Der Urologe. Ausg. A最新文献

{"title":"[Mesothelioma of the tunica vaginalis of the testis-a histopathological finding with far-reaching consequences].","authors":"Dörte Ebbinghaus-Mier,&nbsp;Rainer Ebbinghaus,&nbsp;Hans-Martin Prager,&nbsp;Wolfgang Schöps,&nbsp;Klaus Golka","doi":"10.1007/s00120-021-01689-0","DOIUrl":"https://doi.org/10.1007/s00120-021-01689-0","url":null,"abstract":"<p><p>Mesotheliomas are very aggressive tumors, almost exclusively caused by asbestos. Four of the 5 mesotheliomas assessed in the years 2014-2020 were recognized as occupational diseases, the 5th case was discontinued due to lack of the patient's cooperation. Surgical exposure of the testis was performed under the suspected diagnoses of hydrocele (n = 3), spermatocele (n = 1) as well as \"unknown\" (n = 1). This proves that a histopathological examination of removed tissue is the gold standard in scrotal interventions. Every mesothelioma must always be reported as an occupational disease.</p>","PeriodicalId":11123,"journal":{"name":"Der Urologe. Ausg. A","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39523252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[S2K guideline on the diagnosis and treatment of interstitial cystitis (IC/BPS) : Discussion of the current guideline using a case study].","authors":"J Tolle,&nbsp;B T Kaftan,&nbsp;Th Bschleipfer","doi":"10.1007/s00120-021-01753-9","DOIUrl":"https://doi.org/10.1007/s00120-021-01753-9","url":null,"abstract":"<p><p>IC/BPS is a chronic progressive disorder that is often difficult and unsatisfactory for the person affected and the treating therapist. Treatment should therefore be comprehensive, interdisciplinary, multimodal and take into account the biopsychosocial model. The guideline forms a thread through the diverse diagnostic and therapeutic options and provides extensive background information on the definition, epidemiology and aetiopathogenesis of this rare disease. However, practice and theory/guideline are different. Adaptation to the individual case is therefore necessary and explicitly desired. The guideline should therefore serve as a source of ideas for colleagues to compile their own standards suitable for their practice. On the one hand, therapy approaches that have been tried and tested in everyday clinical practice are passed on. On the other hand, the frequent lack of evidence should also be viewed critically. Further studies, if possible multi-centre, specifically designed for different aspects of IC/BPS would be desirable. Close networking between therapists in private practice and special centres is essential for the best possible treatment of people with IC/BPS. The guideline is intended to show the limits of what can be done in practices and outpatient clinics and to provide guidance on when patients should be referred to a \"Centre for Interstitial Cystitis and Pelvic Pain\". Overall, the guideline has improved the presence of this rare disease among colleagues. A comprehensive supplement, update and further substantiation with the state of current research is thus desirable.</p>","PeriodicalId":11123,"journal":{"name":"Der Urologe. Ausg. A","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39828838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum zu: Zur Praxis der Therapieentscheidung beim lokal begrenzten Prostatakarzinom: Operation vs. Bestrahlung – wer profitiert? : Allokation und Ergebnisse einer unizentrischen, kumulativen Langzeitstudie.","authors":"W-D U Böhm,&nbsp;R Koch,&nbsp;S Latarius,&nbsp;A Mehnert,&nbsp;C Werner,&nbsp;Manfred P Wirth","doi":"10.1007/s00120-021-01638-x","DOIUrl":"https://doi.org/10.1007/s00120-021-01638-x","url":null,"abstract":"","PeriodicalId":11123,"journal":{"name":"Der Urologe. Ausg. A","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39409485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Combining avelumab and stereotactic ablative body radiotherapy in metastatic castration-resistant prostate cancer : Efficacy and safety-phase II ICE-PAC].","authors":"Ulrich Alexander Krafft","doi":"10.1007/s00120-021-01743-x","DOIUrl":"https://doi.org/10.1007/s00120-021-01743-x","url":null,"abstract":"","PeriodicalId":11123,"journal":{"name":"Der Urologe. Ausg. A","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39610558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Metastatic urothelial carcinoma-guideline-based therapy and new options].","authors":"Günter Niegisch,&nbsp;Gunhild von Amsberg,&nbsp;Marc Rehlinghaus,&nbsp;Camilla M Grunewald,&nbsp;Margitta Retz","doi":"10.1007/s00120-022-01760-4","DOIUrl":"https://doi.org/10.1007/s00120-022-01760-4","url":null,"abstract":"<p><p>Due to the approval of immuno-oncological therapies with immune checkpoint inhibitors, the treatment of metastatic urothelial carcinoma has become more complex in all lines of therapy. Thus, in first-line treatment, immunotherapy alone or immune maintenance therapy following platinum-based chemotherapy can be applied in addition to treatment with platinum-based combination therapies alone. In addition to the approval status and guideline recommendation, patient-specific factors such as comorbidities as well as patient preference must always be considered when choosing a therapy. In the following, we summarize the current data on treatment options in the first-line therapy of metastatic urothelial carcinoma and illustrate their practical application using a patient example.</p>","PeriodicalId":11123,"journal":{"name":"Der Urologe. Ausg. A","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39964502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[On the practice of therapy decision in locally limited prostate cancer: surgery vs. radiation-who benefits? : Allocation and results of a monocentric, cumulative long-term study].","authors":"W -D U Böhm,&nbsp;R Koch,&nbsp;S Latarius,&nbsp;A Mehnert,&nbsp;C Werner,&nbsp;Manfred P Wirth","doi":"10.1007/s00120-021-01601-w","DOIUrl":"https://doi.org/10.1007/s00120-021-01601-w","url":null,"abstract":"<p><strong>Aim: </strong>The goal of this two-armed observational study was to map the clinical therapy effectiveness of radical prostatovesiculectomy (RPVE) and external beam radiation therapy (EBRT) in locally limited prostate cancer (PCA) in direct comparison over 20 years under clinical conditions. Retrospectively, the various variables and predictors for the individual therapy decision were identified, and the preference was to compared with studies on survival and recurrence characteristics. The presentation of toxicity was not the focus of this work.</p><p><strong>Methodology: </strong>In all, 743 patients from a single center were enrolled according to biopsy/staging chronologically in the sequence of the initial consultation after clarification and informed consent: 494 patients were in the RPVE arm and 249 patients in the EBRT arm. We used retrospective data analysis with univariate and multivariate comparisons in the alternative therapy arms. Multivariate logical regression models were developed to objectify the allocation process. Univariate processing of survival analyses, the comparison of tumor- and comorbidity-specific mortality rates was co-founded.</p><p><strong>Results: </strong>Predictive variables for RPVE vs. EBRT therapy decision are significantly age, Gleason score, D'Amico index, Charlson index, prostate-specific antigen (PSA), and prostate volume. There was no significance level for the biopsy score. The age gap was in the median 67 (RPVE) and 73 (EBRT) years. Overall survival (n = 734, 20 years, all risks) in the RPVE arm was 56.8% (95% confidence interval [CI] 45.1-67.0%) and in the EBRT arm 19.2% (95%CI 9.2-31.8%). Comorbid risk was highly significantly (p < 0.0001) different (27.1% [95%CI 18.0-36.1%] in the RPVE arm, and 60.4% [95%CI 47.3-73.5%] in the EBRT arm). The risk of tumor-specific death at 16.2% (95%CI 8.1-24.4%) after RPVE and 20.5% (95%CI 11.7-29.3%) after EBRT was not significantly different (p = 0.2122, overlapping 95%CI). After stratification, a clear advantage can be demonstrated for the high-risk tumors after allocation to the RPVE arm.</p><p><strong>Conclusions: </strong>The complexity of the predictive variables of the PCA further complicates the individual therapy decision. According to our data, the higher D'Amico score, the rather low Charlson index, a high Gleason score and a higher organ volume speak for a valid therapy for RPVE.</p>","PeriodicalId":11123,"journal":{"name":"Der Urologe. Ausg. A","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00120-021-01601-w","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39268134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[67/m-Micturition complaints and clearly weakened urinary stream : Preparation for the medical specialist examination: part 18].","authors":"Herbert Leyh","doi":"10.1007/s00120-021-01654-x","DOIUrl":"https://doi.org/10.1007/s00120-021-01654-x","url":null,"abstract":"","PeriodicalId":11123,"journal":{"name":"Der Urologe. Ausg. A","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39489524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Billing audit : When is a healthcare utilization by a patient \"unanticipated\"?]","authors":"Jan Moeck","doi":"10.1007/s00120-021-01757-5","DOIUrl":"https://doi.org/10.1007/s00120-021-01757-5","url":null,"abstract":"","PeriodicalId":11123,"journal":{"name":"Der Urologe. Ausg. A","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39813350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[62/m-acute lumbago and prostate-specific antigen 1430 ng/ml : Preparation for the medical specialist examination: part 22].","authors":"Miriam Hegemann","doi":"10.1007/s00120-021-01664-9","DOIUrl":"https://doi.org/10.1007/s00120-021-01664-9","url":null,"abstract":"","PeriodicalId":11123,"journal":{"name":"Der Urologe. Ausg. A","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39513644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Poly(ADP-ribose) polymerase (PARP-)inhibitors as genetically based precision therapy in metastatic castration-resistent prostate cancer (mCRPC)].","authors":"Isabel Heidegger,&nbsp;Christoph Becker,&nbsp;Igor Tsaur,&nbsp;Tilman Todenhöfer","doi":"10.1007/s00120-021-01754-8","DOIUrl":"https://doi.org/10.1007/s00120-021-01754-8","url":null,"abstract":"<p><p>With PARP inhibitors, the therapeutic landscape for metastatic castration-resistant prostate cancer (mCRPC) has been expanded by a new substance class since November 2020. Currently, the indication for this innovative therapy requires the presence of a mutation in one of the BRCA1/2 genes and prior hormonal therapy. This short review explains the molecular background and summarizes current clinical trials on PARP inhibition-also in combination with other therapy strategies. In view of positive data from the cited studies and the relatively high proportion of patients with \"actionable\" mutations, the personalized therapy concept of BRCA1/2 mutation-dependent PARP inhibition for mCRPC is now reflected in various guidelines including S3 guidelines.</p>","PeriodicalId":11123,"journal":{"name":"Der Urologe. Ausg. A","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39809324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}