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Infra- und supradiaphragmale Urethraverletzungen

Akute Therapie

Infra- and supradiaphragmatic urethral injuries

Acute treatment

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Zusammenfassung

Hintergrund

Harnröhrenverletzungen treten häufig durch stumpfe Traumata oder im Rahmen von Beckenfrakturen auf. Es sollte so früh wie möglich eine Harnableitung erfolgen.

Ergebnisse

Der suprapubische Katheter ist beim stabilen Patienten ohne offene Begleitverletzung im Beckenbereich das Standardverfahren. Eine primäre Wiederherstellung der Kontinuität mittels transurethraler Katheterisierung kann bei schwerwiegenden Begleitverletzungen mit der Notwendigkeit einer offenen Beckenoperation sinnvoll sein, insbesondere bei kompletter Dislokation der Verbindung von Harnröhrenstumpf und Harnblase oder Rektum-, Vaginal- und Blasenhalsverletzungen. In den meisten Fällen wird zu einem späteren Zeitpunkt eine offene Harnröhrenplastik mit End-zu-End-Anastomose erforderlich sein.

Abstract

Background

Urethral injuries are often caused by pelvic fractures or blunt trauma. Drainage of the urinary bladder is the first step of therapy.

Results

Urethral injuries are often caused by pelvic fractures or blunt trauma. Drainage of the urinary bladder is the first step of therapy. Standard procedure is the insertion of a suprapubic stent in stable patients without concomitant open injuries in the pelvis area. Endoscopic realignment is useful in patients with pelvic fracture, vaginal, rectal, or bladder injury, who require open surgery. Delayed repair by stricture excision and open urethroplasty with end-to-end anastomosis is the standard procedure.

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Authors and Affiliations

  1. Urologische Klinik und Poliklinik, Universitätsklinik Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

    O. Engel, K. Boehm, M. Rink, A. Soave & M. Fisch

Authors
  1. O. Engel
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  2. K. Boehm
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  3. M. Rink
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  4. A. Soave
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  5. M. Fisch
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Corresponding author

Correspondence to O. Engel.

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Interessenkonflikt

O. Engel, K. Boehm, M. Rink, A. Soave und M. Fisch geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Engel, O., Boehm, K., Rink, M. et al. Infra- und supradiaphragmale Urethraverletzungen. Urologe 55, 475–478 (2016). https://doi.org/10.1007/s00120-016-0062-0

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  • DOI: https://doi.org/10.1007/s00120-016-0062-0

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