ABSTRACT
Many patients with chronic urological diseases report a long-term suffering. Because of previous failure to recognize the psychosomatic diagnosis they are inefficiently treated or even suffer from complications of unsuccessful therapy attempts, which in retrospect were not indicated. The patients are desperate and put all their hopes and expectations in every new doctor, which is why they put us urologists under tremendous pressure to perform and are a challenge for our diagnostic and therapeutic expertise. Knowledge of psychological comorbidities and their effect on the urogenital tract are essential for the differential diagnostics of the urological complaints and for a purposeful therapy.
Subject(s)
Mental Disorders/diagnosis , Mental Disorders/therapy , Psychophysiologic Disorders/diagnosis , Psychophysiologic Disorders/therapy , Urination Disorders/diagnosis , Urination Disorders/therapy , Diagnosis, Differential , Evidence-Based Medicine , Germany , Humans , Mental Disorders/psychology , Psychophysiologic Disorders/psychology , Treatment Outcome , Urination Disorders/psychologyABSTRACT
Urinary incontinence is a significant impairment of the quality of life. Many patients are treated insufficiently or even suffer from complications of incontinence surgery. Psychosomatic primary care serves to improve the diagnostic work-up and helps to select the appropriate therapeutic option. It also optimizes the treatment outcome by supplementing the somatically oriented urological therapy with the psychosomatically aligned extended medical dialogue and body-oriented methods. Psychosomatic primary care is based on the biopsychosocial model and uses theoretical knowledge and practical techniques that can be learnt under professional guidance.
Subject(s)
Primary Health Care/methods , Projective Techniques , Quality of Life/psychology , Urinary Incontinence/diagnosis , Urinary Incontinence/therapy , Humans , Urinary Incontinence/psychologyABSTRACT
Urinary incontinence in men most commonly occurs after radical prostatectomy. Of these patients, 3-23% remain incontinent a year after prostatectomy. Data on conservative therapy for postoperative incontinence is contradictory. Nonetheless, conservative treatment strategies must generally be attempted before any operative technique. Early pelvic floor muscle training with or without biofeedback therapy and duloxetine seem to have a positive effect on continence. Further randomised controlled studies are necessary to accurately assess other conservative therapeutic options such as extracorporeal magnetic innervation and electrical stimulation therapy.
