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Manual Urologie Frank Finke Manual Urologie Basiswissen für den Stationsdienst Mit 23 Abbildungen 1998 Georg Thieme Verlag Stuttgart • New York Inhalt 1 Urologische Diagnostik 1 1.1 ausführliche Anamnese der urologischen Leitsymptome ... 1 1.2 Körperliche Untersuchung 4 1.3 Körperliche urologische Untersuchung 6 1.4 Labordiagnostik 8 1.4 Ultraschall 13 1.5 Röntgen 17 1.6 Urodynamische Untersuchung . 22 2 Entzündungen des Urogenitaltraktes 24 2.1 Grundsätzliches 24 2.1 Akute Pyelonephritis 25 2.2 Chronische Pyelonephritis 27 2.3 Abszedierende Pyelonephritis (septische Niere) 29 2.4 Pyonephrose (Eitersackniere) 30 2.5 Paranephritischer Abszeß 32 2.6-^ Zystitis 33 2.7 Harnwegsinfektion in der Gravidität 38 2.8 Akute Prostatitis 39 2.9 Chronische Prostatitis 41 2.1.0- -Vesik-ulitis 42 2.11 Vegetatives Urogenital-Syndrom (= Prostata-Neurose, Prostatopathie, Prostatodynie) 43 2.12X Chronisch-granulomatöse Prostatitis 44 2.13 Unspezifische Urethritis (Nicht-Go-Urethritis, ca. 30%) ... 44 2.14 Spezifische Urethritis (Go-Urethritis, ca. 70%) 46 2.15 Akute Epididymitis 47 2.16 Chronische Epididymitis 49 2.17 Orchitis , 50 2.18 Hodenabszeß " 51 2.19 Balanitis 52 Manual Urologie 3 Sonstige skrotale Erkrankungen 53 3.1 Hydrozele 53 3.2 Idiopathische Varikozele testis 54 3.3 Skrotalhernie 56 3.4 Spermatozele 57 4 Benigne Prostatahyperplasie (BPH) 58 5 Onkologie 66 5.1 Prostatakarzinom (PC) 67 5.2 Nierenzellkarzinom (NZK) 75 5.3 Nierenbecken- und Harnleiterkarzinom 82 5.4 Blasentumor 84 5.5 Hodentumor 94 5.6 Peniskarzinom 104 5.7 Harnröhrentumor 108 5.8 Analgesie beim Karzinomschmerz 110 5.9 Medikamentöse Tumortherapie 112 5.10 Tumorvorsorge/Tumornachsorge 116 6 Urolithiasis , 120 6.1 Allgemein 120 6.2 Ätiologie 122 6.3 Ursachen 123 6.4 Symptome 127 6.5 Diagnostik 128 6^6 Therapie 130 6.T3 Metaphylaxe des Steinleidens 133 7 Tuberkulose (Tb) 135 7.1 _ Allgemein 135 7.2 Urogenitaltuberkulose 136 8 Andrologie 144 8.1 Allgemein 144 8.2 Erektionsstörungen (erektile Dysfunktion, erektile Impotenz) 145 9 Kinderurologie < 149 9.1 Phimose 149 9.2 Hypospadie 150t 9.3 Epispadie 151 9.4 Maldescensus testis 152 Inhalt XI 9.5 Hydrocele testis/Hydrocele funiculi spermatici 153 9.6 Varikozele testis 154 9.7 Enuresis . 156 9.8 Megaureter 158 9.9 Vesikoureteraler Reflux 160 9.10 Ureterozele 162 9.11 Nierentumor (Nephroblastom, Wilms-Tumor) 163 9.12 Neuroblastom 164 10 Blasenfunktionsstörungen 166 10.1 Allgemein 166 10.2 Inkontinenz der Frau 170 11 Notfälle in der Urologie 175 11.1 Nierenverletzung 175 11.2 Blasenverletzung 176 11.3 Harnröhrenverletzung 177 11.4 Akutes Skrotum 178 11.5 Sonstige Notfälle 188 12 Therapeutische Eingriffe 206 12.1 Anlage eines Blasenverweilkatheters (BVK, DK) 206 12.2 Anlage einer suprapubischen Blasenfistel 208 12.3 Endoskopische Untersuchungen 209 13 Die ersten Operationen 215 13.1 Aufklärung 215 1353 Öperationsberichte 215 14 Haftungsrecht in der Medizin 221 15r "Stationsalltag 225 15.1 Angina pectoris 225 15.2 Myokardinfarkt 226 15.3 Hypertonus 227 15.4 Hypotonus 228 15.5 Phlebothrombose 229 15.6 Throrribophlebitis 230 15.7 Status asthmatikus 231 15.8 Chronisch-obstruktive Bronchitis (COLD) 232 15.9 Pneumonie 233 15.10 Lungenembolie 234 15!11 Übelkeit und Erbrechen 235 XII Manual Urologie 15.12 Akutes Abdomen/Ileus 237 15.13 Diabetes mellitus 239 15.14 Hypoglykämischer Schock 240 15.15 Apoplex 240 15.16 Wasser-und Elektrolythaushalt 241 16 Medikamente 247 16.1 Antibiotikaeinschränkung durch Niereninsuffizienz (Applikation i.v.) 248 16.2 Antibiotikatherapie in der Schwangerschaft 250 16.3 Antibiotikatherapie bei Kindern 251 16.4 Auswahl einiger Medikamente in der Urologie 252 16.5 Auswahl einiger Medikamente bei Blasenentleerungsstörung 255 16.6 Sonstige Medikamente 256 16.7 Auswahl einiger Medikamente, die die Miktion beeinträchtigen 258 17 Normwerte 260 17.1 Hämatologie 260 17.2 Blutgerinnung 261 17.3 Blutgase und Säure-Basen-Haushalt 261 17.4 Serum-/Plasmaparameter 262 17.5 Urologische Tümormarker 264 17.6 Urinparameter zur Steinabklärung 265 17.7 Hormone 265 17.8 Funktionstest . 267 Literaturverzeichnis 268 Sachverzeichnis 269 Bildnachweis Das Abbildungsmaterial stammt, soweit nicht anders vermerkt, aus: Alken/Walz (1992) Urologie. Chapman & Hall GmbH, Weinheim.
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