{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:14:06Z","timestamp":1719965646003},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T00:00:00Z","timestamp":1716940800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T00:00:00Z","timestamp":1716940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Carl Gustav Carus Dresden an der Technischen Universit\u00e4t Dresden"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Urologie"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:sec>\n                <jats:title>Hintergrund<\/jats:title>\n                <jats:p>Die Belastungsinkontinenz des Mannes ist \u00fcberwiegend iatrogen bedingt. Aktuelle Studien zeigen nicht nur in Deutschland ein Versorgungsdefizit in der operativen Therapie. Ziel ist es, die strukturelle Versorgung der operativen Therapie der m\u00e4nnlichen Belastungsinkontinenz in Deutschland detaillierter zu untersuchen.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material und Methoden<\/jats:title>\n                <jats:p>Die Auswertung der strukturellen Versorgung durch Belastungsinkontinenzoperationen des Mannes in Deutschland erfolgt anhand von OPS-Codes der Qualit\u00e4tsberichte der Krankenh\u00e4user von 2011 bis 2019.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ergebnisse<\/jats:title>\n                <jats:p>Von 2012 bis 2019 zeigt sich ein R\u00fcckgang der Inkontinenzoperationen beim Mann von 2191 auf 1445. Die Zahl der Kliniken, die Inkontinenzoperationen durchf\u00fchren, fiel von 275 auf 244. In der multivariaten Analyse ist eine hohe Zahl (<jats:italic>n<\/jats:italic>\u202f\u2265\u202f50) an radikalen Prostatektomien\/Jahr (RPE\/Jahr) ein unabh\u00e4ngiger Pr\u00e4diktor f\u00fcr eine High-volume-Klinik (\u2265\u202f10\u00a0Eingriffe\/Jahr: Odds Ratio [OR] 6,4 [2,3\u201317,6]; <jats:italic>p<\/jats:italic>\u202f&lt;\u20090,001). Ein deutlicher R\u00fcckgang ist bei Schlingenoperationen (von <jats:italic>n<\/jats:italic>\u202f=\u202f1091 auf 410; <jats:italic>p<\/jats:italic>\u202f&lt;\u20090,001) zu verzeichnen. Hier sank besonders die Fallzahl in Kliniken, die eine hohe Zahl an Schlingen implantierten (\u2265\u202f10\u00a0Schlingen\/Jahr; \u221269\u202f%; \u221262,4\u202f\u00b1\u200915,5\u00a0Operationen\/Jahr; <jats:italic>p<\/jats:italic>\u202f=\u20090,007). Diese haben sich auch in ihrer Anzahl verringert (von <jats:italic>n<\/jats:italic>\u202f=\u202f34\u00a0auf 10; <jats:italic>p<\/jats:italic>\u202f&lt;\u20090,001). Dies betraf insbesondere Klinken, die auch eine geringe Zahl an RPE\/Jahr aufwiesen (Zahl der Kliniken von 9\u00a0auf 0\u00a0gefallen [\u2212100\u202f%]).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Schlussfolgerung<\/jats:title>\n                <jats:p>Die Versorgungssituation der operativen Therapie der m\u00e4nnlichen Belastungsinkontinenz in Deutschland zeigt einen deutlichen R\u00fcckgang der Schlingenimplantation, insbesondere in kleinen Kliniken. Auf der einen Seite reflektiert dies die zunehmend differenzierte Indikationsstellung der Schlingenimplantation. Auf der anderen Seite ergibt sich der Verdacht auf eine entstandene Versorgungsl\u00fccke, da eine Kompensation durch andere operative Verfahren nicht ersichtlich ist.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00120-024-02360-0","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T16:02:27Z","timestamp":1716998547000},"page":"673-680","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Strukturelle Versorgungssituation der operativen Therapie bei m\u00e4nnlicher Belastungsinkontinenz in Deutschland","Structural health care reality in the surgical treatment of male stress incontinence in Germany"],"prefix":"10.1007","volume":"63","author":[{"given":"Viktoria","family":"Menzel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricarda M.","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Grabbert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliane","family":"Putz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Eisenmenger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luka","family":"Flegar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelika","family":"Borkowetz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Huber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Baunacke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"issue":"11","key":"2360_CR1","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1056\/NEJMoa021483","volume":"347","author":"G Steineck","year":"2002","unstructured":"Steineck\u00a0G, Helgesen\u00a0F, Adolfsson\u00a0J, Dickman\u00a0PW, Johansson\u00a0JE, Norlen\u00a0BJ et\u00a0al (2002) Quality of life after radical prostatectomy or watchful waiting. 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