2024-
2025
Urologie
PROF DR EVERAERTS EN PROF DR VAN DER AA
JOZEFIEN CEULEMANS
,Introductie + H1: LUTS deel I ..................................................................................................... 8
Introductie .............................................................................................................................. 8
Wat is urologie?.................................................................................................................. 8
Evidence based medicine ................................................................................................... 9
LUTS: Lower Urinary Tract Symptoms deel I .......................................................................... 9
LUT symptomen ................................................................................................................. 9
Anamnese ......................................................................................................................... 10
Types urinaire incontinentie ............................................................................................ 11
Klinisch onderzoek............................................................................................................ 11
Bijkomende onderzoeken ................................................................................................ 12
LUTS: urgency incontinentie = overactieve blaas ............................................................ 14
Definitie ........................................................................................................................ 14
Pathogysiologie ............................................................................................................ 14
Behandeling .................................................................................................................. 14
LUTS deel II............................................................................................................................... 15
Stressincontinentie............................................................................................................... 15
Pathofysiologie ................................................................................................................. 15
Behandeling ...................................................................................................................... 15
Continue incontinentie......................................................................................................... 16
Overloop incontinentie .................................................................................................... 16
Vesicovaginale fistel ......................................................................................................... 16
Diagnose ....................................................................................................................... 16
Plasproblemen bij de man ‘male LUTS’ ................................................................................ 17
Beninge prostaathyperplasie ........................................................................................... 17
Symtomen .................................................................................................................... 17
Terminologie ................................................................................................................ 17
Epidemiologie ................................................................................................................... 18
Diagnose ........................................................................................................................... 18
Complicaties ..................................................................................................................... 18
Lagere urinewegen ....................................................................................................... 18
Hogere urinewegen ...................................................................................................... 18
Andere .......................................................................................................................... 19
Behandeling ...................................................................................................................... 19
Andere oorzaken en behandelingen ................................................................................ 21
Nachtelijke polyurie ..................................................................................................... 21
1
, Blaassteen .................................................................................................................... 21
Hypocontractiele/atone detrusor ................................................................................ 21
Blaasontsteking ............................................................................................................ 21
TCC/ blaaspoliepen....................................................................................................... 21
Blaashals/bekkenbodemdysfunctie ............................................................................. 22
Blaashalsstenose .......................................................................................................... 22
Fimosis .......................................................................................................................... 22
Meatusstenose ............................................................................................................. 22
Urethra strinctuur ............................................................................................................ 22
Infecties, urolithiasis en problemen HUW .............................................................................. 23
Infecties ................................................................................................................................ 23
Cystitis .............................................................................................................................. 23
Pathologie..................................................................................................................... 23
Symptomen .................................................................................................................. 23
Behandeling .................................................................................................................. 23
Gecompliceerde cystitis ............................................................................................... 23
Recidiverende cystitis ................................................................................................... 24
Rationeel AB gebruik .................................................................................................... 24
Blaaspijnsyndroom ........................................................................................................... 24
Pyelonefritis...................................................................................................................... 25
Behandeling .................................................................................................................. 25
Urosepsis .......................................................................................................................... 25
Pyonefrose........................................................................................................................ 25
Prostatitis ......................................................................................................................... 26
Chronische prostatitis .................................................................................................. 26
Andere infecties ............................................................................................................... 26
Epididymo-orchitis ....................................................................................................... 26
Orchitis ......................................................................................................................... 27
Urethritis ...................................................................................................................... 27
Urolithiasis en problemen van HUW .................................................................................... 27
Pyeloureterale junctie stenose ........................................................................................ 27
Ureterocoele .................................................................................................................... 27
Vesicoureterale reflux ...................................................................................................... 27
Pathofysiologie ............................................................................................................. 28
Nierkoliek ......................................................................................................................... 28
2
, Differentieel diagnose .................................................................................................. 28
Behandeling .................................................................................................................. 28
Metafylaxe .................................................................................................................... 29
Metabool onderzoek .................................................................................................... 29
Penoscrotale afwijkingen ........................................................................................................ 29
Anatomie .............................................................................................................................. 29
Klachten ................................................................................................................................ 30
Differentieel diagnose .......................................................................................................... 30
Goedaardige oorzaken pijnloze scrotale zwelling ................................................................ 30
Hydrocoele ....................................................................................................................... 30
Communicerende hydrocoele ...................................................................................... 30
Niet-communicerende hydrocoele .............................................................................. 31
Liesbreuk .......................................................................................................................... 31
Spermatocoele/epididymiscyste ...................................................................................... 31
Varicocoele ....................................................................................................................... 31
Afwijkingen scrotale huid ................................................................................................. 31
Testistumoren ...................................................................................................................... 32
Epidemiologie ................................................................................................................... 32
Indeling ............................................................................................................................. 32
Metastasen ....................................................................................................................... 32
Kliniek ............................................................................................................................... 32
Tumormerkers .............................................................................................................. 33
Behandeling ...................................................................................................................... 33
Adjuvante therapie ....................................................................................................... 33
Intratubulaire kiemcelneoplasie ...................................................................................... 33
Zuiver seminoma .............................................................................................................. 33
Non-seminomateuze ........................................................................................................ 34
Pijnlijke scrotale zwelling ..................................................................................................... 34
Torsio testis ...................................................................................................................... 34
Acute epididymitis/epididimo-orchitis............................................................................. 34
Trauma testis .................................................................................................................... 35
Gangreen van Fournier..................................................................................................... 35
Indalingsstoornissen van de testis ....................................................................................... 35
Palbeerbare testis......................................................................................................... 36
Niet-palpabele .............................................................................................................. 36
3
2025
Urologie
PROF DR EVERAERTS EN PROF DR VAN DER AA
JOZEFIEN CEULEMANS
,Introductie + H1: LUTS deel I ..................................................................................................... 8
Introductie .............................................................................................................................. 8
Wat is urologie?.................................................................................................................. 8
Evidence based medicine ................................................................................................... 9
LUTS: Lower Urinary Tract Symptoms deel I .......................................................................... 9
LUT symptomen ................................................................................................................. 9
Anamnese ......................................................................................................................... 10
Types urinaire incontinentie ............................................................................................ 11
Klinisch onderzoek............................................................................................................ 11
Bijkomende onderzoeken ................................................................................................ 12
LUTS: urgency incontinentie = overactieve blaas ............................................................ 14
Definitie ........................................................................................................................ 14
Pathogysiologie ............................................................................................................ 14
Behandeling .................................................................................................................. 14
LUTS deel II............................................................................................................................... 15
Stressincontinentie............................................................................................................... 15
Pathofysiologie ................................................................................................................. 15
Behandeling ...................................................................................................................... 15
Continue incontinentie......................................................................................................... 16
Overloop incontinentie .................................................................................................... 16
Vesicovaginale fistel ......................................................................................................... 16
Diagnose ....................................................................................................................... 16
Plasproblemen bij de man ‘male LUTS’ ................................................................................ 17
Beninge prostaathyperplasie ........................................................................................... 17
Symtomen .................................................................................................................... 17
Terminologie ................................................................................................................ 17
Epidemiologie ................................................................................................................... 18
Diagnose ........................................................................................................................... 18
Complicaties ..................................................................................................................... 18
Lagere urinewegen ....................................................................................................... 18
Hogere urinewegen ...................................................................................................... 18
Andere .......................................................................................................................... 19
Behandeling ...................................................................................................................... 19
Andere oorzaken en behandelingen ................................................................................ 21
Nachtelijke polyurie ..................................................................................................... 21
1
, Blaassteen .................................................................................................................... 21
Hypocontractiele/atone detrusor ................................................................................ 21
Blaasontsteking ............................................................................................................ 21
TCC/ blaaspoliepen....................................................................................................... 21
Blaashals/bekkenbodemdysfunctie ............................................................................. 22
Blaashalsstenose .......................................................................................................... 22
Fimosis .......................................................................................................................... 22
Meatusstenose ............................................................................................................. 22
Urethra strinctuur ............................................................................................................ 22
Infecties, urolithiasis en problemen HUW .............................................................................. 23
Infecties ................................................................................................................................ 23
Cystitis .............................................................................................................................. 23
Pathologie..................................................................................................................... 23
Symptomen .................................................................................................................. 23
Behandeling .................................................................................................................. 23
Gecompliceerde cystitis ............................................................................................... 23
Recidiverende cystitis ................................................................................................... 24
Rationeel AB gebruik .................................................................................................... 24
Blaaspijnsyndroom ........................................................................................................... 24
Pyelonefritis...................................................................................................................... 25
Behandeling .................................................................................................................. 25
Urosepsis .......................................................................................................................... 25
Pyonefrose........................................................................................................................ 25
Prostatitis ......................................................................................................................... 26
Chronische prostatitis .................................................................................................. 26
Andere infecties ............................................................................................................... 26
Epididymo-orchitis ....................................................................................................... 26
Orchitis ......................................................................................................................... 27
Urethritis ...................................................................................................................... 27
Urolithiasis en problemen van HUW .................................................................................... 27
Pyeloureterale junctie stenose ........................................................................................ 27
Ureterocoele .................................................................................................................... 27
Vesicoureterale reflux ...................................................................................................... 27
Pathofysiologie ............................................................................................................. 28
Nierkoliek ......................................................................................................................... 28
2
, Differentieel diagnose .................................................................................................. 28
Behandeling .................................................................................................................. 28
Metafylaxe .................................................................................................................... 29
Metabool onderzoek .................................................................................................... 29
Penoscrotale afwijkingen ........................................................................................................ 29
Anatomie .............................................................................................................................. 29
Klachten ................................................................................................................................ 30
Differentieel diagnose .......................................................................................................... 30
Goedaardige oorzaken pijnloze scrotale zwelling ................................................................ 30
Hydrocoele ....................................................................................................................... 30
Communicerende hydrocoele ...................................................................................... 30
Niet-communicerende hydrocoele .............................................................................. 31
Liesbreuk .......................................................................................................................... 31
Spermatocoele/epididymiscyste ...................................................................................... 31
Varicocoele ....................................................................................................................... 31
Afwijkingen scrotale huid ................................................................................................. 31
Testistumoren ...................................................................................................................... 32
Epidemiologie ................................................................................................................... 32
Indeling ............................................................................................................................. 32
Metastasen ....................................................................................................................... 32
Kliniek ............................................................................................................................... 32
Tumormerkers .............................................................................................................. 33
Behandeling ...................................................................................................................... 33
Adjuvante therapie ....................................................................................................... 33
Intratubulaire kiemcelneoplasie ...................................................................................... 33
Zuiver seminoma .............................................................................................................. 33
Non-seminomateuze ........................................................................................................ 34
Pijnlijke scrotale zwelling ..................................................................................................... 34
Torsio testis ...................................................................................................................... 34
Acute epididymitis/epididimo-orchitis............................................................................. 34
Trauma testis .................................................................................................................... 35
Gangreen van Fournier..................................................................................................... 35
Indalingsstoornissen van de testis ....................................................................................... 35
Palbeerbare testis......................................................................................................... 36
Niet-palpabele .............................................................................................................. 36
3
