1 Congenitale aandoeningen van de nieren en de blaas........................................................................3
1.1 Pyelo-ureterale junctie stenose...................................................................................................3
1.2 Hydro-ureteronefrose...................................................................................................................3
1.3 Vesico-ureterale reflux.................................................................................................................4
2 Kleine kinderurologie...........................................................................................................................4
2.1 Fimosis..........................................................................................................................................4
2.2 Parafimosis...................................................................................................................................5
2.3 Liesbreuk......................................................................................................................................5
2.4 Hydrocoele...................................................................................................................................5
3 Urinaire incontinentie en enuresis......................................................................................................5
3.1 Definitie........................................................................................................................................5
3.2 Prevalentie....................................................................................................................................6
3.3 Pathogenese.................................................................................................................................6
3.3.1 Pathogenese van urinaire incontinentie................................................................................6
3.3.2 Pathogenese van monosymptomatische enuresis.................................................................7
3.3.2.1 Nachtelijke polyurie........................................................................................................7
3.3.2.2 Beperkte blaascapaciteit en/of overactiviteit van de detrusor.......................................8
3.3.2.3 Gestoord slaappatroon...................................................................................................8
3.3.2.4 Genetische factoren........................................................................................................8
3.4 Comorbiditeit................................................................................................................................8
3.5 Diagnose.......................................................................................................................................8
3.5.1 Anamnese..............................................................................................................................8
3.5.2 klinisch onderzoek.................................................................................................................8
3.5.3 Laboratoriumtesten...............................................................................................................9
3.5.4 Niet-invasieve diagnostische middelen..................................................................................9
3.5.4.1 Plas- en drinkdagboek.....................................................................................................9
3.5.4.2 De uroflow......................................................................................................................9
3.5.4.3 Echografie.......................................................................................................................9
3.5.5 Invasieve diagnostische technieken.......................................................................................9
3.5.5.1 Video-urodynamisch onderzoek.....................................................................................9
3.5.5.2 Cystoscopie onder narcose...........................................................................................10
3.6 Behandeling van urinaire incontinentie......................................................................................10
3.6.1 Urotherapie.........................................................................................................................10
3.6.2 Biofeedback.........................................................................................................................10
3.6.3 Neuromodulatie...................................................................................................................10
3.6.4 De dagwekker......................................................................................................................10
, 3.6.5 Medicamenteuze behandeling............................................................................................10
3.6.5.1 De antimuscarinica.......................................................................................................10
3.6.5.2 Botulinetoxine-A...........................................................................................................10
3.7 Behandeling van enuresis nocturna............................................................................................11
3.7.1 De plaswekker......................................................................................................................11
3.7.2 Medicamenteuze behandeling............................................................................................11
3.7.2.1 Desmopressine.............................................................................................................11
3.7.2.2 Anticholinergica............................................................................................................11
3.7.2.3 Tricyclische antidepressiva............................................................................................11
3.7.3 Combinatietherapie.............................................................................................................11
1.1 Pyelo-ureterale junctie stenose...................................................................................................3
1.2 Hydro-ureteronefrose...................................................................................................................3
1.3 Vesico-ureterale reflux.................................................................................................................4
2 Kleine kinderurologie...........................................................................................................................4
2.1 Fimosis..........................................................................................................................................4
2.2 Parafimosis...................................................................................................................................5
2.3 Liesbreuk......................................................................................................................................5
2.4 Hydrocoele...................................................................................................................................5
3 Urinaire incontinentie en enuresis......................................................................................................5
3.1 Definitie........................................................................................................................................5
3.2 Prevalentie....................................................................................................................................6
3.3 Pathogenese.................................................................................................................................6
3.3.1 Pathogenese van urinaire incontinentie................................................................................6
3.3.2 Pathogenese van monosymptomatische enuresis.................................................................7
3.3.2.1 Nachtelijke polyurie........................................................................................................7
3.3.2.2 Beperkte blaascapaciteit en/of overactiviteit van de detrusor.......................................8
3.3.2.3 Gestoord slaappatroon...................................................................................................8
3.3.2.4 Genetische factoren........................................................................................................8
3.4 Comorbiditeit................................................................................................................................8
3.5 Diagnose.......................................................................................................................................8
3.5.1 Anamnese..............................................................................................................................8
3.5.2 klinisch onderzoek.................................................................................................................8
3.5.3 Laboratoriumtesten...............................................................................................................9
3.5.4 Niet-invasieve diagnostische middelen..................................................................................9
3.5.4.1 Plas- en drinkdagboek.....................................................................................................9
3.5.4.2 De uroflow......................................................................................................................9
3.5.4.3 Echografie.......................................................................................................................9
3.5.5 Invasieve diagnostische technieken.......................................................................................9
3.5.5.1 Video-urodynamisch onderzoek.....................................................................................9
3.5.5.2 Cystoscopie onder narcose...........................................................................................10
3.6 Behandeling van urinaire incontinentie......................................................................................10
3.6.1 Urotherapie.........................................................................................................................10
3.6.2 Biofeedback.........................................................................................................................10
3.6.3 Neuromodulatie...................................................................................................................10
3.6.4 De dagwekker......................................................................................................................10
, 3.6.5 Medicamenteuze behandeling............................................................................................10
3.6.5.1 De antimuscarinica.......................................................................................................10
3.6.5.2 Botulinetoxine-A...........................................................................................................10
3.7 Behandeling van enuresis nocturna............................................................................................11
3.7.1 De plaswekker......................................................................................................................11
3.7.2 Medicamenteuze behandeling............................................................................................11
3.7.2.1 Desmopressine.............................................................................................................11
3.7.2.2 Anticholinergica............................................................................................................11
3.7.2.3 Tricyclische antidepressiva............................................................................................11
3.7.3 Combinatietherapie.............................................................................................................11
