Urologie最新文献

{"title":"[Penile cancer: management strategies for patients with lymph node involvement : A systematic review].","authors":"Desiree Louise Dräger","doi":"10.1007/s00120-026-02813-8","DOIUrl":"10.1007/s00120-026-02813-8","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"530-533"},"PeriodicalIF":0.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505026","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":"[Influence of MRI fusion biopsy on treatment recommendations : How reliable are biopsy results?]","authors":"P Schildhauer, M Müller, A S Merseburger, S M Weiler, A Fürschke, Y Elser, A Moderegger, H E Fender","doi":"10.1007/s00120-025-02738-8","DOIUrl":"10.1007/s00120-025-02738-8","url":null,"abstract":"<p><strong>Background: </strong>The detection of clinically significant prostate cancer remains a diagnostic challenge. The combination of magnetic resonance imaging (MRI) fusion biopsy and systematic biopsy is currently considered standard in primary diagnostics.</p><p><strong>Objectives: </strong>The study examined differences in guideline-based treatment recommendations derived from the histology of MRI fusion versus systematic biopsy and their concordance with prostatectomy histology.</p><p><strong>Materials and methods: </strong>A total of 476 patients who underwent prostate biopsy between January 2022 and December 2024 were included. Primary endpoints were histological classification by biopsy method and the resulting treatment recommendations. In a subgroup of 57 patients (115 lesions) who underwent radical prostatectomy, concordance between biopsy and surgical histology was analyzed based on Prostate Imaging Reporting and Data System (PI-RADS) scores. Statistical analyses included binomial test, McNemar's test, Cohen's κ, and binary logistic regression (significance level p < 0.05).</p><p><strong>Results: </strong>The combined approach detected significantly more clinically relevant cancers than systematic biopsy alone (41.7% vs. 27.9%; p < 0.001) and led to more curative treatment recommendations (36.0% vs. 26.2%; p < 0.001). Compared with MRI fusion biopsy alone, it also yielded a higher rate of curative recommendations (36.0% vs. 32.8%; p < 0.001). Concordance of Gleason scores with prostatectomy findings was highest for PI-RADS 5 lesions (κ = 0.294) and significantly higher than for PI-RADS 3 (p = 0.029).</p><p><strong>Conclusion: </strong>The combined biopsy approach increases the rate of guideline-concordant curative treatment recommendations. However, the added diagnostic value of systematic biopsy remains limited. Higher concordance between biopsy and prostatectomy histology was observed only in PI-RADS 5 lesions.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"513-520"},"PeriodicalIF":0.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709575","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":"Berufspolitik BvDU.","authors":"","doi":"10.1007/s00120-026-02826-3","DOIUrl":"https://doi.org/10.1007/s00120-026-02826-3","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":"65 5","pages":"563-575"},"PeriodicalIF":0.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783268","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":"[At-home tests in the healthcare market-opportunities, limitations, and clear oversight using the example of PSA home testing].","authors":"Sulafah El-Khadra","doi":"10.1007/s00120-026-02814-7","DOIUrl":"10.1007/s00120-026-02814-7","url":null,"abstract":"<p><p>Mobile health tests are gaining increasing relevance in healthcare systems and address existing gaps in care, including low participation in preventive screening, access barriers, and the growing demand for patient autonomy in health management. In particular, home-based tests, such as those measuring prostate-specific antigen (PSA), offer low-threshold access to preventive care and may serve as an entry point into the medical care pathway.From a urological perspective, however, these potentials are clearly limited. Self-tests provide only isolated measurements and do not replace medical diagnostics or clinical evaluation. Especially in the context of PSA testing, there is a significant risk of misinterpretation: both false-positive results, leading to unnecessary diagnostic cascades, and false-negative findings, creating false reassurance, may compromise patient safety.Key challenges also include pre-analytical limitations, the absence of structured indication, and insufficient integration into established care pathways. Patients are often left alone with potentially critical results, both organizationally and emotionally. Regulatory approval ensures minimum safety standards but does not substitute for structured, quality-assured medical process management.The German Professional Association of Urology (BvDU) critically assesses PSA home testing without mandatory medical involvement. In urology, PSA is not an isolated screening parameter but part of a complex, risk-adapted diagnostic pathway.Home testing is therefore only justifiable if it is systematically integrated into structured, physician-led care pathways. This includes adequate patient information, appropriate indication, professional interpretation of results, and ensured follow-up in case of abnormal findings.In conclusion, mobile tests may represent a valuable access point to healthcare; however, they must not replace medical responsibility. Patient safety must take precedence over market dynamics.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"537-541"},"PeriodicalIF":0.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640028","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":"[Early detection of prostate cancer-recommendations of the updated S3 guideline 2025].","authors":"Rouvier Al-Monajjed, Peter Albers, Tobias Franiel, Thomas Kötter, Glen Kristiansen, Ken Herrmann, Thomas Wiegel","doi":"10.1007/s00120-026-02811-w","DOIUrl":"10.1007/s00120-026-02811-w","url":null,"abstract":"<p><strong>Background: </strong>The 2025 update of the German S3 guideline on prostate cancer introduces major revisions in early detection and diagnostic strategies, marking a paradigm shift in the management of localized prostate cancer.</p><p><strong>Methods: </strong>This review summarizes the main evidence-based recommendations on early detection derived from the systematic evidence synthesis conducted for the 2025 guideline update.</p><p><strong>Results: </strong>The revised guideline establishes a risk-adapted, prostate-specific antigen (PSA)-based screening strategy starting at age 45, with individualized follow-up intervals (2 or 5 years) and indication-based diagnostic clarification using short-term PSA retesting, multiparametric magnetic resonance imaging (mpMRI), and targeted biopsy where appropriate. Digital rectal examination is no longer recommended for screening purposes. The structured integration of mpMRI increases the detection of clinically significant prostate cancer while reducing unnecessary biopsies and overdiagnosis. Active surveillance (AS) is a key component of the updated early detection and management strategy. For men with low-risk disease (ISUP 1), the guideline issues a strong \"should\" recommendation for AS, whereas for men with favorable intermediate-risk disease (ISUP 2 without cribriform or intraductal growth and with a limited proportion of Gleason pattern 4), AS carries a weaker \"may\" recommendation. Recent 15-year long-term results from the international Prostate Cancer Research International: Active Surveillance (PRIAS) cohort confirm the oncological safety of AS and highlight the pivotal role of mpMRI in patient selection and longitudinal monitoring.</p><p><strong>Conclusion: </strong>Combining individualized PSA-based early detection with high-quality MRI diagnostics enables precise, risk-adapted, and patient-centered prostate cancer management. This approach minimizes overdiagnosis and overtreatment while ensuring timely intervention for clinically relevant disease.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"470-479"},"PeriodicalIF":0.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582320","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":"[Shock waves for comrades. Urology as a topic in GDR newspapers (1946-1990)].","authors":"Florian G Mildenberger","doi":"10.1007/s00120-026-02801-y","DOIUrl":"https://doi.org/10.1007/s00120-026-02801-y","url":null,"abstract":"<p><p>The press in totalitarian states offers only a limited overview of social and health realities. However, an analysis of the three most important newspapers in the German Democratic Republic (GDR; Neues Deutschland, Neue Zeit, Berliner Zeitung) provides insight into how propaganda ultimately attempts in vain to conceal problems in the healthcare system and highlight the apparent triumph of socialism.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717438","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":"[Parallels with coincidental connections. Urology and constitutional medicine in the 20th century].","authors":"Florian G Mildenberger","doi":"10.1007/s00120-026-02821-8","DOIUrl":"https://doi.org/10.1007/s00120-026-02821-8","url":null,"abstract":"<p><p>Urologists and the proponents of a modern theory of constitution formed as distinct groups in the years before the First World War, but the urologists showed little interest in incorporating theories of the body into their own work. Only under political pressure from 1933 onwards were these ideas superficially accepted, which, however, soon dissipated again. After 1945, both sides finally conducted research independently of each other.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595290","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":"[Physicians' pension schemes and the system of medical pension entitlements].","authors":"Heiner van Randenborgh","doi":"10.1007/s00120-026-02792-w","DOIUrl":"10.1007/s00120-026-02792-w","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"422-423"},"PeriodicalIF":0.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504961","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":"Termine.","authors":"","doi":"10.1007/s00120-026-02808-5","DOIUrl":"https://doi.org/10.1007/s00120-026-02808-5","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":"65 4","pages":"464-466"},"PeriodicalIF":0.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575635","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":"[Pharmacotherapy of benign prostatic syndrome : Medications, innovations and future prospects].","authors":"P Keller, Alexander Tamalunas, Michael Atzler, Marc Kidess, Leo Stadelmeier, N Pyrgidis, Martin Hennenberg, Christian G Stief, Philipp Weinhold","doi":"10.1007/s00120-026-02784-w","DOIUrl":"10.1007/s00120-026-02784-w","url":null,"abstract":"<p><p>Lower urinary tract symptoms (LUTS) affect the majority of men over 60 years old in Germany to varying degrees. These symptoms include issues with bladder storage and bladder emptying. The most common cause of such disorders by far is prostate enlargement (benign prostatic hyperplasia, BPH), which leads to urethral narrowing (benign prostatic obstruction, BPO). Due to the aging population, the prevalence of BPH is steadily increasing and a good understanding of individualized patient treatment is of major importance. Treatment options range from watchful waiting and behavioral therapy to phytotherapy and pharmacotherapy up to surgical procedures. While the range of surgical and interventional therapeutic options is rapidly expanding, innovations in conservative treatment procedures have lagged behind in recent years; however, new drugs and combination treatment with existing medications offer promising possibilities to improve the quality of life and slow progression of the disease in patients.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"429-437"},"PeriodicalIF":0.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515278","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}