{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:27Z","timestamp":1740126807015,"version":"3.37.3"},"reference-count":50,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aktuelle Urol"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Das Harnblasenkarzinom ist, nach dem Lungenkrebs, bei Querschnittgel\u00e4hmten die zweith\u00e4ufigste zum Tode f\u00fchrende Tumorerkrankung. Die vorliegende Arbeit gibt einen umfassenden \u00dcberblick \u00fcber die f\u00fcr den Urologen wichtigen Unterschiede im Vergleich zu Harnblasentumoren in der Allgemeinbev\u00f6lkerung.<\/jats:p><jats:p>Querschnittgel\u00e4hmte sind zum Zeitpunkt der Tumordiagnose im Durchschnitt 1 bis 2 Jahrzehnte\n      j\u00fcnger als Patienten ohne Querschnittl\u00e4hmung. Der histopathologische Befund bei Erstdiagnose\n      eines Harnblasenkarzinoms bei Menschen mit Querschnittl\u00e4hmung ist wesentlich ung\u00fcnstiger als\n      bei Harnblasenkarzinomen in der Allgemeinbev\u00f6lkerung. Muskelinvasive Tumoren und Tumoren mit\n      geringer Differenzierung sind wesentlich h\u00e4ufiger und der Anteil an Plattenepithelkarzinomen\n      ist deutlich erh\u00f6ht. Die H\u00e4ufigkeit nimmt nach \u00fcber 10 L\u00e4hmungsjahren zu. Die\n      Harnblasenkarzinom-Mortalit\u00e4t ist deutlich erh\u00f6ht und steigt mit zunehmender L\u00e4hmungsdauer\n      an.<\/jats:p><jats:p>Bei diagnostischen Eingriffen und insbesondere bei der radikalen Zystektomie sind klinisch\n      wichtige Besonderheiten zu beachten. So k\u00f6nnen z. B. urodynamische Untersuchungen oder eine\n      Zystoskopie eine Autonome Dysreflexie mit hypertensiven Krisen und der Gefahr einer\n      lebensbedrohlichen Bradykardie triggern. <\/jats:p><jats:p>Bei einer radikalen Zystektomie sind intraoperativ\n      u.a. die h\u00e4ufig auftretenden Verwachsungen und Verschwielungen der Harnblase zu beachten.\n      Postoperativ treten u.a. h\u00e4ufig, bedingt durch die neurogene St\u00f6rung des Darmes, schwere\n      Paralysen und prolongierte Darmatonien auf. Die unmittelbar nach der Operation vorzunehmende Lagerung der\n      Patienten zur Vermeidung von Dekubiti und zur Unterst\u00fctzung der Atmung sowie das\n      Querschnittgel\u00e4hmten-spezifische Darmmanagement sind unbedingt zu beachten. Weitere\n      Besonderheiten bei querschnittgel\u00e4hmten Patienten mit Harnblasenkarzinom, die auch in der\n      klinischen Praxis Beachtung finden sollten, sowie \u00dcberlegungen zum Screening nach\n      Harnblasentumoren werden im Beitrag dargestellt.<\/jats:p>","DOI":"10.1055\/a-1684-9870","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:10:50Z","timestamp":1640131850000},"page":"137-147","source":"Crossref","is-referenced-by-count":1,"title":["Harnblasentumoren als Langzeitfolge einer Querschnittl\u00e4hmung \u2013 Bedeutung f\u00fcr die Praxis"],"prefix":"10.1055","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3037-8066","authenticated-orcid":false,"given":"Ralf","family":"B\u00f6thig","sequence":"additional","affiliation":[{"name":"Neuro-Urologie, BG Klinikum Hamburg, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Sch\u00f6ps","sequence":"additional","affiliation":[{"name":"Praxis f\u00fcr Urologie, Sankt Augustin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Zellner","sequence":"additional","affiliation":[{"name":"Abteilung Urologie und Neurourologie, Johannesbad Fachklinik Bad F\u00fcssing, Bad F\u00fcssing, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Fiebag","sequence":"additional","affiliation":[{"name":"Neuro-Urologie, BG Klinikum Hamburg, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgitt","family":"Kowald","sequence":"additional","affiliation":[{"name":"Neuro-Urologie, BG Klinikum Hamburg, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ines","family":"Kurze","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Paraplegiologie und Neuro-Urologie, Zentralklinik Bad Berka GmbH, Bad Berka, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"B\u00f6hme","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie, Asklepios Klinik Barmbek, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thura","family":"Kadhum","sequence":"additional","affiliation":[{"name":"Abt. Psychosomatische Medizin, Mittelrhein-Klinik Fachklinik f\u00fcr psychosomatische Rehabilitation, Boppard - Bad Salzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"Golka","sequence":"additional","affiliation":[{"name":"Klinische Arbeitsmedizin, Leibniz-Institut f\u00fcr Arbeitsforschung an der TU Dortmund, Dortmund, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,12,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/S1474-4422(18)30415-0","article-title":"Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"18","author":"GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators","year":"2019","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1038\/sc.2017.64","article-title":"Causes of death after traumatic spinal cord injury \u2013 a 70-year British study","volume":"55","author":"G Savic","year":"2017","journal-title":"Spinal Cord"},{"article-title":"Krebs in Deutschland f\u00fcr 2015\/2016. 12. 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