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Der Urologe

, Volume 58, Issue 2, pp 197–206 | Cite as

Management von Harnleiterverletzungen

  • S. Ledderose
  • V. Beck
  • M. Chaloupka
  • A. Kretschmer
  • F. Strittmatter
  • S. TritschlerEmail author
CME
  • 9 Downloads

Zusammenfassung

Harnleiterverletzungen machen weniger als 3 % der Traumata im Urogenitaltrakt aus. Sie entstehen meist iatrogen während operativer Eingriffe im Bauchraum. Die Symptome sind unspezifisch und für die Diagnosestellung wenig hilfreich. Je später die Verletzung erkannt wird, desto häufiger kommt es zu Komplikationen. Daher ist es wichtig, bei entsprechender Anamnese an die Möglichkeit einer Harnleiterverletzung zu denken und weiterführende Diagnostik zu veranlassen. Verschiedene diagnostische Methoden stehen zur Verfügung. Neben der direkten Inspektion der Ureteren und der retrograden Ureteropyelographie hat sich die Computertomographie-Urographie etabliert. Abhängig vom Zeitpunkt der Diagnosestellung, dem Ausmaß und der Lokalisation der Verletzung wird das Prozedere festgelegt. Bei geringgradigen Verletzungen ist meist die Einlage einer Harnleiterschiene Therapie der Wahl, bei höhergradigen muss eine operative Rekonstruktion erfolgen, wobei verschiedene Operationsverfahren Anwendung finden.

Schlüsselwörter

Urogenitaltrakt Trauma Computertomographie Retrograde Ureteropyelographie Harnleiterrekonstruktion 

Management of ureteral injuries

Abstract

Ureteral injuries account for less than 3% of genitourinary injuries. Most of them are caused iatrogenically during abdominal surgery. The symptoms are often non-specific and do not aid in diagnosis. The later the injury is detected, the more often complications occur. Therefore, in such situations it is important to consider the possibility of ureteral injury and initiate further diagnostic steps as soon as possible. A variety of diagnostic tests are available. In addition to the direct inspection of the ureters and retrograde ureteropyelography, computed tomography (CT) urography is routinely used. Based on the time of diagnosis as well as the extent and the localization of the injury, the further procedure can be determined. For minor injuries, the insertion of a ureteral splint is usually the treatment of choice. In the case of higher grade damage, operative reconstruction by one of several possible surgical procedures is indicated.

Keywords

Urogenital system Injuries Computed tomography Retrograde ureteropyelography Surgical repair 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

S. Ledderose, V. Beck, M. Chaloupka, A. Kretschmer, F. Strittmatter und S. Tritschler geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • S. Ledderose
    • 1
  • V. Beck
    • 2
  • M. Chaloupka
    • 1
  • A. Kretschmer
    • 1
  • F. Strittmatter
    • 1
  • S. Tritschler
    • 1
    • 2
    Email author
  1. 1.Urologische Klinik und Poliklinik, Klinikum GroßhadernLudwig-Maximilians-Universität MünchenMünchenDeutschland
  2. 2.Klinik für Urologie und Urologische Onkologie, Loretto-KrankenhausRKK-Klinikum FreiburgFreiburgDeutschland

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