Urologie最新文献_第2页

[Retroperitoneal lymphadenectomy in the treatment of testicular germ cell tumors-Is the robot-assisted technique superior to the open surgical approach?] 腹膜后淋巴结切除术治疗睾丸生殖细胞肿瘤——机器人辅助技术是否优于开放手术方法？］

IF 0.4 4区医学

Urologie Pub Date : 2025-10-01 Epub Date: 2025-09-15 DOI: 10.1007/s00120-025-02678-3

Markus Angerer, Klaus-Peter Dieckmann, Christian Wülfing

{"title":"[Retroperitoneal lymphadenectomy in the treatment of testicular germ cell tumors-Is the robot-assisted technique superior to the open surgical approach?]","authors":"Markus Angerer, Klaus-Peter Dieckmann, Christian Wülfing","doi":"10.1007/s00120-025-02678-3","DOIUrl":"10.1007/s00120-025-02678-3","url":null,"abstract":"Background: Retroperitoneal lymph node dissection (RPLND) is an established treatment modality for nonseminomatous germ cell tumours (NSGCT) and selected seminomas. The advent of minimally invasive techniques, particularly robot-assisted RPLND (R-RPLND), involves the prospects of reducing procedure-related morbidity while maintaining oncologic efficacy.Materials and methods: We performed a narrative review comparing contemporary data on R‑RPLND and open RPLND (O-RPLND) across different clinical settings (primary, clinical stages I-II, and postchemotherapy). Guideline recommendations are reviewed regarding results from prospective and retrospective studies, as well as recent meta-analyses.Results: R‑RPLND consistently demonstrated advantages in perioperative outcomes, including reduced blood loss, shorter length of hospital stay, and faster convalescence. High-grade complication rates (Clavien-Dindo ≥ III) were comparable or lower than with O‑RPLND. Oncologic outcomes, including recurrence-free survival, were noninferior across all stages. In the postchemotherapy setting, R‑RPLND was associated with lower morbidity, though surgical feasibility is highly dependent on tumour size, location, and prior abdominal surgery.Conclusion: R‑RPLND represents a safe and effective alternative to O‑RPLND in selected patients when performed in high-volume centres. Its perioperative advantages, coupled with equivalent short-term oncologic outcomes, render R‑RPLND an attractive option. However, high-quality randomised trials with long-term follow-up are required to confirm oncologic equivalence and to refine patient selection criteria.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"1046-1054"},"PeriodicalIF":0.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065776","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

AUO.

IF 0.4 4区医学

Urologie Pub Date : 2025-10-01 DOI: 10.1007/s00120-025-02684-5

引用次数: 0

[Therapy for an overactive bladder in 5 minutes? The INKA app makes it possible]. 5分钟治疗膀胱过度活动？INKA应用程序使这成为可能]。

IF 0.4 4区医学

Urologie Pub Date : 2025-10-01 Epub Date: 2025-09-12 DOI: 10.1007/s00120-025-02682-7

Nora Michalik

引用次数: 0

[Follow-up in patients with testicular germ cell tumors-an update]. [睾丸生殖细胞肿瘤患者的随访研究进展]。

IF 0.4 4区医学

Urologie Pub Date : 2025-10-01 Epub Date: 2025-09-20 DOI: 10.1007/s00120-025-02675-6

Klaus-Peter Dieckmann, Markus Angerer, Felix Bremmer, Armin Soave

{"title":"[Follow-up in patients with testicular germ cell tumors-an update].","authors":"Klaus-Peter Dieckmann, Markus Angerer, Felix Bremmer, Armin Soave","doi":"10.1007/s00120-025-02675-6","DOIUrl":"10.1007/s00120-025-02675-6","url":null,"abstract":"Systematic follow-up (FU) examinations in patients with testicular germ cell tumors (GCTs) came into practice in the 1980s. The goal is to detect recurrent disease as early as possible to facilitate successful treatment. Cross-sectional imaging and tumor marker measurements (AFP, bHCG) represent the mainstay of FU examinations. Due to the biological and clinical diversity of GCTs, there is no uniform general pattern of examinations that would suit all GCT patients. Therefore, FU should be performed in a risk-adapted way; the rationale of which is to tailor examinations to the extent needed, while keeping examinations as short as possible. In the entire population of testicular GCTs, there are around 20 different risk categories that are characterized by histology, clinical stage, and antecedent treatment and that differ from each other with respect to frequency of relapses (2-50%), time interval to relapse, and topography of recurrent disease. In terms of clinical practice, three risk groups should be employed: (1) seminoma all stages, (2) nonseminoma clinical stage 1, and (3) nonseminoma all other clinical stages. The FU examinations specifically required in these categories are listed in three roster tables, accordingly. The following items are at variance with the German S3 guidelines from 2019: (a) the number of risk groups is reduced to three (instead of 4) and the groups are newly defined, (b) cross-sectional imaging with computed tomography (CT) is replaced by magnetic resonance imaging (MRI) for reasons of radiation protection, (c) abdominal sonography is replaced by MRI for reasons of superior diagnostic accuracy, (d) no more chest X‑ray in FU of seminoma patients, and (e) lactate dehydrogenase (LDH) no longer a marker for testing in FU. Another goal of FU is the early detection of second diseases ensuing from treatment of GCT such as hypogonadism, metabolic syndrome, cardiovascular diseases, and second malignancies. Therefore, FU should be continued beyond the 5 year threshold with annual visits.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"1024-1036"},"PeriodicalIF":0.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092507","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

[First diagnosis of renal cell carcinoma via a testicular metastasis]. 【通过睾丸转移首次诊断肾细胞癌】。

IF 0.4 4区医学

Urologie Pub Date : 2025-10-01 Epub Date: 2025-04-24 DOI: 10.1007/s00120-025-02584-8

Leonhard Buck, Hans Christoph von Knobloch, Jakob Kohler, Fatih Yalcin, Christiane Maria Stuhlmann-Laeisz, Severin Rodler, Jonas Jarczyk, Philipp Nuhn

引用次数: 0

BvDU Kurz notiert. BvDU简短注释。

IF 0.4 4区医学

Urologie Pub Date : 2025-10-01 DOI: 10.1007/s00120-025-02686-3

引用次数: 0

[Retroperitoneal lymphadenectomy (RPLND) for the treatment of testicular germ cell tumors-open or robotic? Pro open surgery : RPLND in the management of testis cancer]. 腹膜后淋巴结切除术（RPLND）治疗睾丸生殖细胞肿瘤-开放还是机器人？开放性手术：RPLND在睾丸癌治疗中的应用。

IF 0.4 4区医学

Urologie Pub Date : 2025-10-01 Epub Date: 2025-09-11 DOI: 10.1007/s00120-025-02673-8

Axel Heidenreich, David Pfister

{"title":"[Retroperitoneal lymphadenectomy (RPLND) for the treatment of testicular germ cell tumors-open or robotic? Pro open surgery : RPLND in the management of testis cancer].","authors":"Axel Heidenreich, David Pfister","doi":"10.1007/s00120-025-02673-8","DOIUrl":"10.1007/s00120-025-02673-8","url":null,"abstract":"Retroperitoneal lymphadenectomy (RPLND) represents an established surgical treatment option for patients with testicular germ cell tumors and might be performed at various clinical stages depending on individual risk factors. Typically, RPLND is performed via a trans- or extraperitoneal open approach with dissection of a unilateral or bilateral template. Since robot-assisted approaches have been established in uro-oncological surgery, the question arises whether there is already an established indication to perform robot-assisted RPLNDs (R-RPLND). International guidelines recommend that such a surgical procedure should only be performed for selected patients in testicular cancer referral centers by highly experienced testicular cancer surgeons. We reviewed the recently published data of R‑RPLND and we conclude that R‑RPLND is technically feasible and that it can be performed with equal complication rates if done in an expert center. However, there is no benefit in terms of oncological and functional outcome. Based on the results of multicenter trials and meta-analyses, antegrade ejaculation is only preserved in 65-70% of the patients, which is inferior to open surgery done in expert centers. Duration of surgery is significantly longer compared to open surgery. Oncological outcome following R‑RPLND is difficult to validate due to the short follow-up intervals and the selection of patients. Comparison of postchemotherapeutic R‑RPLND with open surgery is also hampered due to highly selected patients with only small residual masses and short follow-up periods. In summary, R‑RPLND should only be established in testicular cancer expert centers. Currently, we perform R‑RPLND especially for marker negative clinical stage IIA/B with lymph node metastases with a size of less or equal to 3 cm.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"1037-1045"},"PeriodicalIF":0.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065843","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

[Elevation of β-subunit of human chorionic gonadotropin in urological patients-not always a germ cell tumor]. 泌尿科患者β-人绒毛膜促性腺激素亚基升高-并不总是生殖细胞肿瘤。

IF 0.4 4区医学

Urologie Pub Date : 2025-10-01 Epub Date: 2025-09-16 DOI: 10.1007/s00120-025-02679-2

Luisa Witte, Matthäus Majewski

{"title":"[Elevation of β-subunit of human chorionic gonadotropin in urological patients-not always a germ cell tumor].","authors":"Luisa Witte, Matthäus Majewski","doi":"10.1007/s00120-025-02679-2","DOIUrl":"10.1007/s00120-025-02679-2","url":null,"abstract":"Background: The determination of the β‑subunit of human chorionic gonadotropin (HCG) is routinely used in urology as a tumor marker for germ cell tumors. This review highlights the differential diagnoses of β‑HCG elevation unrelated to germ cell cancer.Results: Causes of elevated β‑HCG levels include, among others, measurement errors due to the homology between luteinizing hormone (LH) and β‑HCG or in cases of immunoglobulin A (IgA) deficiency syndrome, reduced excretion in renal insufficiency, iatrogenic causes (e.g., substitution therapy, during androgen deprivation therapy), or hormonal disorders. Additionally, β‑HCG is produced autocrinely by 10-30% of all malignant nongerm cell tumors. In urothelial carcinoma, literature reports show positive detection in 30-76% of serum samples, 35-73% of urine samples, and approximately 35% in immunohistochemical analyses. Apart from testicular tumors, β‑HCG currently has no established role in routine tumor diagnostics. The expression pattern in the metastatic stage of urothelial carcinoma correlates with therapeutic response.Conclusion: In cases of implausible β‑HCG elevation during testicular tumor diagnostics or follow-up, one must consider the numerous differential diagnoses. In the future, β‑HCG could become a promising marker for monitoring hormone-expressing, metastatic urothelial carcinoma.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"1064-1073"},"PeriodicalIF":0.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070792","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

[Testicular germ cell tumors-stage-specific treatment for long-term quality of life]. [睾丸生殖细胞肿瘤-阶段特异性治疗的长期生活质量]。

IF 0.4 4区医学

Urologie Pub Date : 2025-10-01 Epub Date: 2025-10-02 DOI: 10.1007/s00120-025-02681-8

Christian Ruf, Friedemann Zengerling

引用次数: 0

Mitteilungen der DGU. DGU通讯。

IF 0.4 4区医学

Urologie Pub Date : 2025-10-01 DOI: 10.1007/s00120-025-02685-4

引用次数: 0