In postmenopausal patients, stress and urge incontinence often occur as a consequence of oestrogen deficiency. We performed a comparative study in a prospectively randomised and placebo controlled group of women with urge incontinence to investigate different dosages of intravaginally applied oestriol. Clinical and urodynamic parameters were also compared. 15 women (Group I) received 1 mg oestriol applied daily intravaginally over 3 weeks; 15 women (Group II) received a daily dosage of 3 mg and 10 women received a placebo. A complete clinical and urodynamic evaluation was carried out twice at a 4-week interval. The women receiving a daily dose of 3 mg oestriol applied intravaginally demonstrated a significant improvement of the parameters strong desire to void, pollakisuria, and nycturia. No improvement was seen in patients with motoric urge incontinence.

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In recent years, accurate preoperative diagnosis has been increasingly emphasized as an important therapeutic aspect of urinary incontinence in women. Forty patients suffering from recurrent stress incontinence underwent a dura-sling operation, i.e. loop surgery. The mean period od incontinence complaints prior to secondary surgery was 2.6 years. Follow-up urodynamic parameters revealed a slight improvement in urethral closure pressure (UCP) as well as significant improvement in functional urethral length and depression quotient. Radiologic investigations before and after sling surgery demonstrated good morphological results (angle beta). One year after surgery, 85% of the women had both clinical and urodynamic continence. Medium-term micturition complaints, however, have to be accepted in some of the patients.

Zusammenfassung Fragestellung: Durch die Entwicklung und Freigabe von Atosiban, einem selektiven Oxytocin-Rezeptor-Antagonisten, steht ein Medikament mit einer neuartigen, besonders auf die Physiologie der Schwangerschaft bezogenen Wirkung zur Tokolyse zur Verfügung. Diese Studie berichtet in Form einer Anwendungsbeobachtung über Erfahrungen beim Einsatz von Atosiban zur Tokolyse bei Patientinnen mit drohender Frühgeburt. Material und Methodik: 79 Patientinnen mit Diagnosestellung einer drohenden Frühgeburt wurden in die Studie inkludiert. Aufnahmediagnosen waren vorzeitige Wehentätigkeit (50), vorzeitiger Blasensprung (21), vaginale Blutung (6) und Zervixinsuffizienz (6), 4 Patientinnen wurden nach Entlassung neuerlich aufgenommen. Das Gestationsalter lag zwischen 21. und 33. Schwangerschaftswoche. Vorzeitige Wehentätigkeit wurde bei einem tokographischen Nachweis von mindestens 4 Kontraktionen/30 min und mindestens einem positiven Ergebnis der beiden Untersuchungen: 1. sonographisch nachgewiesener Zervixverkürzung unter 30 mm oder 2. positiver Nachweis von fetalem Fibronectin im Vaginalsekret, diagnostiziert. Die Wirksamkeit der Tokolyse wurde bei Diagnose einer vorzeitigen Wehentätigkeit anhand der Anzahl bestehender Schwangerschaften nach 48 Stunden und 7 Tagen ermittelt. Die Kontraktionsfrequenz wurde vor und 3 ± 12 h nach Applikation gemessen. Das peri-und neonatale, kindliche Outcome der geborenen Kinder wurde ermittelt. AbstractPurpose: To evaluate the effects of Atosiban which has been recently made available for routine treatment of patients with threatening pre-term delivery. Advantage of this tocolytic drug is its specific action on reproductive tissues. Material and Methods: 79 Patients were retrospectively evaluated, diagnoses at admission were pre-term labor (50), preterm rupture of membranes (21), vaginal bleeding (6) and incompetent cervix (6). Gestational age lied between 21st and 33rd week of pregnancy. Pre-term labor was defined as ³ 4 uterine contractions/30 min and at least one of these 2 examinations positive: 1. cervical length < 30 mm examined by vaginal ultrasound, 2. detection of vaginal fetal fibronectin. Tocolytic effectiveness was determined as the number of women having a diagnose of pre-term labor who were still pregnant after 48 hours and after 7 days. The influence on the frequency of contractions before and 3 ± 12 hours after start of treatment was assessed. Maternal side effects, perinatal and neonatal morbidity was evaluated Results: After 48 hours 86.0 % of patients with threatening preterm delivery and after 7 days 80.0 % of these patients had not been delivered. Atosiban decreased the frequency of contractions from 8.0 4.9 (mean sed) before treatment to 2.4 3.2 contractions/30 min after start of treatment. At the initial bolus application 33% of patients presented drug related side effects as nausea, vertigo and flush over a short period of 1 ± 2 minutes. During infusion in 6% of patients side effects possibly related to Atosiban Originalarbeit 755 Institutsangaben