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2014 | OriginalPaper | Buchkapitel

29. Vesikoureteraler und vesikorenaler Reflux

verfasst von : R. Stein, J.W. Thüroff

Erschienen in: Facharztwissen Urologie

Verlag: Springer Berlin Heidelberg

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Zusammenfassung

Unterschieden wird zwischen primärem und sekundärem vesikoureteralem und vesikorenalem Reflux. Ja nach Ausprägung und Erweiterung auch des Nierenbeckenkelchsystems wird der Reflux nach der International Reflux Study Group in 5 Grade eingeteilt. Der primäre Reflux ist durch eine (anatomisch-funktionelle) Störung des ureterovesikalen Übergangs bedingt, er kann sich mit dem Wachstum des Kindes rückbilden. Zur Diagnostik gehören Sonografie, MCU zur Darstellung des Refluxes und der DMSA-Scan zur Dokumentation von Parenchynarben. Ziel der Therapie ist die Vermeidung von Parenchymnarben. Die Therapie ist von den Risikofaktoren abhängig (Alter und Geschlecht des Kindes, Blasen und Darmentleerungsstörungen, vorangegangene Harnwegsinfektionen, Parenchymnarben, Grad des Refluxes (dilatierender versus nichtdilatierender Reflux)). Die konservative Therapie beinhaltet das Ausschalten von Risikofaktoren unter einem antibiotischen Schutz. Endoskopische Verfahren stellen bei Patienten mit niedrigem Risiko eine Alternative zur antibiotischen Prophylaxe dar. Offene operative Verfahren sollten insbesondere bei Patienten mit hohem Risiko angestrebt werden. Beim sekundären Reflux erfolgt zunächst die Therapie der Ursache (funktionelle oder anatomische infravesikale Obstruktion).

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Titel: Vesikoureteraler und vesikorenaler Reflux
verfasst von: R. Stein
J.W. Thüroff
Verlag: Springer Berlin Heidelberg
Buch: Facharztwissen Urologie
Print ISBN: 978-3-642-44941-3

Electronic ISBN: 978-3-642-44942-0

Copyright-Jahr: 2014
DOI: https://doi.org/10.1007/978-3-642-44942-0_29

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29. Vesikoureteraler und vesikorenaler Reflux

Zusammenfassung

Neu im Fachgebiet Urologie

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Stufenschema weist Prostatakarzinom zuverlässig nach

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

Varikozelen bei Jugendlichen: Das Für und Wider der Operation

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Neu im Fachgebiet Urologie

Bei Senioren mit Prostatakarzinom auf Anämie achten!

Stufenschema weist Prostatakarzinom zuverlässig nach

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

Varikozelen bei Jugendlichen: Das Für und Wider der Operation

Update Urologie