泌尿外科是看什么_泌尿科属于内科一经外科

泌尿外科是看什么先容1、泌尿科是看什么病的? 2、泌尿科属于内科一经外科, 3、泌尿外科学的先容 4、苏州哪个男科是最佳的病院?

泌尿科是看什么病的?

妇科主若是看生殖器官的疾病，如外阴，阴谈，宫颈，子宫，卵巢，输卵管，盆腔等。泌尿科主若是看有无泌尿系统的疾病，如尿路感染，膀胱炎，输尿管结石，肾结石，泌尿系统的肿瘤等。观点淡薄：淡薄一定要去正规的病院查验，在专科医师的教唆下进行积极有作用的诊疗，平时一定要可贵保握外阴清洁卫生，每天更换内裤。

泌尿科属于内科一经外科,

一般老例是泌尿外科，主若是诊疗干系的泌尿系统疾病如泌尿捆绑石、感染、肿瘤以及男性生殖等的干系问题，侧重于手术诊疗干系疾病。而诊疗肾脏的肾小球肾炎等疾病属于肾内科观点淡薄：你好，一般老例是泌尿外科，主若是诊疗干系的泌尿系统疾病如泌尿捆绑石、感染、肿瘤以及男性生殖等的干系问题，侧重于手术诊疗干系疾病。而诊疗肾脏的肾小球肾炎等疾病属于肾内科

泌尿外科学的先容

高考达成了，当今行将插足填报志愿的阶段，这时候除了推敲学校，还要推敲专科。有东谈主思了解泌尿外科学是什么。接下来我为宇宙整理了泌尿外科学的先容，但愿对你有匡助哦!

泌尿外科

泌尿外科，是主要会诊和诊疗泌尿系统“外科”部分疾病的病院科室，主要诊疗多样泌尿性疾病。

诊疗畛域

多样尿结石和复杂性肾结石;肾脏和膀胱肿瘤;前线腺增生和前线腺炎;睾丸附睾的炎症和肿瘤;睾丸精索鞘膜积液;多样泌尿系毁伤;泌尿系先天性乖谬如尿谈下裂、隐睾、肾盂输尿管邻接部狭小所导致的肾积水等等。

泌尿外科是个相比陈腐的专科，有较久的历史;但同期却又是个相比新的专科，甚而到2013年，在有的分科病院里，一经有别的专科而只有莫得泌尿外科。这讲明，这个专科是迫切的，但发展亦然起义衡的。

差异

泌尿外科不应该叫“泌尿科”，因为它不包括与尿关联的“内科”部分，如肾炎、糖尿病、尿崩症等，这应当加以差异而幸免羞耻。可是情况在变化，科学在前进，不休地有新的形势由内科畛域转入到泌尿外科中来，举例肾血管性高血压、肾上腺的一些疾病等，是以也必须辩证唯物地看待问题。

泌尿外科学

泌尿外科学主要内容为肾脏移植，腹腔镜手术，肾上腺腺瘤、嗜铬细胞瘤、原发性醛固酮增多症等肾上腺手术诊疗，肾、膀胱、前线腺肿瘤手术，前线腺癌手术，肾盂输尿管叮咛部狭小手术，肾、输尿管、膀胱结石手术诊疗，经膀胱、耻骨后前线腺增生摘除手术，经尿谈膀胱肿瘤电切手术，经膀胱镜愚弄钬激光进行膀胱肿瘤切除，尿谈下裂、阴茎下屈整形等手术，体外碎石诊疗肾、输尿管、膀胱结石。连年来开展了慢性前线腺炎的病因查验和诊疗，以及男性性功能遮拦和男性不育的诊治。

案例：梗阻性尿路疾病

Obstruction is one of the most important abnormalities of the urinary tract， since it eventually leads to decompensation of the muscular conduits and reservoirs， back pressure， and atrophy of renal parenchyma. It also invites infection and stone formation， which cause additional damage and can ultimately end in complete unilateral or bilateral destruction of the kidneys.

梗阻是泌尿谈最迫切的特殊之一，因其最终使肌性管谈极度容器失去代偿才智，发生反压及肾内容萎缩。它亦可导致感染及结石形成，加剧肾脏损害，最终使一侧或双侧肾脏统统侵略。

Both the level and degree of obstruction are important to an understanding of the pathologic consequences. Any obstruction at or distal to the bladder neck may lead to back pressure affecting both kidneys. Obstruction at or proximal to the ureteral orifice leads to unilateral damage unless the lesion involves both ureters simultaneously. Complete obstruction leads to rapid decompensation of the system proximal to the site of obstruction ，with immediate muscular failure. For example， acute retention occurs if the obstruction is distal to the bladder， and anuria occurs if obstruction involves both ureters. Partial obstruction leads to gradual progressive muscular hypertrophy followed by gradual dilation. decompensation ，and hydronephrotic changs. Vesicoureteral reflux may develop in some cases.

梗阻的平面及进度对了解其病后果是迫切的。膀胱颈或膀膛颈以下部位梗阻，其反压可影响双侧肾脏，而输尿管口或其近端梗阻则引起单侧损害，除非双侧输尿管同期有病变。统统梗阻可能可使梗阻以上泌尿系统飞速升值失代偿才智，伴有坐窝肌力丧失。举例梗阻在膀胱以下部位不错引起急性尿潴留，而双侧输尿管发生梗阻则可出现无尿。部分梗阻则迟缓引起进行性肌肉肥厚，随后出现迟缓扩张，代偿功能丧失及肾积水变化。膀胱输尿管反流可在某些病例出现。

Etiology

病因

Acquired urinary tract obstruction may be due to inflammatory or traumatic urethral strictures， bladder outlet obstruction (benign prostatic hypertrophy or cancer of the prostate)， vesical tumors， neuropathic bladder， extrinsic ureteral compression (tumor， retroperitoneal fibrosis， or enlarged lymph nodes)， ureteral or pelvic stones， ureteral strictures， or ureteral or pelivic tumors.

赢得性尿路梗阻可能由于炎性或毁伤性尿谈狭小，膀胱出口梗阻(良性前线腺肥硕或前线腺癌)、膀胱肿瘤、神经性膀胱疾病、外源性输尿管压迫(肿瘤、腹膜后纤维化或高大的淋取悦)、输尿管结石或肾盂结石、输尿管狭小、及输尿管或肾盂肿瘤引起。

Pathogenesis

病原学

Regardless of its cause， acquired obstruction leads to similar changes in the urinary tract， which vary depending on the severity and duration of obstruction.

不论何种原因，赢得性梗阻引起尿路内相近似的转换，而转换的具体情况则因梗阻的严重进度和本领短长有所不同。

a. Urethral Changes： Proximal to the obstruction， the urethra dilates and balloons. Aurethral diverticulum may develop， and dilatation and gaping of the prostatic and ejaculatory ducts may occur.

a.尿谈转换：梗阻近端尿谈扩张及蔓延可发展为尿谈憩室、前线腺管及射精管扩张及裂口。

b. Vesical Changes： Early， the detrusor and trigonal thickening and hypertrophy compensate for the outlet obstruction， allowing complete bladder emptying . This change leads to progressive development of bladder trabeculation， cellules， saccules， and then， diverticula. Subsequently， bladder decompensation occurs and is characterized by the above changes plus incomplete bladder emptying， resulting in residual urine. Trigonal hypertrophy leads to secondary urteral obstruction owing to increased resistance to flow through the intravesical ureter. With detrusor decompensation and residual urine accumulation， there is strectching of the hypertrophied trigone， which appreciable increases ureteral obstruction. This is the mechanism of back pressure on the kidney in the presence of vesical outlet obstruction (while the urterovesical junction maintains its competence)。 Catheter drainage of the bladder relieves trigonal stretch and improves drainage from the upper tract.

b.膀胱转换：早期为使膀胱统统排空，逼尿肌及膀胱三角增厚及肥厚，以代偿膀胱出口梗阻。这种转换迟缓发展成膀胱小梁、小腺泡、囊泡，终成为膀胱憩室，临了膀胱失去代偿功能，进展永远握征为上述转换加剧，和膀胱排空不统统，最终出现残余尿。膀胱三角区肥厚可引起继发性输尿管口梗阻，这是由于尿液通过膀胱壁部分输尿管时阻力增多而形成的。由于逼尿肌失代偿及残余尿增多，肥厚的三角区过度伸展，加剧输尿管梗阻，这即是由于膀胱出口梗阻对肾脏发生反压的机制(此时膀胱输尿管邻接处功能健全)。膀胱置管引流减少三角区牵张，并改善上尿路引流。

A very late change with persistent obstruction (more frequently encountered with neuropathic dysfunction) is decompensation of the ureterovesical junction， leading to reflux. Reflux aggravates the back pressure effect on the upper tract by exposing it to abnormally high intravesical pressures——in addition to favoring the onset or persistence of urinary tract infection.

握续性梗阻(常由于神经原疾病膀胱功能失常)极度晚期限转换为输尿管膀胱邻接处失偿导致尿液响应。濒临膀胱极度高的压力，尿液反流除促使尿路发生感染或使感染握续性，还加剧上尿路的反压。

c. Ureteral Changes： The first noted change is a gradually progressive increase in uretereal distention. This increases ureteral wall stretch， which in turn increase contractile power and produces ureteral hyperactivity and hypertrophy. Because the ureteral musculature runs in an irregular helical pattern， stretching of its muscular elements leads to lengthening as well as widening. This is the start of ureteral decompensation， where tortuosity and dilatation become apparent. These changes progress until the ureter becomes atonic， with infrequent and ineffective or completely absent peristalsis.

c.输尿管转换：开始可见的转换为输尿扩张迟缓增多，这就增多输尿管壁的牵张，从而增多减弱力，产生输尿管过度行径及肥厚。因为输尿管是不法例螺旋形走向，肌内成份的牵张使输尿管延长及增宽。输尿管的鬈曲及扩张标识着它功能失偿的启动，这种转换链接进行直至输尿管失去张力，蠕动减少或完消亡。

d. Pelvicaliceal Changes： The renal pelvis and calices， being subjected to progressively increasing volumes of retained urine， progressively distend. The pelvis first shows evidence of hyperactivity and hypertrophy and then progressive dilatation and atony. The calices show the same changes to a variable degree， depending on whether the renal pelvis is intrarenal or extrarenal. In the latter， caliceal dilatation may be minimal in spite of marked pelvic dilatation. In the intrarenal pelvis， caliceal dilatation and renal parenchymal damage are maximal. The successive phases seen with obstruction are rounding of the fornices， followed by flattening of the papillae and finally clubbing of the minor calices.

d.肾盂肾盏转换：肾盂肾盏由于承受的残余尿容量迟缓增多而扩张。肾盂早期进展是蠕动增强及肥厚，以后迟缓扩大及无张力。肾盂证明其是肾内肾盂抑或外肾盂，而呈不同进度的相同转换。如为后者，天然肾盂已显著扩大，肾盏扩张可能不显著;而若为肾内肾盂，肾盏扩张和肾内容损害均严重。其梗阻一语气相(Successive phase)所见为穹窿呈圆形，接着肾乳头呈扁平，临了肾小盏呈杵状。

e. Renal Parenchymal Changes： With progressive pelvicaliceal distention， there is parenchymal compression against the renal capsule. This， plus the more important factor of compression of the arcuate vessels as a result of the expanding distended calices， results in a marked drop in renal blood flow. This leads to progressive parenchymal compression and ischemic atrophy. Lateral groups of nephrons are affected more than central ones， leading to patchy atrophy with variable degrees of severity. The glomeruli and proximal convoluted tubules suffer most from this ischemia. Associated with the increased intrapelvic pressure， there is progressive dilation of the collecting and distal tubules， with compression and atrophy of tubular cells.

e.肾内容转换：跟着肾盂肾盏进行性扩大，肾内容向包膜侧受压，加上由于肾盏扩大，向弓形动脉压迫这一迫切身分终于使血流显著下落，而导致进行性肾内容受压和缺血性萎缩。侧组肾单元受累较中央组为重，而导致严重进度不等的斑状萎缩。肾小球及近曲小管受缺血损害最重。跟随肾盂内压增多，合并管及远曲小管呈进行性扩大，肾小管细胞受压和萎缩。

Clinical Findings

临床进展

a. Symptoms and Signs： The findings vary according to the site of obstruction：

症状与体征：其进展因梗阻位置而异。

Infravesical obstruction——Infravesical obstruction leads to difficulty in initiation of voiding， a weak stream， and a diminished flow rate with terminal dribbling. Burning and frequency are common associated symptoms. A distended or thickened bladder wall may be palpable. Urethral induration of a stricture， benign prostatic hypertrophy， or cancer of the prostate may be noted on rectal examination. Meatal stenosis and impacted urethral stones are readily diagnosed by physical examination.

膀胱下梗阻：膀胱下梗阻导致肇端排尿穷苦，排尿无力及尿流率减少，跟随尿后滴沥。烧灼感及尿频为常见跟随症状。可波及蔓延或增厚的膀胱壁，肛门查验可发现狭小部尿谈变硬，良性前线腺增多或前线腺癌。尿谈口狭小和尿谈嵌塞结石常可由物理学查验而获会诊。

Supravesical obstruction——Renal pain or renal colic and gastrointestinal symptoms are commonly associated. Supravesical obstruction may be completely asymptomatic when it develops gradually over a period of several weeks or months. An enlarged kidney may be palpable. Costovertebral angle tenderness may be present.

膀胱上梗阻：肾区祸患或肾绞痛常与胃肠谈症状同期出现。当膀胱上梗阻发展安逸时。经数周或数月可统统无症状。可波及增大的肾脏。肋脊角可有压痛。

b. Laboratory Findings： Evidence of urinary infection， hematuria， or crystalluria may be seen. Impaired kidney function is noted by elevated blood urea nitrogen and serum creatinine， with the ratio well above the normal 10：1 because of urea reabsorption.

b.化验适度：可不雅察到感染尿，血尿或晶体尿，血尿素氮及血清酐升高，由于尿素氮再罗致以致其比值高于10：1.这标明肾功能受损害。

c. X-Ray Findings： Radiologic examination is usually diagnostic in cases of stasis， tumors， and strictures. Dilatation and anatomic changes occur above the level of obstruction， whereas distal to the obstruction， the configuration is usually normal. This helps in localizing the site of obstruction .Combined antegrade imaging by intravenous urograms and retrograde imaging by ureterograms or urethrograms， depending on the site of obstruction， is sometimes needed to demonstrate the extent of the obstructed segment. In supravesical obstruction， demonstration of stasis and delayed drainage is essential to establish and measure the severity of obstruction.

c.X线示意：尿液胡滞，肿瘤或狭小的病例，辐照学查验可获会诊。梗阻平面以上有扩张和剖解学转换，而在梗阻远详察貌为平方，这有助于会诊梗阻位置。证明梗阻位置未必需同期作顺利性静脉尿路造影及逆行性输尿管造影或尿谈造影，以详情梗阻段的伸延。在膀胱以上梗阻，走漏郁滞及延伸，引流，关于详情及推断梗阻的严重性是迫切的。

d. Special Examinations：

d.特殊查验：

Antegrade urography via percutaneous needle or tube nephrostomy is of particular value when the obstructed kidney fails to excrete the radiopaque material on excretory urography. This procedure allows application of the Whitaker test， during which fluid is introduced into the renal pelvis at varying rates. The fluid transport can be measured and the degree of obstruction estimated by the use of a pressure monitor.

顺行时尿路造影：当高低的肾脏在排泄性尿路中造影剂弗成排泄时，使用经皮针大略说导管行肾造瘘特殊有价值，这种操作可推论Whitaker考试，在考试本领液体不错不同进度注入肾盂。可测量液体障碍，以压力监测器来推断梗阻进度。

Ultrasonography——This will reveal the degree of dilatation of the renal pelvis and calices and allows for diagnosis of hydronephrosis in the prenatal period.

超声显像：它可展示肾盂及肾盏的扩猛进度，及可在胎儿期会诊肾积水。

Isotope studies——A technetium Tc 99m DMSA scan portrays the degree of hydronephrosis， as well as renal function. Use of diruretics during the scan can provide information similar to that obtained with the Whitaker test.

同位素查验：用锝99M DMSA扫描可了解肾盏积水进度及肾功能。在扫描时使用利尿剂可得到与Whitaker考试相似的着力。

CT scan——This may be of value in revealing the degree and site of obstruction as well as the as the cause in many cases. The use of contrast agents will allow estimation of residual renal function.

CT扫描：在某些病例，对走漏梗阻部位，进度以及原因有一订价值，使用对比剂可推断残留有肾功能。

Complications

并发症

The most important complication of urinary tract obstruction is renal parenchymal atrophy as a result of back pressure. Obstruction also predisposes to infection and stone formation， and infection occurring with obstruction leads to rapid kidney destruction.

尿路梗阻最迫切的并发症为反压所致的肾内容萎缩。梗阻也不错使肾脏易于感染和形成结石，而发生于梗阻的感染则可加快对肾脏的侵略。

Treatment

诊疗

The aim of therapy is relief of the obstruction(eg， catheterization for relief of acute urinary retention)。 Surgery is often necessary. Simple urethral stricture may be managed conservatively by dilation or urethrotomy. However， urethroplasty may be required. Benign prostatic hypertrophy and obstructing bladder tumors require surgical removal.

诊疗的盘算推算在于破除梗阻(举例：上导尿管以破除急性尿潴留)。常常需要外科诊疗。单纯尿谈狭小可用尿谈扩张及尿谈切开等保遵法诊疗，但未必需行尿谈成形术。良性前线腺增生及高低性膀胱肿瘤需外科切除。

Impacted stones must either be removed or bypassed by a catheter if it is thought that they may pass spontaneously. If they do not pass spontaneously， the stones must be removed surgically later.

嵌顿性结石必须取石;如以为结石可能自行排出，亦可经旁谈置管。如弗成自行排出，以后必须手术取石。

Ureteral or ureteropelvic junction obstruction requires surgical revision and plastic repair， either by ureterovesicoplasty， ureteroureteral anastomosis， bladder flaps to bridge a gap in the lower ureter， transureteroureteral anastomosis or ureteropyeloplasty. Penal stones may be removed instrumentally via percutaneous nephrostomy or by irrigation through a tube placed directly into the kidney.

输尿谈或肾盂输尿管交壤梗阻需行手术校正或行整形修补;输尿管膀胱成形术，输尿管输尿管吻合术，或输尿管肾盂成形术。不才段输尿管则可用膀胱瓣作搭桥填补缺损。肾结石可通过皮穿器械摘除，大略经皮穿刺肾造瘘或经肾平直置管进行冲洗。

Preliminary drainage above the obstruction is sometimes needed to improve kidney function. Occasionally， permanent drainage and diversion by cutaneous ureterostomy， ileal or colonic loop diversion， or permanent nephrostomy is required. If damage is advanced， nephrectomy may be indieated.

未必为改善肾功能可先在梗阻上方置管引流，未必需作长久性引流，输尿管皮肤造口尿流改谈术，回肠或结肠改谈或长久性肾造口等。如损害加剧，可通适用肾切除。

Prognosis

预后

The prognosis depends on the cause， site， duration， and degree of kidney damage and renal decompensation. In general， relief of obstruction leads to improvement in kidney function except in seriously damaged kidneys， especially those destroyed by inflammatory scarring.

预后取决于原因，位置，病程及肾脏损害和肾脏失偿进度。一般来说，破除梗阻可使肾功能改善，除非肾脏严重受损，尤其是炎性疤痕所侵略的。

泌尿外科学的先容干系著述：

★ 泌尿外科学的先容

★ 泌尿系统学问

★ 泌尿外科

★ 泌尿外科实习心多礼会3篇

★ 泌尿外科实习心多礼会

★ 泌尿外科医师述职文牍

★ 泌尿外科实习心多礼会范文

★ 2019泌尿外科医师述职文牍精选5篇

★ 泌尿外科科室年终回来范文

★ 泌尿外科医师述职文牍