Urolithiasis – Diagnostik und Therapie der akuten Harnleiterkolik

Zusammenfassung

Die Urolithiasis ist eine Volkskrankheit, der bis zuletzt eine steigende Inzidenz in Industrieländern bescheinigt wurde. Neuesten Daten zufolge beläuft sich die Prävalenz in Deutschland auf ca. 3 %, bei einer jährlichen Neuerkrankungsrate von 0,4 %. Rezidive treten bei einem Viertel der Patienten mit meist zwei oder mehr Episoden auf. Während Nierensteine oft asymptomatisch sind, führt deren Migration in den Ureter i. d. R. zu akuten Flankenschmerzen, die häufig zu einer notfallmäßigen, ärztlichen Konsultation führen. Mit steigender Inzidenz des Harnsteinleidens wurde eine Zunahme notärztlicher Vorstellungen und stationärer Aufnahmen beobachtet. Dieser Artikel widmet sich dem diagnostischen und therapeutischen Vorgehen bei akuten Flankenschmerzen mit dem Verdacht auf einen Harnleiterstein. Hierbei wird v. a. auf das Einschätzen der Dringlichkeit einer Therapie und den zur Verfügung stehenden Therapieoptionen Wert gelegt.

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