments. The infra-coccygeal sacropexy can achieve dorsal stabilization of the vaginal wall. Currently, polypropylene meshes are increasingly used for repairing supporting pelvic fasciae. The most recommended conservative methods are exercises to strengthen the pelvic floor muscles. Duloxetine increases the rhabdosphincter contractility during the filling phases, but not during voiding, and therefore is a promising drug for clinical use.
Liedl
B
B
Urologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München. Bernard.Liedl@med.uni-muenchen.de
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D017326:Clinical Trials, Phase III as Topic; D000068736:Duloxetine Hydrochloride; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D017773:Pelvic Floor / Q000503:physiopathology; D011126:Polypropylenes; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012737:Sex Factors; D013526:Surgical Mesh; D013876:Thiophenes / Q000627:therapeutic use; D001743:Urinary Bladder / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy
D018759:Adrenergic Uptake Inhibitors; D000068736:Duloxetine Hydrochloride; D011126:Polypropylenes; D017367:Selective Serotonin Reuptake Inhibitors; D013876:Thiophenes