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Samenvatting deel Functionele Urologie
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Dit is een samenvatting van het deel functionele urologie gegeven door professor Everaert.
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Functionele urologieInhoud
Inleiding..................................................................................................................................................4
1 Neurogene blaas..................................................................................................................................4
1.1 Neuroanatomie, fysiologie en pathologie.....................................................................................4
1.1.1 Efferente innervatie...............................................................................................................4
1.1.2 Afferente innervatie...............................................................................................................4
1.1.3 Mictiereflex............................................................................................................................4
1.1.4 Pontiene coördinatie.............................................................................................................5
1.2 De neurogene blaas......................................................................................................................5
1.2.1 Detrusorhyperreflexie met sfinctersynnergie........................................................................5
1.2.2 Detrusorhypperreflexie met sfincterdyssynnergie................................................................5
1.2.3 De areflexe neurogene blaas.................................................................................................5
1.3 Specifieke neurogene aandoeningen............................................................................................6
1.3.1 Spinale shock fase..................................................................................................................6
1.3.2 diabetes mellitus....................................................................................................................6
1.3.3 Syndroom van Parkinson.......................................................................................................7
1.3.4 Multiple Sclerose...................................................................................................................7
1.3.5 Spina Bifida............................................................................................................................8
1.4 Neurogene aandoeningen bij patiënten met urologische symptomen........................................8
1.5 Uropathie bij patiënten met gekend neurogeen lijden.................................................................8
1.6 Intermittente sondage..................................................................................................................8
2 Blaas dysfuncties.................................................................................................................................8
2.1 Het overactieve blaas syndroom..................................................................................................8
2.1.1 Etiologie.................................................................................................................................9
2.1.2 Pathofysiologie......................................................................................................................9
2.1.3 Kliniek....................................................................................................................................9
2.1.4 Diagnose................................................................................................................................9
2.1.5 Therapie...............................................................................................................................10
2.2 Hypo-acontractiele blaas............................................................................................................10
2.2.1 Etiologie...............................................................................................................................10
2.2.2 Pathofysiologie....................................................................................................................10
2.2.3 kliniek...................................................................................................................................11
2.2.4 Diagnose..............................................................................................................................11
, 2.2.5 Therapie...............................................................................................................................11
3 Bekkenbodemdysfuncties..................................................................................................................11
3.1 Deficiënte bekkenbodem (“stress”-incontinentie en prolaps)....................................................11
3.1.1 Etiologie...............................................................................................................................11
3.1.2 Fysiologie.............................................................................................................................12
3.1.3 Kliniek..................................................................................................................................12
3.1.4 Diagnose..............................................................................................................................12
3.1.5 Therapie...............................................................................................................................12
3.2 Hypertone bekkenbodem...........................................................................................................13
3.2.1 Etiologie...............................................................................................................................13
3.2.2 Fysiologie.............................................................................................................................13
3.2.3 Kliniek..................................................................................................................................13
3.2.4 Diagnose..............................................................................................................................13
3.2.5 Therapie...............................................................................................................................13
4 Incontinentie.....................................................................................................................................14
4.1 Incontinentie bij de vrouw..........................................................................................................14
4.1.1 Inleiding...............................................................................................................................14
4.1.3 Evaluatie van een vrouw met urineverlies, behandelen of doorsturen?.............................14
4.1.4 Heelkunde bij urineverlies bij de vrouw...............................................................................14
4.2 Incontinentie bij de man.............................................................................................................14
4.2.1 Inleiding...............................................................................................................................14
4.2.2 Therapie...............................................................................................................................15
4.3 Incontinentie bij de bejaarde......................................................................................................15
4.3.1 Factoren die kunnen aanzetten tot incontinentie................................................................16
4.3.1.1 Transiënte incontinentie...............................................................................................16
4.3.1.2 Chronische incontinentie..............................................................................................16
4.3.2 Incontinentie als oorzaak van andere problemen................................................................17
4.3.3 Diagnostiek van incontinentie..............................................................................................17
4.3.4 Therapie...............................................................................................................................17
4.3.4.1 Blaastraining en gedragstherapie.................................................................................17
4.3.4.2 Medicatie......................................................................................................................17
4.3.4.3 Kinesitherapie...............................................................................................................18
4.3.4.4 Chirurgie.......................................................................................................................18
4.3.4.5 Andere hulpmiddelen...................................................................................................18
4.3.5 Conclusie..............................................................................................................................18
5 chronische pelvische pijn syndroom..................................................................................................18
, 5.1 Definitie en prevalentie..............................................................................................................18
5.2 Etiologie......................................................................................................................................19
5.3 Chronisch blaaspijn syndroom....................................................................................................19
5.3.1 wat is het.............................................................................................................................19
5.3.2 diagnose...............................................................................................................................19
5.3.3 Therapie...............................................................................................................................19
4.5 Chronische prostatitis of prostatodynie.....................................................................................19
5.4.1 Definitie...............................................................................................................................19
5.4.2 Diagnose..............................................................................................................................19
5.4.3 Therapie...............................................................................................................................20
5.5 Chronische scrolate pijn..............................................................................................................20
5.5.1 Definitie...............................................................................................................................20
5.5.2 Onderzoek...........................................................................................................................20
5.5.3 Therapie...............................................................................................................................20
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