Uropathy 尿路梗阻课件.ppt

Obstructive Uropathy Dept. Of Urology. shanghai Renji Hospital WANG YIXIN General Conception Stone Obstruction Infection Renal function 1.Obstruction eventually Leads to decompensation of the muscular conduits and reservoirs,back pressure,and atrophy of renal parenchyma. 2.It also invites infection and stone formation. Pathologic consequences: infravesical Level of obstruction supravesical complete Degree of obstruction partial Nature of obstruction infection,injury,stone, tumor…… Duration of obstruction The conseqences include Incresed intraluminal pressure urinary stasis infection stone formation loss of renal function Etiology Congenital meatal stenosis ureteral strictures posterior urethral strictures ureterovesical junction obstruction ureteropelvic junction obstruction (various causes) neurologic deficites Acguired urethral strictures inflammatory or traumatic bladder outlet obstruction (BPH or PCA) vesical tumor neuroginec bladder extrinsic ureteral compression ureteral or pelvic stones, strictures and tumor The causes of hydrocalycosis The causes of hydronephrosis Pathogenesis (patholophysiology)1 The changes in the various segments in the urinary tract, depending on the obstructive severity and duration 1. Urethral changes: dilatation, diverticulum 2. Vesical changes: trabeculation, residual urine, diverticula 3. Ureteral changes: distention, dilatation and lengthening Pathogenesis (patholophysiology)2 4. Pelvicalyceal changes: first shows evidence of hyperactivity and hypertrophy and then progressive dilatation and stony,rounding of the fornic