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HEMATURIA

HEMATURIA. Dr. Arnold Simandjuntak, Sp.U. Hematuria : - Inisial - Total - Terminal. Sumber Pendarahan Traktus urinarus bagian atas Ginjal + Ureter Traktus urinarus bagian tengah Kandung kemih = Bladder = Blaas Traktus urinarius bagian bawah

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HEMATURIA

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  1. HEMATURIA Dr. Arnold Simandjuntak, Sp.U

  2. Hematuria :- Inisial - Total - Terminal • Sumber Pendarahan • Traktus urinarus bagian atas Ginjal + Ureter • Traktus urinarus bagian tengah Kandung kemih = Bladder = Blaas • Traktus urinarius bagian bawah Urethra

  3. Hematuria Penyebab : • Gross haematuria + Painless Tumor : Tumor buli – buli • Makroskopik : 20% disebabkan tumor • Mikroskopik : 2% disebabkan tumor

  4. Hematuria • Makroskpik = Gross haematuria • Mikroskopik • Pseudohaematuria • Haemoglobinuria Lysis erythrocyt : B.J. Urine < 1.008 PH. Urine > 7 • Keluhan : - Urine Merah - Air Teh - Cucian daging

  5. Hematuria • Tanpa sakit : Silent haematuria • Dengan sakit : - Sakit saat miksi - Sakit pinggang - Kolik - Tumpul (“dull pain”)

  6. Pemeriksaan Tujuan : Mencari penyebabnya Cara: • Anamnesis : Bentuk hematuria Gejala lain Trauma Perdarahan lain • Pemeriksaan : Massa flank/pelvis Nyeri tekan - CVA - Suprapublik Kulit

  7. Pemeriksaan Penunjang • BNO-IVP • USG • Urethrocystography • Retrograde pyelografi • Angiografi • Cystoscopy

  8. Penyebab • Anak : Glomerulonefritis akut Infeksi traktus urinarus akut Kelainan kongenital Obstruksi • Dewasa muda : Infeksi akut Urolithiasis Tumor buli-buli

  9. Dewasa : Wanita : Infeksi akut Batu Tumor buli-buli Laki – laki : Tumor buli-buli Batu Infeksi akut Tua : Wanita : Tumor Infeksi Laki – laki : Prostat Tumor Infeksi

  10. Neoplasma Traktus Urinarus Tumor Ginjal • Jinak (Angiomyolipoma) • Ganas - Adenokarsinoma = tumor grawitz = Hypernephroma = Renal cell carcinoma - Nephroblastoma = tumor wilms = Adenomyosarcoma

  11. - Tumor Urothelium - Ca Sel Transisional Pelvis Ginjal Ureter Buli-buli Urethra Penyebab? Rokok Zat Warna: Amin Aromatik (mengganggu metabolisme triptofan)

  12. Tumor buli-buli • Tranisisional cell Ca = 90-95% • Epidermoid Ca (Squamous cell Ca) • Adeno ca jarang = 5% • Prognosis tergantung staging tumor

  13. Terima Kasih

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