Zusammenfassung
Obstruktionen des Harntraktes sind ein alltägliches klinisches Problem. Die Behinderung
des Harnabflusses kann akut oder chronisch, partiell oder komplett, ein- oder beidseitig
auftreten und im Bereich der gesamten ableitenden Harnwege vorkommen. Die Ursachen
von Harntraktobstruktionen variieren mit dem Alter der Patienten. Anatomische Fehlbildungen
wie z. B. eine Nierenbeckenabgangsstenose sind im Kindesalter am häufigsten. Dagegen
sind im mittleren Erwachsenenalter Harnsteine vorherrschend, während die benigne Prostatahyperplasie,
das Prostatakarzinom, retroperitoneale oder pelvine Tumore und Steine bei älteren
Patienten die Hauptursachen darstellen. Obstruktionen des Harntraktes führen zu verschiedenen
pathophysiologischen Veränderungen und verursachen dadurch unterschiedliche Symptome.
Die folgende Übersichtsarbeit präsentiert neben der Ätiologie, Pathophysiologie und
Klinik der obstruktiven Uropathie bei Erwachsenen auch moderne diagnostische und therapeutische
Verfahren.
Abstract
Urinary tract obstruction is a common clinical problem. The obstruction of the urinary
flow may be acute or chronic, partial or complete, unilateral or bilateral, and may
occur at any site of the urinary tract. The major causes of urinary tract obstruction
vary with the age of the patient. Anatomic abnormalities, e. g. ureteropelvic junction
obstruction, account for the majority of cases in children. In comparison, calculi
are most common in young adults, while prostatic hyperplasia or carcinoma, retroperitoneal
or pelvic neoplasms, and calculi are the primary causes in older patients. Urinary
tract obstruction results in different pathophysiological changes causing various
symptoms. In addition to the aetiology, pathophysiology and clinical presentation
of obstructive uropathy in adults, modern diagnostic and therapeutic options are presented
in this review.
Schlüsselwörter
Obstruktion - Uropathie - Ätiologie - Pathophysiologie - Klinik - Diagnose - Therapie
Key words
Obstruction - uropathy - aetiology - pathophysiology - clinical presentation - diagnosis
- treatment
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Dr. med. Stefan Bierer
Klinik und Poliklinik für Urologie · Universitätsklinikum Münster
Albert-Schweitzer-Str. 33
48149 Münster
Telefon: 0251/83-48001
Fax: 0251/83-48348 ·
eMail: bierers@mednet.uni-muenster.de