Urologie最新文献

{"title":"[Patient management in emergency and acute care: well-considered decision-making instead of actionism].","authors":"Christian Pfeiffer","doi":"10.1007/s00120-025-02607-4","DOIUrl":"https://doi.org/10.1007/s00120-025-02607-4","url":null,"abstract":"<p><p>Emergency and acute care in Germany is at a crossroads. Without a practical strategy tailored to regional circumstances, we run the risk of destabilizing healthcare provision in Germany in the long term. The care landscape in emergency medicine is highly complex and any reform must take this interplay into account. Another current problem is the increasing shortage of staff. In recent years, Bavaria has shown what future-oriented emergency care can look like. We must reform emergency care with caution and expertise. Politicians must not be guided by short-term promises of solutions, but must focus on proven, practical concepts.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498203","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":"[Healthcare without boundaries: revolution in cross-sector healthcare delivery].","authors":"Severin Pöchtrager","doi":"10.1007/s00120-025-02622-5","DOIUrl":"https://doi.org/10.1007/s00120-025-02622-5","url":null,"abstract":"<p><p>Hospital at home (HaH) is an internationally evaluated and widely established model of care in many countries. HaH is an acute clinical service that provides personnel, equipment, technology, medications, and skills that are typically available in hospitals, and delivers hospital-level care for selected individuals in their own homes or in nursing facilities. An interprofessional team consisting of nurses, therapists, and physicians treats patients-who would otherwise be cared for in a conventional hospital bed-in their own beds at home. Patients receive needs-based nursing and medical visits several times a day, and the team is available 24 h a day, 7 days a week. The average duration of treatment is similar to that of a conventional inpatient stay, ranging from 3-9 days. In current pilot projects in Switzerland, patients with internal medicine or palliative acute conditions are predominantly being treated. A Cochrane review based on 20 randomized studies on HaH shows high patient safety, lower complication rates compared to the traditional inpatient setting, lower treatment costs, and high patient satisfaction.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477018","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":"[Practical artificial intelligence for urology : Technical principles, current application and future implementation of AI in practice].","authors":"Severin Rodler, Konrad Hügelmann, Hans Christoph von Knobloch, Marie-Luise Weiss, Leonhard Buck, Jakob Kohler, Alexander Fabian, Jonas Jarczyk, Philipp Nuhn","doi":"10.1007/s00120-025-02620-7","DOIUrl":"https://doi.org/10.1007/s00120-025-02620-7","url":null,"abstract":"<p><p>Artificial intelligence (AI) is a disruptive technology that is currently finding widespread application after having long been confined to the domain of specialists. In urology, in particular, new fields of application are continuously emerging, which are being studied both in preclinical basic research and in clinical applications. Potential applications include image recognition in the operating room or interpreting images from radiology and pathology, the automatic measurement of urinary stones and radiotherapy. Certain medical devices, particularly in the field of AI-based predictive biomarkers, have already been incorporated into international guidelines. In addition, AI is playing an increasingly more important role in administrative tasks and is expected to lead to enormous changes, especially in the outpatient sector. For urologists, it is becoming increasingly more important to engage with this technology, to pursue appropriate training and therefore to optimally implement AI into the treatment of patients and in the management of their practices or hospitals.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477019","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":"Modern management of BCG-refractory non-muscle-invasive urothelial carcinoma of the urinary bladder.","authors":"Domenique Escobar, Chirag Doshi, Mazyar Zahir, Siamak Daneshmand","doi":"10.1007/s00120-025-02625-2","DOIUrl":"https://doi.org/10.1007/s00120-025-02625-2","url":null,"abstract":"<p><strong>Background: </strong>High-risk non-muscle-invasive bladder cancer (NMIBC) is most commonly treated with Bacillus Calmette-Guérin (BCG) as first-line therapy. However, in light of the ongoing BCG shortage in the United States, a significant need exists for alternative treatment options, both in the upfront setting as well as for patients with BCG-refractory disease. While radical cystectomy remains the gold standard for patients with BCG-refractory disease, many patients are unfit or unwilling to undergo this procedure. Several new agents, many with novel mechanisms of action, have been approved or are actively being investigated in this setting.</p><p><strong>Materials and methods: </strong>Articles were chosen for review based on expert knowledge of the literature as well as on PubMed literature searches for the topics of focus. Appropriate articles were selected for inclusion by reviewing article titles, abstracts, and full texts.</p><p><strong>Results: </strong>There is ample evidence for emerging therapies in BCG-refractory NMIBC including systemic immunotherapy and various intravesical options, such as chemotherapy, gene therapy, and novel drug delivery systems. Radical cystectomy, however, remains the gold standard. Response rates and duration of response vary across treatment modalities, with complete response rates at any time ranging from 41% to 82%. Radical cystectomy should still be recommended to patients with high-risk features given the risks of recurrence, progression, upstaging, and occult lymph node metastases.</p><p><strong>Conclusion: </strong>While radical cystectomy remains the standard of care for patients with BCG-refractory disease, many patients are unable or unwilling to undergo the procedure. Several novel therapies have been recently approved or are currently being investigated with overall promising early results.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477021","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":"[Visualizing the 'unspeakable': venereal diseases at the 1926 GeSoLei (Great Exhibition for Health Care, Social Welfare, and Physical Exercise)].","authors":"Matthis Krischel, Sarah Czirr, Friedrich H Moll","doi":"10.1007/s00120-025-02633-2","DOIUrl":"10.1007/s00120-025-02633-2","url":null,"abstract":"<p><p>The GeSoLei (Great Exhibition for Health Care, Social Welfare, and Physical Exercise) held in Düsseldorf in 1926 was one of the largest exhibitions of the Weimar Republic. At its core was the often visual communication of health-related topics-including the presentation of sexually transmitted diseases. These subjects were conveyed within the complex interplay between medical education, moral normalization, and esthetic staging. The section \"Common Diseases, Common Ailments, Common Vices\" (Main Section Social Welfare) brought together conditions such as tuberculosis, alcoholism, and syphilis-sicknesses that were not only medically, but also socially and morally charged. Through the use of information boards, wax models (moulages), and interactive exhibits, connections between sexuality, disease, and social responsibility were emphasized. The visual strategy followed a pedagogical and often deterrent approach, which, through standardized forms of representation, enabled communication suited for a mass audience. In addition to the guiding principle of social hygiene, the exhibition also incorporated ideas of racial and hereditary health, placing sexually transmitted diseases within the context of \"public health\" and \"rational population management.\" However, aspects of sexual diversity or sexology-as advocated by figures like Magnus Hirschfeld-were deliberately excluded. This article analyzes the visual and conceptual presentation of sexually transmitted diseases at GeSoLei as a representative example of the medicalization and moralization of sexuality in the early 20th century-embedded in a complex web of science, society, politics, and aesthetics.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337125","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":"[Surgical techniques to improve continence after robot-assisted laparoscopic radical prostatectomy based on video-anatomy-a review].","authors":"Jens Rassweiler, Sara Sander","doi":"10.1007/s00120-025-02627-0","DOIUrl":"https://doi.org/10.1007/s00120-025-02627-0","url":null,"abstract":"<p><strong>Background: </strong>Since robot-assisted laparoscopic prostatectomy (RALP) has become widely accepted in German-speaking countries, there needs to be an agreement on the most efficient surgical techniques. This should be based on the video-anatomy of the prostate and a summary of the actual literature.</p><p><strong>Materials and methods: </strong>Based on video material of different surgical techniques, a systematic literature search in PubMed has been performed focusing on preservation of continence and minimal rates of positive margins. This is based on the anatomy of the male pelvis applying a standard nomenclature. The original 3825 publications could be reduced to 604 articles according to the inclusion criteria (randomized controlled trials, meta-analyses, systematic reviews, and clinical studies). When expanding the search to encompass individual operation techniques, we identified 27 relevant articles.</p><p><strong>Results: </strong>Crucial surgical details include preserving the levator fascia, the puboprostatic collar, a long urethral stump with protection of the urethral lissosphincter and posteriorly reconstruction of the rectourethralis with the prostatovesical muscle. Fascial preservation for the levator ani muscle results in 1‑year continence between 78.0 and 98.3%, preservation of the puboprostatic collar and detrusor apron between 95.6 and 100%, maximal functional urethral length between 90.5 and 97.5%. Posterior reconstruction leads to a 3-month continence between 92.3 and 96.9%. Preserving the Retzius' space and thus the total anterior sphincter apparatus results in 1‑year continence of 95.8%; however, it is associated with a higher rate of positive surgical margins (14-42 vs. 10-29%).</p><p><strong>Conclusion: </strong>Based on the increase of knowledge and the feasibility to translate this into novel surgical techniques, the continence rates could be significantly improved. This includes approaches to spare anatomical structures of the sphincter apparatus, such as preservation of the levator fascia, the puboprostatic collar, the urethral lissosphincter, but also reconstructive techniques, such as posterior reconstruction of the vesicoprostatic and rectourethralis muscle. Demanding techniques, such as the Retzius-sparing approach result in higher continence rates, but are also associated with a higher rate of surgical margins.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303081","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":"[Women in urological research: benefits and opportunities for german urology].","authors":"Michèle J Hoffmann, Maria Schubert, Kati Erdmann, Laila Schneidewind, Gerit Theil, Melanie Freifrau von Brandenstein, Eva Jüngel, Kerstin Junker","doi":"10.1007/s00120-025-02624-3","DOIUrl":"https://doi.org/10.1007/s00120-025-02624-3","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286644","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":"[Management of isolated urinary bladder amyloidsis].","authors":"Agneta Seebold, Thomas Büttner, Guido Fechner, Jan-Frederic Lau, Philipp Krausewitz","doi":"10.1007/s00120-025-02621-6","DOIUrl":"https://doi.org/10.1007/s00120-025-02621-6","url":null,"abstract":"<p><p>Isolated bladder amyloidosis is a rare condition characterized by amyloid deposits within the bladder wall. We present the case of a patient with recurrent, painless gross hematuria accompanied by irritative and dysuric voiding symptoms-clinical features typical of bladder amyloidosis. This case highlights the diagnostic challenges and therapeutic strategies associated with the disease, emphasizing the importance of appropriate surveillance intervals, follow-up techniques, and long-term symptom management.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276075","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":"[Secondary bladder cancer following radiation therapy for prostate cancer: a systematic review and meta-analysis of incidence and outcomes].","authors":"Annemarie Uhlig","doi":"10.1007/s00120-025-02592-8","DOIUrl":"10.1007/s00120-025-02592-8","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"584-587"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041808","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":"BvDU Kurz notiert.","authors":"","doi":"10.1007/s00120-025-02608-3","DOIUrl":"https://doi.org/10.1007/s00120-025-02608-3","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":"64 6","pages":"613-614"},"PeriodicalIF":0.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209685","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}