Urologie最新文献

{"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":"[Application of low-intensity shockwave therapy in patients with erectile dysfunction].","authors":"Frank Kunath","doi":"10.1007/s00120-026-02829-0","DOIUrl":"https://doi.org/10.1007/s00120-026-02829-0","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783315","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":"[\"Urologic controlling 2026-mastering the shift to outpatient care, assuring quality, optimizing revenues\" : Symposium of the DGU-working group for Healthcare Research, Quality, and Economics in Heidelberg].","authors":"Philipp Reimold, Johannes Huber, Christer Groeben","doi":"10.1007/s00120-026-02833-4","DOIUrl":"https://doi.org/10.1007/s00120-026-02833-4","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783270","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":"[Digital twins in uro-oncology].","authors":"Johanna Smielowski, Maximilian Glienke, Sherif Mehralivand, Gregor Duwe, Felix Chun, Hendrik Borgmann, Magdalena Görtz","doi":"10.1007/s00120-026-02827-2","DOIUrl":"https://doi.org/10.1007/s00120-026-02827-2","url":null,"abstract":"<p><strong>Background: </strong>Uro-oncology is moving toward precision medicine, driven by high-dimensional longitudinal data from imaging, pathology, molecular profiling, and follow-up. However, clinical decision-making often relies on static risk scores that cannot fully capture individual disease dynamics. Digital twins aim to integrate multimodal patient data and to provide patient-specific, dynamically updated simulation models, thereby enabling \"what-if\" testing of interventions.</p><p><strong>Objective: </strong>How is a medical digital twin defined, which data foundation is available in uro-oncology, and which clinical use cases can be envisaged?</p><p><strong>Methods: </strong>This work comprises a narrative review including a description of the digital twin concept, a structured presentation of multimodal data (laboratory parameters, imaging, pathology, omics, long-term outcomes), and an overview of representative published applications (e.g., tumor growth reconstruction, virtual pathology, surgical 3D twins).</p><p><strong>Results: </strong>Current digital twin research in uro-oncology largely represents partial digital twins (e.g., tumor progression models, virtual assessment, patient-specific 3D surgical planning). Potential clinical value of digital twins includes dynamic risk stratification, individualized treatment planning, and adaptive follow-up strategies. Major limitations relate to data quality, interoperability, external validation, interpretability, data privacy, and regulatory requirements for clinical deployment.</p><p><strong>Conclusion: </strong>Digital twins have the potential to enable a new era of predictive precision medicine in uro-oncology. Progress toward clinically actionable digital twins requires multimodal architectures, rigorous monitoring, and seamless integration into clinical workflows under robust governance and regulatory frameworks.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783264","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":"[Large language models as a communication and organizational infrastructure in urology: evidence, limitations, and clinical responsibility].","authors":"Emily Rinderknecht, Radu Alexa, Christian Wülfing, Nicolas Carl, Matthias May, Sebastian Frees","doi":"10.1007/s00120-026-02818-3","DOIUrl":"https://doi.org/10.1007/s00120-026-02818-3","url":null,"abstract":"<p><p>Large language models (LLMs) mark a structural turning point in digital medicine, as they are now capable not only of processing medical information but of conveying it in ways that are context-sensitive, linguistically coherent, and tailored to the needs of specific audiences. In urology, a specialty defined by high communication demands, explanation-intensive disease entities, and complex organizational interfaces, the central question is no longer one of technical feasibility but of the fundamental repositioning of clinical communication. This article analyzes the role of LLMs as a communication and organizational infrastructure within urologic care, grounded in current empirical evidence. Systematic comparisons demonstrate that artificial intelligence (AI)-generated responses to patient questions are perceived in most studied contexts as equivalent or superior to physician responses, particularly with respect to clarity, empathy, and overall satisfaction, while revealing a pronounced divergence between patient-centered and professional evaluative standards. Urology-specific data on the automated generation of layperson summaries further show that LLMs can achieve significantly improved readability and formal quality without compromising factual accuracy. At the same time, studies on AI-assisted documentation and ambient scribe systems underscore that gains in efficiency and reductions in documentation burden remain inseparable from the need for physician oversight and institutional governance. These findings are not interpreted as a substitution of medical expertise but as the emergence of a new mediating layer between clinical knowledge, organizational requirements, and patient perception. The integration of generative AI, thus, becomes a professional and institutional challenge that extends beyond the deployment of individual tools and shapes the future communication architecture of urology.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634243","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":"[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}

{"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}