Publications (7)1.49 Total impact
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Article: [Functional retrourethral sling. A change of paradigm in the treatment of stress incontinence after radical prostatectomy].
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ABSTRACT: The ever rising number of radical prostatectomies entails an increasing number of patients suffering from postoperative stress incontinence. Several minimally invasive techniques exist as surgical intervention options. All these procedures are based on an obstruction of the urethra. The functional retrourethral sling is a new and innovative sling suspension, which offers for the first time a non-obstructive functional therapeutic approach. The sling adjusts the changed anatomy after radical prostatectomy and exerts its effect by repositioning the lax and descended supporting structures of the sphincter in the former preoperative position. Thus continence can be achieved again. The success rate of this new technique is very good, yielding good results regarding both improving incontinence and continence rate. This new technique is secure and the results are reproducible.Der Urologe 10/2008; 47(9):1224-8. · 0.50 Impact Factor -
Article: Die funktionelle retrourethrale Schlinge
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ABSTRACT: Aufgrund der immer weiter zunehmenden Anzahl von durchgeführten radikalen Prostatektomien nimmt auch die Anzahl an Patienten zu, die an einer postoperativen Belastungsinkontinenz leiden. Zur operativen Therapie stehen diverse minimal-invasive Verfahren zur Verfügung. All diese erzielen ihre Wirkung durch eine Obstruktion der Urethra. Mit der funktionellen retrourethralen Schlinge ist nun erstmals eine Schlinge verfügbar, die ihre Wirkung nicht durch Obstruktion erzielt, sondern es ermöglicht, die im Rahmen einer radikalen Prostatektomie veränderte Anatomie zu korrigieren. Durch die Reposition der gelockerten und deszendierten Haltestrukturen des Sphinkters in seine natürliche Position kann die Kontinenz wiedererlangt werden. Die Erfolgsquote dieses neuen Operationsverfahrens ist sowohl bezüglich der Besserung der Inkontinenz als auch bezüglich der Kontinenzrate sehr gut. Das Verfahren ist sicher und die Ergebnisse reproduzierbar. The ever rising number of radical prostatectomies entails an increasing number of patients suffering from postoperative stress incontinence. Several minimally invasive techniques exist as surgical intervention options. All these procedures are based on an obstruction of the urethra. The functional retrourethral sling is a new and innovative sling suspension, which offers for the first time a non-obstructive functional therapeutic approach. The sling adjusts the changed anatomy after radical prostatectomy and exerts its effect by repositioning the lax and descended supporting structures of the sphincter in the former preoperative position. Thus continence can be achieved again. The success rate of this new technique is very good, yielding good results regarding both improving incontinence and continence rate. This new technique is secure and the results are reproducible.Der Urologe 01/2008; 47(9):1224-1228. · 0.50 Impact Factor -
Article: [Causes and diagnosis of female urinary incontinence].
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ABSTRACT: The primary cause of stress incontinence is birth traumata. However, obesity, asthma, chronic constipation or hard physical work can also overtax the pelvic floor and lead to injury of the connective tissue and a slackening of the ligamentous apparatus. Pelvic floor defects are initially diagnosed simply through a thorough urogynaecological examination. To predict the success of a surgical treatment, the functions can be tested by performing simulated operations.MMW Fortschritte der Medizin 10/2007; 149(38):27-9. -
Article: [Conservative treatment of urinary incontinence].
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ABSTRACT: Urinary incontinence can be treated with medicinal products in addition to active pelvic floor muscle training and electrostimulation. A local hormone therapy should be first discussed with the gynaecologist. The active substance duloxetine has been used for a few years for treating stress incontinence. Several older and newer active substances are available for treating irritable bladder and stress incontinence.MMW Fortschritte der Medizin 10/2007; 149(38):30-1; quiz 32. -
Article: [Surgical treatment of female urinary incontinence].
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ABSTRACT: Through modern surgical procedures, a reconstruction approaching the physiological anatomical conditions can be achieved. According to the integral theory, the typical symptoms are assigned to an anterior, middle and posterior zone of damage. Surgical treatment of female urinary incontinence consists of refixation of the slackened supporting ligaments of the vagina, bladder and urethra. Furthermore, the slackening of the vaginal wall, which arose from the defects of the pelvic floor are corrected. With the aid of minimally invasive interventions usually using the vaginal approach, tapes and meshes are introduced that are also used to repair hernias.MMW Fortschritte der Medizin 10/2007; 149(38):33-4. -
Article: [Diagnosing urinary incontinence in the elderly woman].
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ABSTRACT: The diagnostic work-up of the elderly incontinent woman should always be done on an individual basis. Temporary episodes of incontinence caused by the use of certain drugs or by difficulty in getting to a toilet can be identified by a stepwise diagnostic approach and easily dealt with, for example, by replacing the drug by another, or effecting changes in the environment that improve the patient's access to a toilet. A mandatory aspect of the systematic diagnostic work-up is an attempt to achieve a positive effect through the use, for example, of anticholinergics or local hormone replacement therapy, so as to spare the patient stressful examinations.MMW Fortschritte der Medizin 12/2005; 147(44):42, 44-5. -
Article: [The development of concepts of female (in)continence. Pathophysiology, diagnostics and surgical therapy].
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ABSTRACT: The integral theory postulates that defect ligaments and fascias, which impair the supporting function of the vaginal wall, can cause stress urinary incontinence as well as urgency and voiding dysfunction. The anatomical and pathophysiologic basis for these dysfunctions are presented. Voiding dysfunctions can be treated by the substitution of defect structures using the principle of "restoration of structure leads to restoration of function". Essential elements of this therapeutic algorithm are suburethral vaginal slings (retropubic or transobturatoric), further a posterior sling, which runs through the fossa ischiorectalis and suspends the vaginal vault near the sacrospinal ligaments, thus reconstructing defect uterosacral ligaments. In cystoceles, lateral and medial defects can be restored by ventral meshes, which are fixed at the arcus tendineus fasciae pelvis by lateral transobturatoric slings. The use of polypropylene slings and meshes is well-founded because they are well tolerated in the tissues and through the development of scar tissue lead to neoligaments with long-lasting therapeutic effects.Der Urologe 08/2005; 44(7):W803-18; quiz W819-20. · 0.50 Impact Factor
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2005–2007
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Ludwig-Maximilian-University of Munich
- Department of Urology
München, Bavaria, Germany
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