郑州市经开区男性泌尿科此文目次1、泌尿科是看什么病的? 2、泌尿科是干什么的 3、泌尿外科学的先容 4、泌尿科的先容 5、河南省军区病院的泌尿外科
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。见解冷漠：冷漠一定要去正规的病院检讨，在专科医师的带领下进行积极灵验的调养，平时一定要留意保握外阴清洁卫生，每天更换内裤。
泌尿科泌尿科是独特征询男女泌尿系统与男性生殖系统的一门医学，是从外科学细分而来的下属专科。男性的泌尿与生殖系统密不可分，而女性的泌尿谈则启齿于外阴部。不管男女，泌尿谈与生殖谈息息干系，两者的疾病常会彼此影响。泌尿科学涵盖的器官包括肾脏、输尿管、膀胱、尿谈，以及男性生殖系统的睾丸、附睾、输精管、精囊、前线腺、阴囊与阴茎。泌尿科可进一步细分出泌尿肿瘤学、泌尿谈结石、排尿远程、赤子泌尿学、性功能远程、男性不孕等多样次专科。泌尿外科和好多医学规模如肾脏科、妇产科、男性科、肿瘤科的关系也都终点密切。
高考收场了，当今行将参加填报志愿的阶段，这时候除了磋议学校，还要磋议专科。有东谈主思了解泌尿外科学是什么。接下来我为全球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，是主要会诊和调养泌尿系统“外科”部分疾病的病院科室，主要调养多样泌尿性疾病。
调养规模
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;泌尿系先天性乖张如尿谈下裂、隐睾、肾盂输尿管调治部局促所导致的肾积水等等。
泌尿外科是个比拟迂腐的专科，有较久的历史;但同期却又是个比拟新的专科，以至到2013年，在有的分科病院里，也曾有别的专科而惟有莫得泌尿外科。这诠释，这个专科是膺惩的，但发展亦然不屈衡的。
区分
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，这应当加以区分而幸免耻辱。然而情况在变化，科学在前进，阻抑地有新的技俩由内科规模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调养，肾、膀胱、前线腺肿瘤手术，前线腺癌手术，肾盂输尿管嘱托部局促手术，肾、输尿管、膀胱结石手术调养，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，经膀胱镜诓骗钬激光进行膀胱肿瘤切除，尿谈下裂、阴茎下屈整形等手术，体外碎石调养肾、输尿管、膀胱结石。连年来开展了慢性前线腺炎的病因检讨和调养，以及男性性功能远程和男性不育的诊治。
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.
梗阻是泌尿谈最膺惩的相当之一，因其最终使肌性管谈过甚容器失去代偿才智，发生反压及肾推行萎缩。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皆备破裂。
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.
梗阻的平面及流程对了解其病后果是膺惩的。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。皆备梗阻可能可使梗阻以上泌尿系统马上升值失代偿才智，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。部分梗阻则逐渐引起进行性肌肉肥厚，随后出现逐渐扩张，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.
得回性尿路梗阻可能由于炎性或毁伤性尿谈局促，膀胱出口梗阻(良性前线腺魁梧或前线腺癌)、膀胱肿瘤、神经性膀胱疾病、外源性输尿管压迫(肿瘤、腹膜后纤维化或巨大的淋捧场)、输尿管结石或肾盂结石、输尿管局促、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.
无论何种原因，得回性梗阻引起尿路内相访佛的更动，而更动的具体情况则因梗阻的严重流程和时代丧祭有所不同。
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.尿谈更动：梗阻近端尿谈扩张及彭胀可发展为尿谈憩室、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.膀胱更动：早期为使膀胱皆备排空，逼尿肌及膀胱三角增厚及肥厚，以代偿膀胱出口梗阻。这种更动逐渐发展成膀胱小梁、小腺泡、囊泡，终成为膀胱憩室，临了膀胱失去代偿功能，发扬永远握征为上述更动加剧，和膀胱排空不皆备，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加多而形成的。由于逼尿肌失代偿及残余尿加多，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(此时膀胱输尿管调治处功能健全)。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)相称晚期限更动为输尿管膀胱调治处失偿导致尿液响应。面临膀胱相称高的压力，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.输尿管更动：早先可见的更动为输尿扩张逐渐加多，这就加多输尿管壁的牵张，从而加多裁减力，产生输尿管过度活动及肥厚。因为输尿管是不规定螺旋形走向，肌内成份的牵张使输尿管延长及增宽。输尿管的挫折及扩张标识着它功能失偿的启动，这种更动连续进行直至输尿管失去张力，蠕动减少或完消除。
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.肾盂肾盏更动：肾盂肾盏由于承受的残余尿容量逐渐加多而扩张。肾盂早期发扬是蠕动增强及肥厚，以后逐渐扩大及无张力。肾盂凭据其是肾内肾盂抑或外肾盂，而呈不同流程的相同更动。如为后者，天然肾盂已昭着扩大，肾盏扩张可能不昭着;而若为肾内肾盂，肾盏扩张和肾推行损害均严重。其梗阻连气儿相(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.肾推行更动：跟着肾盂肾盏进行性扩大，肾推行向包膜侧受压，加上由于肾盏扩大，向弓形动脉压迫这一膺惩要素终于使血流昭着下落，而导致进行性肾推行受压和缺血性萎缩。侧组肾单元受累较中央组为重，而导致严重流程不等的斑状萎缩。肾小球及近曲小管受缺血损害最重。追随肾盂内压加多，蚁合管及远曲小管呈进行性扩大，肾小管细胞受压和萎缩。
Clinical Findings
临床发扬
a. Symptoms and Signs： The findings vary according to the site of obstruction：
症状与体征：其发扬因梗阻位置而异。
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：膀胱下梗阻导致肇始排尿困难，排尿无力及尿流率减少，追随尿后滴沥。烧灼感及尿频为常见追随症状。可波及彭胀或增厚的膀胱壁，肛门检讨可发现局促部尿谈变硬，良性前线腺加多或前线腺癌。尿谈口局促和尿谈嵌塞结石常可由物理学检讨而获会诊。
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：肾区难受或肾绞痛常与胃肠谈症状同期出现。当膀胱上梗阻发展冷静时。经数周或数月可皆备无症状。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.化验限度：可不雅察到感染尿，血尿或晶体尿，血尿素氮及血清酐升高，由于尿素氮再采纳以致其比值高于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线暗示：尿液胡滞，肿瘤或局促的病例，辐照学检讨可获会诊。梗阻平面以上有扩张和剖解学更动，而在梗阻远端阵势为平方，这有助于会诊梗阻位置。凭据梗阻位置未必需同期作告成性静脉尿路造影及逆行性输尿管造影或尿谈造影，以确信梗阻段的伸延。在膀胱以上梗阻，清晰郁滞及蔓延，引流，关于确信及预计梗阻的严重性是膺惩的。
d. Special Examinations：
d.特殊检讨：
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：当艰涩的肾脏在排泄性尿路中造影剂不成排泄时，使用经皮针大略说导管行肾造瘘突出有价值，这种操作可推论Whitaker考试， 在考试时代液体不错不同流程注入肾盂。可测量液体飞动，以压力监测器来预计梗阻流程。
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流程，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.
同位素检讨：用锝99M DMSA扫描可了解肾盏积水流程及肾功能。在扫描时使用利尿剂可得到与Whitaker考试相似的效果。
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，对清晰梗阻部位，流程以及原因有一订价值，使用对比剂可预计残留有肾功能。
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.
尿路梗阻最膺惩的并发症为反压所致的肾推行萎缩。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破裂。
Treatment
调养
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.
调养的盘算在于清除梗阻(举例：上导尿管以清除急性尿潴留)。时常需要外科调养。单纯尿谈局促可用尿谈扩张及尿谈切开等保遵法调养，但未必需行尿谈成形术。良性前线腺增生及艰涩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;如合计结石可能自行排出，亦可经旁谈置管。如不成自行排出，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接壤梗阻需行手术改造或行整形修补;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。鄙人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顺利置管进行冲洗。
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流程。一般来说，清除梗阻可使肾功能改善，除非肾脏严重受损，尤其是炎性疤痕所破裂的。
泌尿外科学的先容干系 著作 ：
★ 泌尿外科学的先容
★ 泌尿系统常识
★ 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
★ 泌尿外科医师述职发挥
★ 泌尿外科实习心多礼会范文
★ 2019泌尿外科医师述职发挥精选5篇
★ 泌尿外科科室年终归来范文
★ 泌尿外科医师述职发挥
泌尿科是独特征询男女泌尿谈与男性生殖系统的一门医学，它主若是从外科细分而来。男性的泌尿与生殖系统密不可分，而女性的泌尿谈则启齿于外阴部。不管男女，泌尿谈与生殖谈息息干系，两者的疾病常会彼此影响。泌尿外科可进一步细分出泌尿肿瘤学、泌尿谈结石、排尿远程、赤子泌尿学、性功能远程、男性不育等多样次专科。
河南省军区病院泌尿外科中心是国内有一定影响的极品工程达标科室。是河南省军区病院全心打造的要点科室、特质科室。中心针对泌尿疾病防治日益严峻的方位，在河南省军区病院的因循下，率先配置了泌尿外科疾病专项实验中心，对千般泌尿外科常见病、多发病及疑难杂症进行监控、征询，对泌尿外科疾病规模的防治具有膺惩的策略意旨。同期，在日常诊疗中具体诓骗实验中心的征询后果，完毕了个体化、针对性的调养。科室精确细分诊治更具巨擘。河南省军区病院泌尿外科中心共分前线腺疾病、生殖感染、性功能远程、性传播疾病、生殖整形、男性不育专项征询，凭据不同类型的疾病，从病症、病因病理、危害、调养、照管等方面进行专科细分，完毕专病专治、精确调养确保疗效着实。其中针对前线腺炎、生殖感染、生殖整形、生殖湿疣、包皮包茎、龟头炎、尿谈炎、睾丸炎、、男性功能远程（如阳痿、遗精、不育等）调养具有国内当先水平。针对泌尿疾病复杂难断的困扰，河南省军区病院泌尿中心率先在国内引进了“格赛特”泌尿诊疗系统。“格赛特”诊疗系统，是国表里广阔泌尿学大家吸取当先本事的基础上，合并先进诊疗开拓，经反复的实践、论证，归来出的一套泌尿系统疾病调养体系，对泌尿系疾病从病种、症状、病理病因、疗法等方面作念出了系统性的整理，对泌尿系疾病的会诊具有导向作用。 河南省军区病院遵从各级卫生行政部门的调换和处分，巨大医护东谈主员死力钻研业务本事，配置邃密医德医风，自愿温雅病院的邃密形象。病院屡次被市卫生局等干系巨擘部门授予多项荣誉名称，连气儿四年被市级卫生部门定名为：“郑州市铺张者靠得住单元”、“天下匹夫宽心示范病院”、“军警民共建先进单元”、“诚信诡计单元”、共获三军科技当先二等奖2项，三等奖5项，在军表里发表论文97篇；被评为机关院校先进门诊部，并三次荣立集体三等功。
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