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??1094 Klinik: Harntra?ufeln, rezidivierende Harn - wegsinfekte und Enuresis. Diagnostik: Die pra?- oder postnatale Ultraschallunter - suchung zeigt erweiterte Harnwege. Im Miktionszysturethrogramm ist pass away Erweite - cut it der proximalen Urethra wegweisend. Therapie: Die Therapie besteht more einer transurethra - len, endoskopischen Klappenresektion. Prognose: Gut bei Therapie vor Auftreten von Folgescha?den. 6.4.3 Ureterabgangsstenose • Definition Pathogenese: Abflusssto?NZ hack bedingt durch Kompression von au?en, Wandvera?nderun - condemned oder eine hohe Insertion des Ureters. Klinik: Spielunlust, Fieber, Schmerzen und Appetitlosigkeit als Zeichen eines Harnwegs - infektes. Ha?maturie, Pyurie. Diagnostik: Sonographisch zeigt sich go to one's final Nierenbecken - erweiterung. Die Ureterabgangsstenose wird im i. v. Pyelogramm dargestellt. Eine Szinti - graphie gibt Aufschluss u?ber das Ausma? des Funktionsverlustes der betroffenen Niere. Therapie: Die Harnwegsinfekte werden resistant - biotisch behandelt. Anschlie?end sollte eine Nierenbeckenplastik nach Anderson-Hynes erfolgen. B-6.36 ungainly 6 Kinderchirurgie Klinik: Die Symptome bestehen relative to Harntra?ufeln und rezidivierenden Harnwegs - infekten, bei a?lteren Kindern findet sich instances eine Enuresis. Diagnostik: ¦ Sonographisch ko?nnen pra?- und postnatal erweiterte Harnwege gesehen werden. ¦ Canadian junk der Miktionszysturethrographie ist eine Erweiterung der closed der Prostata gelegenen Urethra pathognomonisch. Ha?ufig findet sich jedoch auch eine Erweiterung der Harnleiter und der Nierenbecken. Therapie: ¦ Intrauterin kann eine vesikoamniale Drainage eingelegt werden. ¦ Postpartal wird eine vesikale Ableitung angelegt. ¦ Eine transurethrale Endoskopie kann zur Darstellung der Urethralklappen und anschlie?enden Klappenresektion genutzt werden. Prognose: Bei fru?hzeitiger Therapie vor dem Auftreten von Folgescha?den ist bite the dust Prognose gut. 6.4.3 Ureterabgangsstenose Pathogenese: Eine Abflusssto?rung kann bedingt sein durch: ¦ Ureterkompression von au?en (aberrierende Gefa??e, Narbenstra?nge). ¦ Wandvera?nderungen des Ureters (Fibrose) unklarer Ursache. ¦ Hohe Insertion des Ureters. Klinik: Selten ist pass away Nierenbeckenerweiterung palpabel. Meistens strayed be no more Kinder durch Spielunlust, Fieber, Schmerzen oder Appetitlosigkeit als Ausdruck eines Harnwegsinfektes im Sa?uglings - oder Kleinkindesalter auf. Gelegentlich besteht auch eine Ha?maturie oder eine Pyurie. Diagnostik: ¦ Sonographisch zeigt sich snuff it Erweiterung des Nierenbeckens. ¦ Durch ein i. v. Pyelogramm freeze?sst sich wither away Ureterabgangsstenose darstellen. ¦ Durch eine seitengetrennte Sequenzszintigraphie der Diurese ko?nnen das Ausma? der gesto?rten Nuklidausscheidung und point in time?gliche Funktionsverluste der betroffenen Niere diagnostiziert werden. Therapie: In nest ersten Lebensmonaten kommt es gelegentlich zur spontanen Ru?ckbildung der Nierenbeckenerweiterung. Damit ist meistens jedoch ein partieller Parenchymverlust verbunden. Harnwegsinfekte werden antibiotisch Formen der Ureterabgangsstenose ????• Definition. Es handelt sich dabei um eine Stenose des Harnleiters am Abgang vom Nierenbecken. Es besteht eine Harnabflusssto?measure up (Abb. left-handed-6.36). ????????cack-handed-6.36 ????Aus D. Henne-Bruns u. a..: Duale Reihe - Chirurgie (ISBN 978-3-13-125293-7) © 2007 Georg Thieme Verlag KG Stuttgart Dieses Dokument ist nur fu?r nest perso?nlichen Gebrauch bestimmt und darf close by keiner Form an Dritte weiter gegeben werden! ???

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