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Horst-Dieter Becker · Arnulf Stenzl
Diethelm Wallwiener · Tilman T. Zittel
Editors
Urinary and Fecal Incontinence
An Interdisciplinary Approach
Horst-Dieter Becker · Arnulf Stenzl
Diethelm Wallwiener · Tilman T. Zittel
Editors
Urinary and Fecal
Incontinence
An Interdisciplinary Approach
With 95 Figures,43 in Color and 89 Tables
Prof.Dr.Horst-Dieter Becker
Universitätsklinik für Allgemeine,
Viszeral- und Transplantationschirurgie
Zentrum für Medizinische Forschung
Waldhörnlestrasse 22
72072 Tübingen
Germany
Prof.Dr.Diethelm Wallwiener
Universitätsfrauenklinik
Calwerstrasse 7
72076 Tübingen
Germany
Prof. Dr. Arnulf Stenzl
Universitätsklinik für Urologie
Hoppe-Seyler-Strasse 3
72076 Tübingen
Germany
PD Dr.Tilman T.Zittel
Universitätsklinik für Allgemeine,
Viszeral- und Transplantationschirurgie
Hoppe-Seyler Strasse 3
72076 Tübingen
Germany
Library of Congress Control Number: 2004116516
ISBN-10 3-540-22225-1 Springer Berlin Heidelberg New York
ISBN-13 978-3-540-22225-5 Springer Berlin Heidelberg New York
This work is subject to copyright. All rights are reserved, whether the whole or part of the material is
concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of
this publication or parts thereof is permitted only under the provisions of the German Copyright
Law of September 9, 1965, in its current version, and permission for use must always be obtained
from Springer. Violations are liable to prosecution under the German Copyright Law.
Springer is a part of Springer Science+Business Media
springeronline.com
© Springer-Verlag Berlin Heidelberg 2005
Printed in Germany
The use of general descriptive names, registered names, trademarks, etc. in this publication does
not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
Product liability: the publishers cannot guarantee the accuracy of any information about dosage
and application contained in this book. In every individual case the user must check such information by consulting the relevant literature.
Editor:
Desk Editor: Meike Stoeck, Heidelberg, Germany
Production: ProEdit GmbH, 69126 Heidelberg, Germany
Cover: Frido Steinen-Broo, EStudio Calamar, Spain
Typesetting: K. Detzner, 67346 Speyer, Germany
Printed on acid-free paper 21/3151 ML 5 4 3 2 1 0
Contents
Contents
Part I
Epidemiology and Health Costs of Incontinence
1 Epidemiology of Urinary Incontinence . . . . . . . . . . . . . . . . . . 1
Steinar Hunskaar
2 Epidemiology of Fecal Incontinence:
A Review of Population-based Studies . . . . . . . . . . . . . . . . . . 13
Catherine W. McGrother, Madeleine Donaldson
V
3 Economic Costs of Urinary Incontinence in Germany . . . . . . . . . . 25
Günter Neubauer, Sandra Stiefelmeyer
4 Perception of Incontinence in and by Society . . . . . . . . . . . . . . 33
Paul Enck,Sibylle Klosterhalfen
Part II
Pelvic Anatomy, Physiology and Etiology of Incontinence
5 An Attempt at an Explanation of Stress Urinary Incontinence
Through the Rodent Animal Model . . . . . . . . . . . . . . . . . . . . 41
Karl-Dietrich Sievert, Emer Bakircioglu,Lora Nunes, Tony Tsai,
Tom F. Lue
6 Birth Trauma and Incontinence . . . . . . . . . . . . . . . . . . . . . . 87
Ralf Tunn,Ursula Peschers
7 Neurogenic Urinary Incontinence . . . . . . . . . . . . . . . . . . . . . 95
Helmut Madersbacher
8 Fecal Incontinence after Rectal and Perianal Surgery . . . . . . . . . . 103
Alan G. Thorson
VI
Contents
Part III
Diagnostic Methods to Detect Incontinence
9 Evaluation of Anorectal and Pelvic Floor Muscle Function . . . . . . . 119
Fernando Azpiroz,Aniceto Puigdollers, Carlos Amselem
10 Imaging of the Pelvic Floor – Videoproctography and Dynamic MRI
of the Pelvic Floor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Alois Fürst,Lilli Hutzel, Klaus Guenther,Andreas Schreyer,
Christian Paetzel
11 Diagnostic Methods to Detect Female Urinary Incontinence . . . . . 155
Heinz Koelbl,Gert Naumann
Part IV
Conservative Therapy of Incontinence
12 Pharmacological Treatment of Urinary Incontinence . . . . . . . . . . 167
Gert Naumann, Heinz Koelbl
13 Medical, Behavioural and Minimally Invasive Therapy –
A Urologist’s View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Christopher R. Chapple, Sawrabh Bhargava, Karl-Erik Andersson
14 Medical and Behavioral Treatment of Fecal Incontinence . . . . . . . 199
William E.Whitehead
Part V
Operative Therapy of Urinary Incontinence
15 Innovative and Minimally Invasive Treatment
of Stress Urinary Incontinence . . . . . . . . . . . . . . . . . . . . . . . 211
Christl Reisenauer, Konstantinos Gardanis,Diethelm Wallwiener
16 Abdominal,Vaginal or Laparoscopic Approach
for Urinary Incontinence? . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Wolfgang Zubke, Ines Gruber, Diethelm Wallwiener
17 Diagnostic and Surgical Management of Stress Urinary Incontinence 251
Karl-Dietrich Sievert, Arnulf Stenzl
18 The Artificial Urinary Sphincter . . . . . . . . . . . . . . . . . . . . . . 271
Roberto Olianas, M.Fisch
Contents
Part VI
Operative Therapy of Fecal Incontinence
19 Sphincteroplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
Tilman T. Zittel
20 Dynamic Graciloplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Cor G.M.I. Baeten, Jarno Melenhorst
21 The Artificial Bowel Sphincter in the Treatment
of Severe Fecal Incontinence in Adults . . . . . . . . . . . . . . . . . . 297
Nicolas Regenet,Guillaume Meurette,Paul-Antoine Lehur
22 Innovations in Fecal Incontinence: Sacral Nerve Stimulation . . . . . 311
Klaus E. Matzel, Uwe Stadelmaier,Werner Hohenberger
23 Stoma Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325
Martin E. Kreis,Ekkehard C. Jehle
Part VII
VII
Postoperative Care of Patients After Pelvic Operations
24 Postoperative Management After Surgery for Incontinence
and Prolapse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333
Ursula M.Peschers, Ralf Tunn
25 Postoperative Management of Urinary Incontinence
After Urologic Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . 339
Daniela Schultz-Lampel
26 Incontinence Treatment After Rectal or Perianal Surgery . . . . . . . 357
Christoph A.Ausch, Harald R. Rosen
Part VIII
Quality of Life and Long-term Results After Incontinence Treatment
27 Quality of Life with Urinary and Fecal Incontinence . . . . . . . . . . 369
Todd H. Rockwood
28 Long-Term Results After Surgery for Urinary Incontinence . . . . . . 385
Wolfgang Zubke, Ella Retzlaw,Diethelm Wallwiener
VIII
Contents
29 Long-term Results of Surgery for Stress Urinary Incontinence –
A Urologist’s View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397
Prasad Patki,Rizwan Hamid, Julian R. Shah
30 Long-term Results After Fecal Incontinence Surgery . . . . . . . . . . 403
Tilman T. Zittel
31 Quality of Life with a Permanent Colostomy . . . . . . . . . . . . . . . 429
Brigitte Holzer, Harald R.Rosen
Part IX
How can we Improve the Treatment of Incontinence?
32 Is Urinary or Fecal Incontinence a Preventable Event? . . . . . . . . . 439
Daniele Perucchini, Daniel Faltin
33 Concept of the Pelvic Floor as a Unit:
The Case for Multi-disciplinary Pelvic Floor Centers . . . . . . . . . . 457
G. Willy Davila
Part X
On Asymmetry in Sphincters
34 Functional Asymmetry of Pelvic Floor Innervation and Its Potential
Role in the Pathogenesis of Fecal and Urinary Incontinence –
Report from the EU-Sponsored Research Project OASIS
(On Asymmetry In Sphincters) ..................... 467
Paul Enck,Fernando Azpiroz,Roberto Merletti
Subject Index .................................. 491
Contents
List of Contributors
Carlos Amselem, MD
Pelvic Floor Institute,Barcelona, Spain
Karl-Erik Andersson, MD
Lund University Hospital,Department of Clinical Pharmacology,22185 Lund,
Sweden (e-mail: Karl-Erik.Andersson@klinfarm.lu.se)
Christph A. Ausch, MD
Chirurgische Abteilung,Donauspital / SMZ-Ost, Langobardenstrasse 122,
1220 Vienna,Austria (e-mail: christoph.ausch@smz.magwien.gv.at)
Fernando Azpiroz,MD
University of Barcelona, Hospital General Vall d’ Hebron,
Digestive System Research Unit,08035 Barcelona, Spain
(e-mail: fernando.azpiroz@wol.es)
IX
Cor G.M.I. Baeten, MD,PhD
Maastricht University Hospital, Department of Surgery,P. Debyelaan 25,
6202 AZ Maastricht, The Netherlands (e-mail: C.Baeten@surgery.azm.nl)
M. Emer Bakircioglu,MD
TAS Mektep S.No 59/12, Erenkoy,Istanbul 81060, Turkey
(e-mail: ebakircioglu@yahoo.com)
Horst-Dieter Becker,MD
Universitätsklinik für Allgemeine,Viszeral- und Transplantationschirurgie,
Zentrum für Medizinische Forschung,Waldhörnlestrasse 22, 72072 Tübingen,
Germany (e-mail: horst.dieter.becker@med.uni-tuebingen.de)
Sawrabh Bhargava,MD
Royal Hallamshire Hospital,Department of Urology,Glossop Road, Sheffield,S10 2JF,
UK
Christopher R. Chapple, MD
Royal Hallamshire Hospital,Department of Urology,Glossop Road, Sheffield,S10 2JF,
UK (e-mail: c.r.chapple@sheffield.ac.uk)
X
List of Contributors
Madeleine Donaldson
Department of Epidemiology and Public Health, University of Leicester,
22–28 Princess Road West, Leicester,LE1 6TP,UK
Paul Enck, MD
Medizinische Klinik VI,Psychosomatische Medizin und Psychotherapie,
Schaffhausenstr.113, 72072 Tübingen,Germany (e-mail: paul.enck@uni-tuebingen.de)
G.Willy Davila, MD
Cleveland Clinic Florida, Department of Gynecology,2950 Cleveland Clinic Blvd.,
Weston,FL 33331, USA (e-mail: davilag@ccf.org)
Daniel Faltin,MD
Universitätsspital Zürich, Departement Frauenheilkunde, Frauenklinikstrasse 10,
8091 Zürich, Switzerland (e-mail: daniel.faltin@hcuge.ch)
M. Fisch, MD
Allgemeines Krankenhaus Hamburg-Harburg, Eissendorfer Pferdeweg 52,
21075 Hamburg, Germany
Alois Fürst, MD, PhD
Caritas-Krankenhaus St.Josef, Landshuterstr.65, 93053 Regensburg
(e-mail: alois.fuerst@t-online.de)
Konstantinos Gardanis, MD
Universitätsfrauenklinik, Calwerstraße 7,72076 Tübingen, Germany
(e-mail: konstantinos.gardanis@med.uni-tuebingen.de)
Ines Gruber,MD
Universitätsfrauenklinik, Calwerstraße 7,72076 Tübingen, Germany
(e-mail: ines.gruber@med.uni-tuebingen.de)
Klaus Günther,MD
Klinikum Fürth, Jakob-Henle-Str. 1, 90766 Fürth
(e-mail: klaus.guenther@klinik.uni-regensburg.de)
Rizwan Hamid,MBBS, FRCS
Institute of Urology & Nephrology,48, Riding House Street,London W1W 7EY,
United Kingdom (e-mail: hamid_rizwan@hotmail.com)
Werner Hohenberger,MD
Chirurgische Klinik mit Poliklinik, Universität Erlangen,Krankenhausstrasse 12,
91054 Erlangen, Germany (e-mail: werner.hohenberger@imed.uni-erlangen.de)
Brigitte Holzer,MD
Ludwig Boltzmann Institut für Chirurgische Onkologie, Donauspital / SMZ-Ost,
Langobardenstrasse 122, 1220 Vienna,Austria
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