For the treatment of male stress urinary incontinence (SUI) the functional retrourethral sling (AdVance sling) is a safe and minimal invasive treatment option with good cure and improvement rates. After radiotherapy the urethra and sphincter region can be afflicted and so e.g. the mobility of the urethra reduced. We evaluated the effectiveness of the AdVance sling after radical prostatectomy and additional adjuvant radiotherapy in the treatment of (SUI).

Stress incontinence after radical prostatectomy has a huge impact on quality of life for men. Two to five percent of the patients with incontinence after radical prostatectomy exhibit a persistent incontinence over 1 year despite conservative therapy attempts. For these patients surgical treatment is recommended. We evaluated the changes in quality of life after implantation of a retrourethral sling.

Trotz verbesserter Operationstechnik leidet auch heute noch eine nicht zu vernachlässigende Anzahl von Patienten an einer Harninkontinenz nach radikaler Prostatektomie. Zur Therapie wird zunächst ein konservativer Therapieversuch in den ersten 6–12 Monaten nach radikaler Prostatektomie empfohlen. Kommt es zu keiner Besserung der Inkontinenz, wird ein operatives Vorgehen empfohlen. Der artifizielle Sphinkter, ein über Jahrzehnte erprobtes System, weißt zwar gute Langzeitergebnisse auf, ist aber auch mit diversen Problemen behaftet. In den letzten Jahren wurden diverse minimal-invasive Systeme zur Therapie der männlichen Belastungsinkontinenz eingeführt, welche entweder mittels Kompression oder funktionell wirken.

Despite improved operative techniques the number of patients suffering from urinary incontinence after radical prostatectomy cannot be ignored. The recommended therapy after radical prostatectomy is initially to attempt conservative therapy during the first 6-12 months. If there is no improvement in the incontinence an operative procedure is recommended. An artificial sphincter which has been established over decades has good long-term results but is also beset by diverse problems. Recently diverse minimally invasive procedures have been introduced for therapy of male stress incontinence which are effective due to compression or have a functional therapeutical approach.

The application of slings for the treatment of male stress urinary incontinence (SUI) is one of the fastest developments in urology. The reason for the introduction of the functional retrourethral sling was to treat the SUI by relocating the posterior urethra into a more proximal position without disturbing the sphincter mechanism. Thus, in patients with residual sphincter function continence can achieved again. The aim of this study was to evaluate the complications after implantation of this new functional retrourethral sling.

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.

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.

Minimal-invasive Eingriffe versprechen heute exzellente Heilungschancen bei der weiblichen Harninkontinenz. Dabei werden Bänder und Netze eingesetzt, die den gelockerten Halteapparat wieder fixieren.

Jede Inkontinenz sollte zunächst mit konservativen Maßnahmen behandelt werden. Zahlreiche physiotherapeutische und elektrophysiologische Verfahren stehen zur Verfügung, um den Beckenboden zu kräftigen. Nicht nur die Drangsymptomatik, auch die Belastungsinkontinenz kann heute medikamentös behandelt werden.

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.