Zusammenfassung
Terminal niereninsuffiziente Patienten bedürfen bis zur Nierentransplantation (NTX) einer regelmäßigen urologischen Vorsorgeuntersuchung. Ziel ist die Früherkennung und Behandlung urologischer Tumoren, die Abklärung der oberen und unteren Harnwege und ggf. die Indikationsstellung zu einer urologischen Operation vor Freigabe zur NTX (z. B. Nephrektomie bei polyzystischen Nieren). Die urologische Nachbetreuung nierentransplantierter Patienten dient vornähmlich der Erkennung und Behandlung von Harnleiterkomplikationen und symptomatischen Lymphozelen. In der längerfristigen Nachsorge liegt das Augenmerk auf der Tumorfrüherkennung. Die Behandlung einer eventuellen erektilen Dysfunktion nach Nierentransplantation gehört ebenfalls zu den Aufgaben des behandelnden Urologen.
Im Rahmen der Lebendnierenspende muss sowohl vorher als auch in der Nachsorge eine urologische Betreuung erfolgen. Die Evaluation der Lebendspender sollte an Hand international gültiger Leitfäden erfolgen
Abstract
Patients with end-stage renal disease awaiting kidney transplantation require regular urological evaluation. The urologist’s main task is early diagnosis and treatment of genitourinary malignancies and evaluation of the lower urinary tract. Furthermore, urologists are often confronted with the question of whether or not to perform pretransplant urological surgery, i.e., native nephrectomy for polycystic kidney disease. Urological care after kidney transplantation involves diagnosis and treatment of ureteral complications, malignancies, lower urinary tract symptoms, and last but not least erectile dysfunction, which has a prevalence of 20–50% among kidney transplant recipients.
For the evaluation and follow-up of the living kidney donor, international guidelines have been developed in recent years to also help the urologist to perform a correct evaluation and follow-up of the kidney donor.
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Fuller, T.F., Liefeldt, L., Dragun, D. et al. Urologische Betreuung von Patienten vor und nach Nierentransplantation. Urologe 45, 53–59 (2006). https://doi.org/10.1007/s00120-005-0964-8
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DOI: https://doi.org/10.1007/s00120-005-0964-8