IF 0.4 4区医学

Urologie Pub Date : 2026-05-07 DOI: 10.1007/s00120-026-02840-5

Felix Seelemeyer, Rouvier Al-Monajjed, Muammar Dib, Jale Lakes, Isabelle Busshoff, Analena Handke, Matthias Boschheidgen, Gerald Antoch, Peter Albers, Jan Philipp Radtke, Lars Schimmöller

{"title":"[Reducing overdiagnosis-how to do I correctly assess the indication for prostate biopsy?]","authors":"Felix Seelemeyer, Rouvier Al-Monajjed, Muammar Dib, Jale Lakes, Isabelle Busshoff, Analena Handke, Matthias Boschheidgen, Gerald Antoch, Peter Albers, Jan Philipp Radtke, Lars Schimmöller","doi":"10.1007/s00120-026-02840-5","DOIUrl":"https://doi.org/10.1007/s00120-026-02840-5","url":null,"abstract":"The indication for prostate biopsy represents the key interface between prostate-specific antigen (PSA)-based early detection and primary diagnostic evaluation in patients with suspected prostate cancer. The aim is to reduce overdiagnosis while ensuring detection of clinically significant prostate cancer (csPCa; International Society of Urological Pathology [ISUP] grade ≥ 2). PSA remains the most important initial test but is limited by low specificity; digital rectal examination provides no relevant additional value. In cases of clinical suspicion, diagnostic work-up includes multiparametric magnetic resonance imaging (MRI) for risk stratification and reduction of unnecessary biopsies. Diagnostic performance depends on image quality and reader expertise. Biparametric MRI may be an alternative under appropriate conditions but does not match the full diagnostic scope of mpMRI. In the presence of suspicious MRI findings, the combination of targeted and systematic biopsy remains the reference standard, with higher detection rates for csPCa but also increased detection of clinically insignificant tumors. Alternative approaches such as perilesional sampling are under investigation. PSA density, serum biomarkers (e.g., 4KScore, Stockholm-3), and risk calculators may further improve prebiopsy selection. This review provides an evidence-based overview and outlines a guideline-conform, risk-adapted diagnostic pathway for biopsy indication.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Uncomplicated urinary tract infections: antibiotic-sparing approaches]. [无并发症尿路感染：免抗生素方法]。

IF 0.4 4区医学

Urologie Pub Date : 2026-05-04 DOI: 10.1007/s00120-026-02836-1

Sebastian Graf

引用次数: 0

[The OPTIMUM trial: microultrasonography-guided vs MRI-guided biopsy for prostate cancer diagnosis]. [最佳试验：微超声引导vs mri引导前列腺癌活检诊断]。

IF 0.4 4区医学

Urologie Pub Date : 2026-05-01 Epub Date: 2026-02-19 DOI: 10.1007/s00120-026-02782-y

Hannes Cash, Angelika Borkowetz

引用次数: 0

[Perioperative therapy for muscle-invasive bladder cancer-current treatment concepts]. 【肌侵性膀胱癌围手术期治疗现状】。

IF 0.4 4区医学

Urologie Pub Date : 2026-05-01 Epub Date: 2026-03-25 DOI: 10.1007/s00120-026-02810-x

Günter Niegisch, Georgios Gakis, Carsten H Ohlmann, Ruth Knüchel-Clarke, Dirk Beyersdorff, Oliver Rick, Klaus Golka, Miriam Hegemann, Peter J Goebell, Philipp Maisch, Jürgen Gschwend

{"title":"[Perioperative therapy for muscle-invasive bladder cancer-current treatment concepts].","authors":"Günter Niegisch, Georgios Gakis, Carsten H Ohlmann, Ruth Knüchel-Clarke, Dirk Beyersdorff, Oliver Rick, Klaus Golka, Miriam Hegemann, Peter J Goebell, Philipp Maisch, Jürgen Gschwend","doi":"10.1007/s00120-026-02810-x","DOIUrl":"10.1007/s00120-026-02810-x","url":null,"abstract":"The updated version of the German S3 guideline for bladder cancer introduces several changes in the areas of diagnostics, perioperative systemic therapy, and rehabilitation, as well as psycho-oncological and palliative care for bladder cancer patients. In urinary diagnostics, the Paris system, including a quality algorithm, has been introduced to improve the comparability of cytological findings. Imaging diagnostics now recommends multiparametric magnetic resonance imaging (MRI) with Vesical Imaging-Reporting and Data System (VI-RADS) reporting as an alternative or complement to computed tomography (CT) scans. CT urography remains the gold standard for the upper urinary tract, while intravenous pyelography (IVP) is no longer recommended. In perioperative systemic therapy, the importance of multidisciplinary case conferences for muscle-invasive bladder cancer (MIBC) is emphasized to enable as many patients as possible to receive perioperative systemic therapy. Rehabilitation now follows quality criteria (multiprofessional teams, long-term concepts) and includes an expanded assessment of physical and psychological burdens. Particularly relevant is the treatment of sexual dysfunction in women after cystectomy. In psycho-oncology and palliative medicine, early integration of the S3 guidelines is required, including advanced care planning (ACP) starting from the diagnosis of advanced tumors. These changes aim for higher diagnostic accuracy, better treatment planning, and holistic patient care.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"490-497"},"PeriodicalIF":0.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Primary vesicoureteral reflux in childhood : Diagnostics, risk stratification and treatment]. 儿童原发性膀胱输尿管反流：诊断、风险分层和治疗。

IF 0.4 4区医学

Urologie Pub Date : 2026-05-01 Epub Date: 2026-04-10 DOI: 10.1007/s00120-026-02816-5

Malin Nientiedt, Raimund Stein

引用次数: 0

[Update of S3 guideline on metastatic prostate cancer-guideline recommendations and expert consensus]. 【S3指南关于转移性前列腺癌的更新——指南建议和专家共识】。

IF 0.4 4区医学

Urologie Pub Date : 2026-05-01 Epub Date: 2026-04-13 DOI: 10.1007/s00120-026-02817-4

Marc-Oliver Grimm, Christian Gratzke, Boris Hadaschik, Matthias Eiber, Ken Herrmann, Eva Hellmis, Jörg Klier, Glen Kristiansen, Andreas Wiedemann, Axel Merseburger, Margitta Retz, Gunhild von Amsberg

{"title":"[Update of S3 guideline on metastatic prostate cancer-guideline recommendations and expert consensus].","authors":"Marc-Oliver Grimm, Christian Gratzke, Boris Hadaschik, Matthias Eiber, Ken Herrmann, Eva Hellmis, Jörg Klier, Glen Kristiansen, Andreas Wiedemann, Axel Merseburger, Margitta Retz, Gunhild von Amsberg","doi":"10.1007/s00120-026-02817-4","DOIUrl":"10.1007/s00120-026-02817-4","url":null,"abstract":"Treatment options for metastatic prostate cancer have evolved and diversified considerably in recent years. In the hormone-sensitive setting (mHSPC), the combination of androgen deprivation therapy (ADT) with androgen receptor pathway inhibitors (ARPI) or abiraterone + prednis(ol)one (Abi), optionally combined with docetaxel, represents the current standard of care. Prior therapy, the principle of switching the mechanism of action, and the patient's individual molecular genetic profile substantially influence treatment selection in the metastatic castration-resistant setting (mCRPC). Testing for genes involved in homologous recombination repair (HRR), particularly BRCA1/2, is essential for the indication of poly(ADP-ribose) polymerase inhibitors (PARPI), which can be used as monotherapy or in combination with an ARPI/Abi, and has prognostic as well as familial implications. Radioligand therapy with lutetium (177Lu) vipivotide tetraxetan has also gained increasing importance. It is indicated for mCRPC after prior treatment with ARPI/Abi and taxane chemotherapy, and may already play a role in the first-line mCRPC setting following treatment with darolutamide + ADT + docetaxel in mHSPC. This article presents current guideline recommendations for mHSPC and mCRPC, summarizes the underlying evidence, and provides practical guidance for treatment selection based on prior therapy and individual genetic profiles in order to support optimal decision-making in an increasingly complex therapeutic landscape.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"480-489"},"PeriodicalIF":0.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Update of the S2k guideline on the diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)]. [更新间质性膀胱炎/膀胱疼痛综合征（IC/BPS）的诊断和治疗S2k指南]。

IF 0.4 4区医学

Urologie Pub Date : 2026-05-01 Epub Date: 2026-04-13 DOI: 10.1007/s00120-026-02812-9

Pia V Zimmermann, Andreas Gonsior, Winfried Vahlensieck, Daniela Schultz-Lampel, Andreas Wiedemann, Björn T Kaftan

{"title":"[Update of the S2k guideline on the diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)].","authors":"Pia V Zimmermann, Andreas Gonsior, Winfried Vahlensieck, Daniela Schultz-Lampel, Andreas Wiedemann, Björn T Kaftan","doi":"10.1007/s00120-026-02812-9","DOIUrl":"10.1007/s00120-026-02812-9","url":null,"abstract":"Background: In July 2025, the S2k guideline on the diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS), developed under the auspices of the German Society of Urology (DGU), was published via the Association of the Scientific Medical Societies in Germany (AWMF) following comprehensive revision. The update aimed to improve diagnostic and therapeutic clarity and clinical applicability.Objective: This article summarizes the key updates of the revised guideline and provides practical guidance for the clinical management of patients with IC/BPS.Results: Major revisions include an updated definition and classification of IC/BPS in accordance with the WHO ICD-11 framework and an expanded overview of current pathogenetic concepts. A clearly structured, multimodal treatment algorithm has been implemented, integrating pharmacological, intravesical, interventional, neuromodulatory, and nonpharmacological therapies. Particular focus is placed on psychosocial comorbidities, individualized dietary management, pelvic floor physiotherapy, pain medicine, and urological rehabilitation.Conclusion: The updated S2k guideline provides an evidence-informed, interdisciplinary, and clinically applicable framework for the management of IC/BPS. Careful diagnostic evaluation and individualized multimodal treatment strategies are essential to improve symptom control and long-term quality of life in affected patients.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"506-512"},"PeriodicalIF":0.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Leitlinien als evidenzbasierter Rahmen – Aktuelles für die Praxis. 基于证据的框架指南-当前的实践。

IF 0.4 4区医学

Urologie Pub Date : 2026-05-01 Epub Date: 2026-04-29 DOI: 10.1007/s00120-026-02819-2

Angelika Borkowetz, Peter J Goebell, G Niegisch

引用次数: 0

[The central role of nurses in detection and management of symptoms in patients with urologic cancer]. 【护士在泌尿系统癌患者症状发现和处理中的核心作用】

IF 0.4 4区医学

Urologie Pub Date : 2026-05-01 Epub Date: 2026-02-23 DOI: 10.1007/s00120-026-02799-3

Stephanie Bull, Angelika Borkowetz, Désirée Louise Dräger

引用次数: 0

[New guideline for supportive care-what is relevant for urologists?] 新的支持性护理指南——与泌尿科医生相关吗？]

IF 0.4 4区医学

Urologie Pub Date : 2026-05-01 Epub Date: 2026-03-30 DOI: 10.1007/s00120-026-02815-6

Désirée Louise Dräger, Chris Protzel

{"title":"[New guideline for supportive care-what is relevant for urologists?]","authors":"Désirée Louise Dräger, Chris Protzel","doi":"10.1007/s00120-026-02815-6","DOIUrl":"10.1007/s00120-026-02815-6","url":null,"abstract":"The updated S3 guideline for supportive care (version 2.0, as of April 2025) provides an evidence-based, interdisciplinary framework for the supportive management of oncology patients. Supportive care encompasses measures aimed at preventing and managing therapy-induced side effects, with the goal of maintaining quality of life, avoiding therapy discontinuation, and ensuring holistic patient care. The new version expands the previous ten topic areas with four central focuses: management of side effects from immunotherapies, cardiovascular complications, central neurotoxicity, and radiation-induced side effects in the genitourinary tract. The guideline offers concrete recommendations for monitoring, prevention, and management of side effects associated with modern therapies, emphasizing the importance of patient-centered and interdisciplinary care. For urologists, the explicit discussion of radiation-induced side effects in the genitourinary tract is particularly relevant, including incontinence, bladder emptying disorders, and sexual dysfunction. The guideline supports structured long-term follow-up, enhances interdisciplinary collaboration, and enables evidence-based planning and management of side effects. Despite comprehensive evidence, the effectiveness of the guideline critically depends on consistent implementation, sufficient resources, and individualized adaptation to patients. The S3 guideline 2025 thus provides a foundation for optimized supportive care in urologic oncology and promotes sustainable improvement of function and quality of life for patients.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"498-505"},"PeriodicalIF":0.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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