Current Developments and Perspectives on the Diagnosis and Treatment of Urinary Incontinence and Genital Prolapse in Women Aktuelle Entwicklungen und Perspektiven in der Diagnostik und Therapie von Harninkontinenz und Genitalsenkung der Frau

As a key area of gynaecology, urogynaecology has undergone impressive changes in the past few years. Together with the high prevalence of func- tional pelvic floor disorders, modern anaesthesia procedures and the introduction of new, innova- tive minimally invasive operation techniques have led to a dramatic increase in the number of operations for incontinence and prolapses. The increasingly subtle diagnostic options, such as, e.g., 2D and 3D sonography of the pelvic floor provide unambiguous findings and facilitate deci- sion making. Tension-free vaginal slings in retro- pubic, trans-obturator or single-incision tech- niques show a high success rate with few compli- cations and have almost completely replaced the more invasive abdominal surgical techniques for the operative management of stress incontinence. Especially for recurrent prolapse the use of allo- plastic nets leads to a markedly improved ana- tomic and functional outcome. In spite of the eu- phoria about modern operation techniques and novel net materials, in-depth knowledge of pelvic floor anatomy, sufficient surgical experience and unequivocal guideline-conform indications are mandatory for satisfactory treatment outcomes. The afflicted women must be informed in detail about alternative procedures and more emphasis should be placed on conservative therapy. Novel surgical techniquesshould be monitored by regis- ters or clinical trials. The professional society is called upon to improve the training curricula for pelvic floor surgery. Zusammenfassung ! " urogynecology l " aconuresis l " descensus