UROLOGIE
H1: Herhaling bachelor ................................................................................................................. 5
Anatomie ................................................................................................................................... 5
Urinair stelsel ............................................................................................................................. 6
Niercirculatie ............................................................................................................................. 6
Urineproductie ........................................................................................................................... 7
Hoge urinewegen ........................................................................................................................ 7
Continentie: vereisten ................................................................................................................. 8
Perifere zenuwstelsel .................................................................................................................. 8
Normale blaassensatie ............................................................................................................... 9
Urethra ...................................................................................................................................... 9
Vereisten voor een goede mictie ................................................................................................... 9
Bekkenbodem ...........................................................................................................................10
Anatomie ..................................................................................................................................11
Functie van de testis ..................................................................................................................12
H2: oncologie – hematurie............................................................................................................13
Algemene regels ........................................................................................................................13
Oorzaken van hematurie.............................................................................................................13
Anamnese ................................................................................................................................13
Klinisch onderzoek ....................................................................................................................14
Technische onderzoeken ............................................................................................................14
Geen duidelijke oorzaken ...........................................................................................................15
Behandeling ..............................................................................................................................15
H3: oncologie – nier .....................................................................................................................16
Algemeen .................................................................................................................................16
Renaal celcarcinoom (RCC) ........................................................................................................16
Benigne niertumor: angiomyolipoma............................................................................................18
Benigne niertumor: oncocytoma .................................................................................................18
Behandeling: minimaal invasieve alternatieven .............................................................................18
Niertumoren: nefroblastoma (Wilmstumor) ..................................................................................19
Benigne niertumoren: niercysten .................................................................................................19
Urotheeltumor van pyelum of ureter ............................................................................................19
H4: Oncologie – prostaatkanker ...................................................................................................21
Incidentie .................................................................................................................................21
Risicofactoren ...........................................................................................................................21
Chemopreventie........................................................................................................................22
1
, Symptomen ..............................................................................................................................22
Onderzoek ................................................................................................................................22
Stadiëring .................................................................................................................................23
Beeldvorming ............................................................................................................................23
Behandeling ..............................................................................................................................23
H5: Oncologie – blaas, testis, penis ..............................................................................................27
Blaastumoren ...........................................................................................................................27
Testistumoren ...........................................................................................................................30
Peniscarcinoom: spinocellulair carcinoom van de penis (SCC) .......................................................31
H6: Urinaire infecties ...................................................................................................................33
Natuurlijke verdediging ...............................................................................................................33
Algemene inleiding UTI ...............................................................................................................33
Acute bacteriële cystitis .............................................................................................................35
Pyelonefritis ..............................................................................................................................37
Prostatitis .................................................................................................................................38
Urethritis ..................................................................................................................................40
Orchi-epidydimitis .....................................................................................................................40
Nosocomiale, kathetergerelateerde infecties ................................................................................41
Recidiverende infecties ..............................................................................................................41
Bijzondere infecties ...................................................................................................................42
H7: Genitale pathologie ...............................................................................................................44
Urethrastricturen .......................................................................................................................44
Peniele kromstand .....................................................................................................................45
Varicocoele ..............................................................................................................................46
Hydrocoele ...............................................................................................................................46
H8: Urologische urgenties en trauma ............................................................................................47
Torsio testis ..............................................................................................................................47
Acute penispathologie ...............................................................................................................47
Blaas/urethra ............................................................................................................................51
Niertrauma ...............................................................................................................................53
Uretertrauma ............................................................................................................................54
Blaastrauma .............................................................................................................................54
Urologische urgenties ................................................................................................................54
H9: sonderen ...............................................................................................................................56
Indicaties kunstmatige blaasdrainage ..........................................................................................56
Wanneer is sondage nodig? ........................................................................................................56
Obstructie en stase....................................................................................................................56
2
, Nefrostomie ..............................................................................................................................56
Transurethrale verblijfsonde .......................................................................................................57
Sonderen ..................................................................................................................................59
Verstopte hematurie sonde.........................................................................................................60
Suprapubische sonde ................................................................................................................60
Intermittente sondage (IC) ..........................................................................................................61
Terugbetaling ............................................................................................................................62
Besluit ......................................................................................................................................63
H10: chronisch primair pelvis pijn syndroom (CPPPS) ...................................................................64
Definities en terminologie ...........................................................................................................64
Inhoud CPPPS ...........................................................................................................................65
Fysiologie en pathofysiologie ......................................................................................................68
H11: neuro-urologie .....................................................................................................................69
Leerdoelen ...............................................................................................................................69
Lage urinewegen: algemeen........................................................................................................69
Neurologische ziektes – urologische klachten ...............................................................................71
H12: functiestoornissen lagere urinewegen ..................................................................................74
Leerdoelen ...............................................................................................................................74
Inleiding ...................................................................................................................................74
Types van UI ..............................................................................................................................76
Stress urinaire incontinentie (SUI) ................................................................................................77
Urgentie urinaire incontinentie (UUI) ............................................................................................80
H13: urolithiasis ..........................................................................................................................87
Epidemiologie ...........................................................................................................................87
Pathogenese .............................................................................................................................87
Type stenen: oorzaken en behandeling .........................................................................................87
Klinisch beeld ...........................................................................................................................88
Differentiaaldiagnose .................................................................................................................88
Diagnose ..................................................................................................................................88
Behandeling ..............................................................................................................................89
H14: lage urinewegobstructie: BPH – LUTS ....................................................................................92
Leerdoelen ...............................................................................................................................92
Obstructie ................................................................................................................................92
Benigne prostaatvergroting .........................................................................................................93
H15: urologische kinesitherapie ................................................................................................. 101
Bekkenbodem (BB) .................................................................................................................. 101
Bekkenbodemdysfunctie .......................................................................................................... 101
3
, Prevalentie urinaire incontinentie .............................................................................................. 102
Bekkenbodemtherapie ............................................................................................................. 103
4
H1: Herhaling bachelor ................................................................................................................. 5
Anatomie ................................................................................................................................... 5
Urinair stelsel ............................................................................................................................. 6
Niercirculatie ............................................................................................................................. 6
Urineproductie ........................................................................................................................... 7
Hoge urinewegen ........................................................................................................................ 7
Continentie: vereisten ................................................................................................................. 8
Perifere zenuwstelsel .................................................................................................................. 8
Normale blaassensatie ............................................................................................................... 9
Urethra ...................................................................................................................................... 9
Vereisten voor een goede mictie ................................................................................................... 9
Bekkenbodem ...........................................................................................................................10
Anatomie ..................................................................................................................................11
Functie van de testis ..................................................................................................................12
H2: oncologie – hematurie............................................................................................................13
Algemene regels ........................................................................................................................13
Oorzaken van hematurie.............................................................................................................13
Anamnese ................................................................................................................................13
Klinisch onderzoek ....................................................................................................................14
Technische onderzoeken ............................................................................................................14
Geen duidelijke oorzaken ...........................................................................................................15
Behandeling ..............................................................................................................................15
H3: oncologie – nier .....................................................................................................................16
Algemeen .................................................................................................................................16
Renaal celcarcinoom (RCC) ........................................................................................................16
Benigne niertumor: angiomyolipoma............................................................................................18
Benigne niertumor: oncocytoma .................................................................................................18
Behandeling: minimaal invasieve alternatieven .............................................................................18
Niertumoren: nefroblastoma (Wilmstumor) ..................................................................................19
Benigne niertumoren: niercysten .................................................................................................19
Urotheeltumor van pyelum of ureter ............................................................................................19
H4: Oncologie – prostaatkanker ...................................................................................................21
Incidentie .................................................................................................................................21
Risicofactoren ...........................................................................................................................21
Chemopreventie........................................................................................................................22
1
, Symptomen ..............................................................................................................................22
Onderzoek ................................................................................................................................22
Stadiëring .................................................................................................................................23
Beeldvorming ............................................................................................................................23
Behandeling ..............................................................................................................................23
H5: Oncologie – blaas, testis, penis ..............................................................................................27
Blaastumoren ...........................................................................................................................27
Testistumoren ...........................................................................................................................30
Peniscarcinoom: spinocellulair carcinoom van de penis (SCC) .......................................................31
H6: Urinaire infecties ...................................................................................................................33
Natuurlijke verdediging ...............................................................................................................33
Algemene inleiding UTI ...............................................................................................................33
Acute bacteriële cystitis .............................................................................................................35
Pyelonefritis ..............................................................................................................................37
Prostatitis .................................................................................................................................38
Urethritis ..................................................................................................................................40
Orchi-epidydimitis .....................................................................................................................40
Nosocomiale, kathetergerelateerde infecties ................................................................................41
Recidiverende infecties ..............................................................................................................41
Bijzondere infecties ...................................................................................................................42
H7: Genitale pathologie ...............................................................................................................44
Urethrastricturen .......................................................................................................................44
Peniele kromstand .....................................................................................................................45
Varicocoele ..............................................................................................................................46
Hydrocoele ...............................................................................................................................46
H8: Urologische urgenties en trauma ............................................................................................47
Torsio testis ..............................................................................................................................47
Acute penispathologie ...............................................................................................................47
Blaas/urethra ............................................................................................................................51
Niertrauma ...............................................................................................................................53
Uretertrauma ............................................................................................................................54
Blaastrauma .............................................................................................................................54
Urologische urgenties ................................................................................................................54
H9: sonderen ...............................................................................................................................56
Indicaties kunstmatige blaasdrainage ..........................................................................................56
Wanneer is sondage nodig? ........................................................................................................56
Obstructie en stase....................................................................................................................56
2
, Nefrostomie ..............................................................................................................................56
Transurethrale verblijfsonde .......................................................................................................57
Sonderen ..................................................................................................................................59
Verstopte hematurie sonde.........................................................................................................60
Suprapubische sonde ................................................................................................................60
Intermittente sondage (IC) ..........................................................................................................61
Terugbetaling ............................................................................................................................62
Besluit ......................................................................................................................................63
H10: chronisch primair pelvis pijn syndroom (CPPPS) ...................................................................64
Definities en terminologie ...........................................................................................................64
Inhoud CPPPS ...........................................................................................................................65
Fysiologie en pathofysiologie ......................................................................................................68
H11: neuro-urologie .....................................................................................................................69
Leerdoelen ...............................................................................................................................69
Lage urinewegen: algemeen........................................................................................................69
Neurologische ziektes – urologische klachten ...............................................................................71
H12: functiestoornissen lagere urinewegen ..................................................................................74
Leerdoelen ...............................................................................................................................74
Inleiding ...................................................................................................................................74
Types van UI ..............................................................................................................................76
Stress urinaire incontinentie (SUI) ................................................................................................77
Urgentie urinaire incontinentie (UUI) ............................................................................................80
H13: urolithiasis ..........................................................................................................................87
Epidemiologie ...........................................................................................................................87
Pathogenese .............................................................................................................................87
Type stenen: oorzaken en behandeling .........................................................................................87
Klinisch beeld ...........................................................................................................................88
Differentiaaldiagnose .................................................................................................................88
Diagnose ..................................................................................................................................88
Behandeling ..............................................................................................................................89
H14: lage urinewegobstructie: BPH – LUTS ....................................................................................92
Leerdoelen ...............................................................................................................................92
Obstructie ................................................................................................................................92
Benigne prostaatvergroting .........................................................................................................93
H15: urologische kinesitherapie ................................................................................................. 101
Bekkenbodem (BB) .................................................................................................................. 101
Bekkenbodemdysfunctie .......................................................................................................... 101
3
, Prevalentie urinaire incontinentie .............................................................................................. 102
Bekkenbodemtherapie ............................................................................................................. 103
4
