Urologie最新文献

{"title":"[Subsequent procedures after masculinizing surgery: neourethra and prosthetics].","authors":"Melanie Poulin, Saskia Morgenstern","doi":"10.1007/s00120-026-02940-2","DOIUrl":"https://doi.org/10.1007/s00120-026-02940-2","url":null,"abstract":"<p><p>The goal of masculinizing genital surgery, which is usually performed over several planned operative stages, is to construct a genital that is both aesthetically and functionally satisfactory. It aims to create a phallus with the best possible sensitivity, a long-term stable neourethra for voiding in a standing position, and to enable penetrative sexual intercourse by means of erectile prostheses. Whether all of these steps are required depends on the individual needs of the trans man. Due to anatomical peculiarities (the absence of stable tissue types designed for the relevant function), both urethral surgery and penile prosthesis implantation differ significantly from those performed on cisgender male patients and result in higher complication rates. Since the neourethra is usually constructed from several tissue types not designed for contact with urine-such as the labia minora, vaginal mucosa, and formerly hair-bearing dermis-the main complications include urethral fistulas, strictures, and diverticulum formation, as well as hair growth within the neourethra with or without stone formation and consequent impaired urinary outflow. The most common complications of prosthesis implantation in trans men are infection, erosion, dislocation, and (premature) mechanical failure, which frequently necessitates further revisions and subsequent operations. The available evidence is predominantly based on retrospective data with small case numbers and is characterized by considerable heterogeneity regarding the definition of endpoints and the assessment of patient-reported outcomes. Despite these methodological limitations, the published studies overall show a high rate of functional satisfaction.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224901","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}

{"title":"[Added benefits of systemic uro-oncological therapies-risk of recourse following elimination of the special practice designation : Part 1: prostate cancer].","authors":"Manfred Johannsen, Roger Zillmann, Jörg Klier, Christian Doehn, Sulafah El-Khadra","doi":"10.1007/s00120-026-02943-z","DOIUrl":"https://doi.org/10.1007/s00120-026-02943-z","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208005","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}

{"title":"[The role of urology in pelvic trauma : Diagnosis and management of associated genitourinary injuries].","authors":"Toni Franz, Christian Kleber, Jens-Uwe Stolzenburg","doi":"10.1007/s00120-026-02944-y","DOIUrl":"https://doi.org/10.1007/s00120-026-02944-y","url":null,"abstract":"<p><p>Pelvic fractures may be accompanied by injuries of the lower urinary tract which, although uncommon, are associated with considerable morbidity and long-term functional impairment. Optimal management requires accurate diagnosis, appropriate treatment, and early integration of urological expertise into interdisciplinary trauma care. This review summarizes current evidence on the diagnosis and management of bladder and posterior urethral injuries associated with pelvic fractures, emphasizing the role of urology throughout clinical decision-making. Recommendations from the European Association of Urology (EAU), the American Urological Association (AUA), and the World Society of Emergency Surgery (WSES) are discussed in the context of key clinical studies. Beyond selecting appropriate diagnostic imaging and treatment strategies, the urological expertise plays an important role in interdisciplinary decision-making, particularly when urological management must be coordinated with pelvic ring stabilization, as well as in reconstructive management and structured long-term follow-up. Early urological involvement is therefore an integral component of interdisciplinary management aimed at minimizing complications and preserving long-term functional outcomes, including urinary continence, voiding and sexual function, and quality of life.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196674","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}

{"title":"[Crisis, disaster and war: the role of urology in resilient healthcare structures].","authors":"Tim Nestler, Kristin Zimmermann, Christian Ruf, Cord Matthies, Karl von Dobschütz, Hans Schmelz","doi":"10.1007/s00120-026-02945-x","DOIUrl":"https://doi.org/10.1007/s00120-026-02945-x","url":null,"abstract":"<p><p>Europe's changed security environment requires the German healthcare system to prepare for crises, disasters, and war. Planning must address not only a sudden influx of casualties but also failures of energy supply, information technology, communications, supply chains, and staffing. This does not justify unrestricted expansion of the urologist's professional remit. In mass casualty incidents, urological contributions should follow a graded competency model: trauma bay and team tasks, surgical assistance, defined core urological procedures, and advanced capabilities restricted to selected experts. Resilience depends on prioritized care, network-based capacity management, analogue fallback procedures, critical stockpiles, and regular exercises. Surgical training for rare open emergency procedures can be supplemented by simulation-based training and interdisciplinary courses. The authors propose a modular, assessable qualification pathway combining stepwise training in routine clinical care, simulation, rotations, and competency assessment. Its purpose is to reinforce interdisciplinary teams while safeguarding routine and emergency urological care.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184792","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}

{"title":"[Administration of antibiotics in patients with polytrauma-based urogenital injuries-a narrative review].","authors":"Khaled Alghueiri, Florian Wagenlehner","doi":"10.1007/s00120-026-02946-w","DOIUrl":"https://doi.org/10.1007/s00120-026-02946-w","url":null,"abstract":"<p><strong>Background: </strong>Urogenital injuries occur in up to 10% of all trauma patients and are associated with increased risk of infectious complications, especially in association with polytrauma. Rational administration of antibiotics is an essential part of care, whereby evidence-based recommendations are lacking for many types of injuries.</p><p><strong>Methods: </strong>A narrative review on the administration of antibiotics to patients with injuries to the upper and lower urinary tract as well as external genital organs taking into consideration current international guidelines, consensus documents, and review articles is presented. In addition, recommendations on antibiotic stewardship, perioperative antibiotic prophylaxis, and specific trauma-related situations are taken into account.</p><p><strong>Results: </strong>Routine antibiotic prophylaxis for uncomplicated, blunt urogenital injuries is not recommended. In surgically managed, penetrating, or contaminated injuries, antibiotic administration should be risk adapted and be oriented based on the injury pattern, degree of contamination, and the expected spectrum of pathogens. In addition to guideline-based perioperative antibiotic prophylaxis, aspects of antibiotic stewardship, altered pharmacokinetic aspects of patients with polytrauma and systemic inflammation, prophylaxis for gas gangrene and tetanus, and the specific requirements associated with war-related injuries are becoming increasingly important.</p><p><strong>Conclusion: </strong>Administration of antibiotics in polytraumatized patients with urogenital injuries should be based on the indication and be guideline conform. Because of the limited amount of evidence, many recommendations are based on expert consensus as well as general trauma and perioperative guidelines. Prospective studies are needed to define indications, choice of antibiotics, and duration of treatment for the various injury patterns.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168886","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}

{"title":"[Belzutifan in the treatment of renal cell carcinoma].","authors":"Thomas Büttner","doi":"10.1007/s00120-026-02939-9","DOIUrl":"https://doi.org/10.1007/s00120-026-02939-9","url":null,"abstract":"<p><p>As the first approved inhibitor of hypoxia-inducible factor 2 alpha (HIF-2α), belzutifan represents a significant advancement in the treatment of clear cell renal cell carcinoma. By directly blocking the transcription factor it interrupts the oncogenic cascade initiated by the loss of the von Hippel-Lindau (VHL) protein. The current approval includes monotherapy in the third-line setting as well as VHL-associated tumors; however, recent data from the LITESPARK studies suggest a possible expansion into second-line and adjuvant settings. The side effect profile is characterized by specific on-target effects, such as anemia and hypoxia, which require close monitoring.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148713","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}

{"title":"[Application and utilization of virtual and augmented reality in surgical specialties-an expert Delphi consensus].","authors":"K F Kowalewski, M E Geissler, J P Bereuter, J Ebbing, M Glienke, J Hatzl, F Heinrich, T Huber, F Joeres, Bfb Mayer, A Preukschas, M Queisner, M W Schmidt, L Schwenderling, C Steiner, J P Struck, H Borgmann","doi":"10.1007/s00120-026-02933-1","DOIUrl":"https://doi.org/10.1007/s00120-026-02933-1","url":null,"abstract":"<p><strong>Background: </strong>Digitalization in healthcare is progressing only slowly in Germany. To counter this trend, four different consensus groups came together as part of the Digital Health Summit in Brandenburg. The aim was to assess the current situation and to formulate demands directed at policymakers and the scientific community in order to advance digitalization.</p><p><strong>Objective: </strong>This paper presents the results of the experts' Delphi process on extended reality (XR) in surgical specialties.</p><p><strong>Materials and methods: </strong>As part of the Digital Health Summit Brandenburg 2024, a multistage expert consensus process was conducted with physicians and researchers. Following an initial literature review, statements on the topics of definition, status quo, translation, and utopia were developed and evaluated within a Delphi process.</p><p><strong>Results: </strong>A total of 31 statements were developed across five categories, the majority of which were endorsed with very strong (41%) or strong (56%) consensus. Participants currently see XR being used primarily in education and training and in surgical planning. For clinical translation, interdisciplinary collaboration as well as the provision of resources and guidelines for clinical integration were key priorities. With regard to optimal use of the technologies, interdisciplinary development as well as mandatory provision and promotion of the technologies were cited.</p><p><strong>Conclusion: </strong>XR applications have already been adopted in certain areas of medicine and have demonstrated benefit in specific domains. However, the current framework conditions for developers and healthcare providers are insufficient for widespread implementation in routine clinical practice. In addition to financial and methodological support, there is a particular need to streamline regulatory barriers.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115541","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}

{"title":"[Blue versus white light during transurethral resection of nonmuscle invasive bladder cancer].","authors":"F Zengerling","doi":"10.1007/s00120-026-02938-w","DOIUrl":"https://doi.org/10.1007/s00120-026-02938-w","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115543","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}

{"title":"[Perceived autonomy of long-term prostate cancer survivors].","authors":"Cornelia Peter, Ann-Kathrin Christmann, Lilly J Schmalbrock, Stefan Schiele, Jürgen E Gschwend, Andreas Dinkel, Kathleen Herkommer","doi":"10.1007/s00120-026-02854-z","DOIUrl":"10.1007/s00120-026-02854-z","url":null,"abstract":"<p><strong>Background: </strong>Autonomy is a fundamental psychological need in old age. It is closely linked to quality of life, psychological well-being, and functional capacity. In long-term prostate cancer (PCa) survivors, autonomy may be compromised by age- and treatment-related factors.</p><p><strong>Objective: </strong>To assess perceived autonomy in long-term PCa survivors and identify sociodemographic, clinical, and psychosocial predictors.</p><p><strong>Methods: </strong>Cross-sectional analysis of data from the German multicentre project \"Familial Prostate Cancer\". A total of 2143 long-term PCa (mean age: 80 years) survivors after radical prostatectomy were included. Perceived autonomy was assessed using an item from the \"Perceived Autonomy in Old Age Scale\" and dichotomized into \"rather autonomous\" vs. \"rather not autonomous\". Sociodemographic, clinical, and psychosocial factors were analysed.</p><p><strong>Results: </strong>Overall, 86% of participants perceived themselves as \"rather autonomous\". Lower perceived autonomy was significantly associated with higher age, lower education, poorer perceived economic situation, current PCa therapy, reduced quality of life, lower subjective well-being, fear of progression, and lack of daily internet use (all p < 0.001).</p><p><strong>Conclusion: </strong>Although perceived autonomy remains high in many older PCa survivors, it is vulnerable and related to modifiable factors. Findings highlight key targets for a patient-centered, autonomy-supportive approach in long-term uro-oncologic survivorship care.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"1066-1072"},"PeriodicalIF":0.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Endoscopic enucleation for prostate volumes ≥ 200 ml: current evidence, technical challenges, and clinical implications].","authors":"Jonas Herrmann, Friedrich O Hartung, Lukas Lusuardi, Christopher Netsch, Thomas R W Herrmann","doi":"10.1007/s00120-026-02857-w","DOIUrl":"10.1007/s00120-026-02857-w","url":null,"abstract":"<p><strong>Background: </strong>Anatomical endoscopic enucleation of the prostate (AEEP) has become an established size-independent standard surgical treatment for benign prostatic hyperplasia. However, evidence regarding treatment of patients with prostate volumes ≥ 200 mL remains limited. This review aims to evaluate the available literature on functional outcomes, complications, technical challenges, and alternative surgical approaches in patients with extremely large prostates.</p><p><strong>Materials and methods: </strong>A systematic literature search was performed in PubMed/MEDLINE, Web of Science, and Scopus. Studies reporting outcomes of endoscopic enucleation in patients with prostate volumes ≥ 200 mL were included. Perioperative outcomes, functional results, complications, and comparisons with alternative surgical techniques were analyzed.</p><p><strong>Results: </strong>The available evidence consists exclusively of retrospective case series from specialized centers. Functional outcomes, including symptom relief, improvement in urinary flow rate, and reduction of post void residual urine, were comparable to those reported for smaller prostate volumes. However, operative and morcellation times were longer, and complication and transfusion rates were increased. Bleeding-related complications were found to correlate with prostate volume. Technical challenges mainly arise from altered anatomy during enucleation and morcellation. In selected cases, staged morcellation, open cystotomy for adenoma retrieval, or temporary perineal urethrotomy may be required. Compared with open simple prostatectomy, AEEP is associated with lower morbidity. Robot-assisted simple prostatectomy represents a potential alternative in experienced centers but has not demonstrated clear functional advantages to date.</p><p><strong>Conclusion: </strong>AEEP is an effective and safe treatment option for prostate volumes ≥ 200 mL. Despite greater technical complexity and higher rates of bleeding-related complications, functional outcomes are comparable to those achieved in smaller glands. In experienced hands, AEEP offers the best available evidence while maintaining lower morbidity than alternative surgical approaches. However, current evidence is derived almost exclusively from expert centers, limiting the generalizability of these findings to institutions with less experience.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"1073-1078"},"PeriodicalIF":0.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176945","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}