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Kontinente Harnableitungen

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Die Urologie

Part of the book series: Springer Reference Medizin ((SRM))

Zusammenfassung

Die in den 80iger- und 90iger-Jahren des letzten Jahrhunderts entwickelten Spielarten der kontinenten Harnableitung dienen bei Patienten mit Zystektomieindikation und/oder defunktionalisierter Blase als möglichst adäquates Blasensubstitut mit entsprechendem Erhalt der Lebensqualität.

Die Prinzipien von Detubularisation und Rekonfiguration zur Sicherung eines Niederdruckreservoirs schützen vor Inkontinenz und Schädigung des oberen Harntraktes und kommen bei allen modernen Harnableitungsformen (orthotop urethral, anal, heterotop kutan) zur Anwendung.

Im Lauf der Zeit sind praktisch alle Segmente des Magen-Darmtraktes auf ihre Eignung als Ausgangsmaterial für eine kontinente Harnableitung getestet worden. Exemplarische Harnableitungstechniken werden unter besonderer Berücksichtigung von Vorzügen und Schwächen, dem jeweils verwendeten Darmsegment und der technischen Besonderheiten bei der Konstruktion des afferenten und efferenten Segmentes detailgenau dargestellt.

Besonderes Augenmerk wurde auf die umfassende Beschreibung von Komplikationsmöglichkeiten und ihrer Prävention bzw. Behandlung gelegt. Dabei folgt die Gliederung den unterschiedlichen Pouchkomponenten (afferentes Segment, efferentes Segment, Reservoir) sowie den metabolischen Konsequenzen kontinenter Harnableitungen für den gesamten Organismus und der aktuellen Problematik der Sekundärmalignomentstehung.

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  1. Marienhospital Erwitte, Langenbeckstr. 1, 55131, Erwitte, Deutschland

    Christian Hampel

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  1. Universitätsklinikum Mannheim, Klinik für Urologie, Mannheim, Baden-Württemberg, Germany

    Maurice Stephan Michel

  2. Klinik für Urologie, Universitätsklinik Mannheim, Mainz, Germany

    Joachim W. Thüroff

  3. Abt. für Urologie, Universitätsklinikum Salzburg, Salzburg, Austria

    Günther Janetschek

  4. Klinik und Poliklinik für Urologie, Univer Tech Univ Dresden, Dresden, Germany

    Manfred Wirth

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Hampel, C. (2016). Kontinente Harnableitungen. In: Michel, M., Thüroff, J., Janetschek, G., Wirth, M. (eds) Die Urologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39940-4_99

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