Bubbles schwche: How operations help?

On each stair, she lost a drop of urine. A few drops, if you lifted a case of water with a jerk. Since a missglüincreased intervertebral disc SURGERY suffered Elke G. from Uslar (lower Saxony) for many years under a ­the so-called stress incontinence. In the case of the Betäpractice in the area of the Rüfold marks had the Ädoctors nerves are paralyzed, which control the emptying of the bladder.

With complaints is open to deal

Each Druckerhöhung in the Bauch­room – it was due to coughing, Laughing or Jogging – gave your Harn­röhre’s a little bit of urine. A burden not only köfrom a physical, but especially für the soul. But zurückzu­drag and in your everyday life einzuschrädrinks came für the real teacher is not out of the question. "I stäcompletely new templates and dark fabrics worn, so you can’t see anything. And often thought: Hopefully break soon."

Help from the pharmacy

In many pharmacies köyou can get to the suitable diaper briefs, pants or templates, incontinence advice. Für products that are not reimbursed by the health insurance companies, is a co-payment is necessary.

For several years, the 69-J&auml is;over the years and as a teacher in a nursing school tätig, where she addressed the topic very offensive. "I said it könne, at any time, be that because of my incontinence a mishap happens."

Their openness was their Schütz­lingen good, they responded verstäunderstanding full. "It is a disease like any other. Why should you dar&uuml not;ber talk?", Elke, the treated so that you always have a positive says. Among the complaints she suffered nonetheless.

Hähammock under the Harnröhre

Almost every fourth woman suffers from in the course ­of your life under a leaky bladder, when these are burdened – more than Diabetes or Migräne. Many struggling unnötig with the disease can be treated well. A small plastic band to improving the lives of patients, often abruptly. As in the case of Elke G. little more than a year, you put a doctor within a few minutes of such a tape under the Harnröhre.

"The BäSerenade is like a Hähammock under the middle of the Harnröhre and stabilized sie", erklärt Professor Boris Gabriel, chief physician of the women’s clinic at the St.-Josefs-Hospital in Wiesbaden. "It is not fixed, but verwäfor the first time with the köthe body’s own Ge­weave."

Usually U-f&ouml is it;rmig behind the pubic bone. In a variant, it is flat and the Hübones he­rum used. In the past years, k&uuml came;lower level and less width Bäof to game, the be incorporated with a plastic anchor into the tissue, slings, so-called Mini. These, however, are not without controversy. It is also unclear whether they are as effective as their role models, für the 20-year data gives.

Tension Free Vaginal Tape

The method of the Swedish doctor, Professor Ulf Ulmsten in the early ‘ 90s developed, revolutionized the standard surgical treatment of stress urinary incontinence. The first product, which launched a U.S. company on the market, hieß "tension free vaginal tape" (TVT) – in German "tension-free Vaginalband".

Until then, a gr&ouml was;ßerer intervention nötig, the one läprolonged hospital stay after her. After a belly of the bladder neck ange&shy was cut;raised to the Harnröto relieve hre and to take the pressure off of her. Kolpo­suspension experts call this still a recognised procedure by laparoscopy is – however, only when a tape-OP is out of the question.

"This is the case, for example, if at the same time a reduction of the front wall vorliegt&quot a divorce;, erläexplained Gabriel. The advantages of the Bändchens: It’s just a &ouml is;local Betäexercise is necessary. It is the tissue strain, because it requires only small cuts. And it uses the vagina as a natür­and minimally invasive Zugangs­way.

Rarely leads to complications and long-term success

The success rate is 80 percent to 90 percent, the heißt: most of the women schließt the bladder after the surgery. The complication rate is low. At about fünf percent of the patients come Blasenentleerungsstömounts on because the BäSerenade was placed too tight. Then it must be in another surgery eased.

So the bubble keeps re-sealing

If non-operative treatment methods will bring no success, stabilize the surgeons, the Organ in the abdomen using a plastic tape

The urinary bladder lies in the pelvis

The U-Shape

this is the häwidely applied surgical procedures. The Band is under the middle of the Harnröhre geführt and loose U-f&ouml is;rmig behind the pubic bone

The Variant

Here, the tape from the plastic is polypropylene, a little flatter in the direction of the relationship way of a thigh bar-inside geführt

The Mini Sling

is küshortener and less wide than the herköconventional Bäor slings. It is equipped on both sides with plastic anchors into the tissue claws

Although injuries to the bladder and inner Blutergüsse occur only rarely, not side effects ausschließen. To gehören Wundheilungsstöretention, Inguinal and thigh pain, and pain during Sex.

Overall, the long-term data, however very good. A künewly in the journal Gynecology and Obstetrics veröpublished study with more than 17 000 participants showed that nine ­Years after surgery only 1.1 percent of patients re-operated &ndash had to be; Experts consider this as a aussagekräbusy document füthe complication of poor and dauer­success of the method.

Textile implants in the criticism

Also für Elke G. the surgery was a blessing. Directly after, spüyou rte a clear relief of their complaints. If you were going to the Qigong or in the gym on the treadmill, it must be no mishap more befüfear. "Since I have the Band, is rest."

She only regrets that you have not already frühere this step has dared, and rät other women with stress incontinence, not unnöto wait for a tig for a long time with a OP. To mömany of those Affected as possible to reach with this message, engaged Elke G. in the Association’s self-help incontinence.

International textile implants made of plastic were in the gynecology jüngst under attack. The discussion entzüfriends on the networks in Senkungszustäthe genital organs are used. The US ­Zulassungsbehörde FDA claimed that the manufacturer should be using to demonstrate the long-term data that these networks are the patients in comparison to the herköconventional OP tat­säch­lich ­a zusäadditional Benefits.

Pelvic floor networks and Inkontinenzbäof

Because not all manufacturers evidence in a timely manner führen could, took the FDA a few products for the time being from the market. Such networks, with the Kunststoffbäto compare the change in the operative therapy of the Belas­­tungsinkon­incontinence be used, is für Gabriel, however, as the comparison between Äpfeln and pears. "In this discussion, it is großflä- language networks as a Tissue replacement, äsimilar to you, you also Leistenbrüchen used."

This benöthe surgeon is not required only größEUA quantities of Material as in the case of a blister band. "The surgical technique is clearly invasive and comes with höhigher complication risks einher", Dr. Christian F&uuml says;nfgeld from Interdisziplinären continence and pelvic floor centre of Tettnang.

Helpful Maßtook before the SURGERY

  • Style &auml life;change: heavy-duty Work to avoid and remove it. This takes the pressure off of the bladder
  • Physiotherapy with pelvic floor exercises: to Kräemployment of the inner postural muscles, possibly combined with Biofeedback and electrical stimulation
  • Medication: DULOXETINE
  • Tampons, Pessaries, Vaginal Cones

Although pelvic floor networks, according to German experts, with the small Inkontinenzbächange must not be confused, are Band-Opera­tions in England, in the meantime, only in the context of studies allowed. "This decision is politically motivated and not scientifically begründbar", Gabriel thinks. The größeren networks and the small Bäof wüauthorities in a pot thrown.

Laser therapy as a küfuture Alternative

Therefore, the &Auml is getting ready to fight;rzteschaft in Germany against mödaily Einschräon – not least for this reason, meeting of the German continence society new and bew&auml were on the year;rigidity "alte" Therapie­­methods as an Alternative are discussed. But these are not studied that part yet very well or have a höhere, the complication rate than the open loop.

Acceptable results Ädoctors, for example, with a treatment using gel-like substances, the polsteräsimilar surveys in the Harnröhre and you should seal this. The success rate is about 60 percent.

In the future köcould also use the laser therapy to be interesting. However, there are für these still experimental method so far, no long-term data. The discussion also provides an occasion for the conservative, non-operative methods verstärkt in the view of rücover, as a priority, the Beckenboden­training, "the Druckütransfer to the Harnröhre verbessert", so Ga­briel.

Conservative method or bubble tape?

In addition, local treatments with östriolhaltigen ointments and Pessaries, which, if required, be used – for example, when Jogging or when Fitness­training. You should st&uuml the pelvic organs from the inside out;appreciate that bladder problems are fixed.

"Before each Operation, müthese non-operative methods of welding maxed out sein&quot been;, F&uuml says;nfgeld. Not every woman who loses urine, needs a Band. "Our motto is: as little as möresembled, as much as nötig", bestäneeded Gabriel.

In the case of Elke G. s&auml remained;all Attempts to alleviate their stress incontinence with conservative methods, without success. "I can’t say that I really brought something hätte." With the pelvic floor training, they scored after half a year regelmäßsodium Übung no improvement. And the Pessaries drüswallowed unerträpossible. "To run or to go m&ouml was not;possible." The Band has done a lot easier, and Elke G. new freedoms given to them.

The addresses of advice centres you can find on the Internet at www.kontinenz-gesellschaft.de