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

Horst-Dieter Becker · Arnulf Stenzl Diethelm Wallwiener · Tilman T. Zittel Editors

Urinary and Fecal Incontinence

With 95 Figures, 43 in Color and 89 Tables

An Interdisciplinary Approach

Prof. Dr. Horst-Dieter Becker Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie Zentrum für Medizinische Forschung Waldhörnlestrasse 22

72072 Tübingen Germany

Prof. Dr. Arnulf Stenzl

Universitätsklinik für Urologie 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

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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

Prof. Dr. Diethelm Wallwiener Universitätsfrauenklinik Calwerstrasse 7 72076 Tübingen Germany

PD Dr. Tilman T. Zittel

Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie Hoppe-Seyler Strasse 3

72076 Tübingen Germany

Contents V

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

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

Contents VI

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 VII

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

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

Contents VIII

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 IX

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)

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)

List of Contributors X

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

List of Contributors XI Steinar Hunskaar, MD, PhD

Section for General Practice, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway (e-mail: steinar.hunskar@isf.uib.no)

Lilli Hutzel, MD

Klinik und Poliklinik für Chirurgie, Universitätsklinikum,

Franz-Josef-Strauss-Allee 11, 93053 Regensburg (e-mail: dr.hutzel@t-online.de) Ekkehard C. Jehle, MD

Oberschwabenklinik, Krankenhaus St. Elisabeth, Elisabethenstrasse 15, 88212 Ravensburg, Germany (e-mail: Ekkehard.Jehle@oberschwabenklinik.de) Sibylle Klosterhalfen, MD

Universitätsklinik Düsseldorf, Institut für Medizinische Psychologie, Moorenstraße 5, 40225 Düsseldorf, Germany (e-mail: klosterh@uni-duesseldorf.de)

Heinz Kölbl, MD

Universitätsfrauenklinik, Langenbeckstrasse 1, 55101 Mainz, Germany (e-mail: koelbl@frauenklinik.uni-mainz.de)

Martin E. Kreis, MD

Klinikum Großhadern, Allgemeine Viszeral- und Transplantationschirurgie, Marchioninistraße 15, 81377 München, Germany

(e-mail: martin.kreis@med.uni-muenchen.de) Paul-Antoine Lehur, MD

Clinique Chirurgicale 2, Hotel Dieu, CHU de Nantes, 44093 Nantes, France (e-mail: paulantoine.lehur@chu-nantes.fr)

Tom F. Lue, MD

UCSF Medical Center, Department of Urology, 400 Parnassus Avenue, A-633 San Francisco, CA 94131, USA (e-mail: tlue@urol.ucsf.edu) Helmut Madersbacher, MD

Abteilung für Neurologie, Universitätshospital Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria (e-mail: Helmut.Madersbacher@tilak.at)

Klaus E. Matzel, MD

Chirurgische Klinik mit Poliklinik, Universität Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany (e-mail: Klaus.Matzel@chir.imed.uni-erlangen.de) Catherine W. McGrother, MD

Department of Epidemiology and Public Health, University of Leicester, 22–28 Princess Road West, Leicester, LE1 6TP, UK (e-mail: sk29@leicester.ac.uk) Guillaume Meurette, MD

Clinique Chirurgicale 2, Hotel Dieu, CHU de Nantes, 44093 Nantes, France (e-mail: guillaume.meurette@chu-nantes.fr)

List of Contributors XII

Roberto Merletti, PhD

COREP – Politecnico di Torino, Dipartimento di Electtronica,

Corso Duca degli Abruzzi 24, 10129 Torino, Italy (e-mail: roberto.merletti@polito.it) Gert Naumann, MD

Universitätsfrauenklinik, Langenbeckstrasse 1, 55101 Mainz, Germany (e-mail: gnaumann@uni-mainz.de)

Günter Neubauer, MD

Institut für Gesundheitsökonomik, Nixenweg 2b, 81739 Munich, Germany Lora Nunes, MD

UCSF Medical Center, Department of Urology, 400 Parnassus Avenue, A-633 San Francisco, CA 94131, USA (e-mail: tlue@urol.ucsf.edu) Roberto Olianas, MD

Allgemeines Krankenhaus Hamburg-Harburg, Eissendorfer Pferdeweg 52, 21075 Hamburg, Germany (e-mail: roberto.oleanas@planet-interkom.de) Christian Paetzel, MD

Institut für Röntgendiagnostik, Universitätsklinikum, Franz-Josef-Strauss-Allee 11, 93053 Regensburg (e-mail: christian.paetzel@klinik.uni-regensburg.de)

Prasad Patki, MBBS, FRCS, FEBU

Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, United Kingdom

Daniele Perucchini, MD

Universitätsspital Zürich, Departement Frauenheilkunde, Frauenklinikstrasse 10, 8091 Zürich, Switzerland (e-mail: perucchini@hin.ch)

Ursula M. Peschers, MD

Frauenklinik, Amper Kliniken AG, Konrad Adenauer Strasse 30, 85221 Dachau, Germany (e-mail: Ursula.Peschers@amperkliniken.de)

Aniceto Puigdollers, MD

Hospital de Mollet, Barcelona, Spain Nicolas Regenet, MD

Clinique Chirurgicale 2, Hotel Dieu, CHU de Nantes, 44093 Nantes, France (e-mail: nicolas.regenet@chu-nantes.fr)

Christl Reisenauer, MD

Universitätsfrauenklinik, Calwerstrasse 7, 72076 Tübingen, Germany (e-mail: christl.reisenauer@med.uni-tuebingen.de)

Ella Retzlaw, MD

Universitätsfrauenklinik, Calwerstraße 7, 72076 Tübingen, Germany (e-mail: ella.retzlaw@med.uni-tuebingen.de)

Todd H. Rockwood, PhD

University of Minnesota, Cities Institute for Public Health Research, Division of Health Services Research, Policy & Administration,

420 Delaware Street S.E., Mayo Mail Stop 729, Minneapolis, MN 55455-0392, USA (e-mail: rockw001@umn.edu)

Harald R. Rosen, MD

Ludwig Boltzmann Institut für Chirurgische Onkologie, Donauspital / SMZ-Ost, Langobardenstrasse 122, 1220 Vienna, Austria (e-mail: rosensurg@compuserve.com) Andreas Schreyer, MD

Institut für Röntgendiagnostik, Universitätsklinikum, Franz-Josef-Strauss-Allee 11, 93053 Regensburg (e-mail: andreas.schreyer@klinik.uni-regensburg.de)

Daniela Schultz-Lampel, MD

Klinikum der Stadt Villingen-Schwenningen, Kontinenzzentrum Südwest, Röntgenstrasse 20, 78054 Villingen-Schwenningen, Germany

(e-mail: Ksw@Klinikumvs.de) Julian R. Shah, MD

Institute of Urology and Nephrology, 48 Riding House Street, London, WIP 7PN, UK (e-mail: pjrshahsec@hotmail.com)

Karl-Dietrich Sievert, MD

Universitätsklinik für Urologie, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany (e-mail: karl.sievert@med.uni-tuebingen.de)

Uwe Stadelmaier, MD

Chirurgische Klinik mit Poliklinik, Universität Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany (e-mail: Uwe.Stadelmaier@web.de)

Sandra Stiefelmeyer, MD

Institut für Gesundheitsökonomik, Nixenweg 2b, 81739 Munich, Germany Arnulf Stenzl, MD

Universitätsklinik für Urologie, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany (e-mail: urologie@med.uni-tuebingen.de)

Alan G. Thorson, MD

Creighton University School of Medicine, Section of Colon and Rectal Surgery, 9850 Nicholas Street, Suite 100, Omaha, NE 68114, USA (e-mail: agthorson@msn.com) Tony Tsai, MD

The New York Medical Center of Queens, Reproductive Endocrinology & Infertility, Department OB/GYN, 45-56 Main Street, New York, NY 1355, USA

Ralf Tunn, MD

Urogynäkologie, Deutsches Beckenbodenzentrum, St. Hedwig-Krankenhaus, Grosse Hamburger Strasse 5–11, 10115 Berlin, Germany (e-mail: r.tunn@alexius.de)

List of Contributors XIII

Diethelm Wallwiener, MD

Universitätsfrauenklinik, Calwerstrasse 7, 72076 Tübingen, Germany (e-mail: diethelm.wallwiener@med.uni-tuebingen.de)

William E. Whitehead, PhD

University of North Carolina at Chapel Hill, CB 7080, 724 Burnett-Womack Building, Chapel Hill, NC 27599, USA, (e-mail: william_whitehead@med.unc.edu)

Tilman T. Zittel, MD

Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie, Hoppe-Seyler Strasse 3, 72076 Tübingen, Germany

(e-mail: tilman.zittel@med.uni-tuebingen.de) Wolfgang Zubke, MD

Universitätsfrauenklinik, Calwerstrasse 7, 72076 Tübingen, Germany (e-mail: wolfgang.zubke@med.uni-tuebingen.de)

List of Contributors XIV

Part I

Epidemiologic and Health Costs

of Incontinence I