Urologie最新文献

{"title":"[Artificial intelligence in the care of geriatric patients-more of a curse or more of a blessing?]","authors":"Andreas Wiedemann, Andreas Manseck, Joachim Stein, Michael Fröhner, Christian Fiebig, Alexander Piotrowski, Martin Umbehr","doi":"10.1007/s00120-026-02890-9","DOIUrl":"10.1007/s00120-026-02890-9","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is conquering medicine in many fields. With geriatric patients, it is important not only to understand the decision tree of, for example, a tumor disease, but also to assess their functionality and functional deficits.</p><p><strong>Methods: </strong>For potential (urological) care of geriatric patients, AI-supported tumor boards, AI-simulated human interaction, and AI-based polypharmacy tools were identified. The advantages and disadvantages, risks and benefits, and practical aspects are weighed against each other.</p><p><strong>Results: </strong>The specific characteristics of geriatric patients arise from their multidimensionality. These often involve functional impairments that can only be systematically assessed. The challenge will be to integrate these functional deficits, along with appropriate cut-offs, life expectancy, patient goals, anamnesis, and the potential risks of any therapy, into treatment decisions, in addition to the characteristics of a (tumor) disease. Ensuring the psychosocial care of nursing home residents during times of staff shortages also presents a challenge. \"Learning\" and \"responsive\" cuddly toys and robots could provide valuable support in this area. A third application of AI is certainly a comprehensive medication tool that compares multiple databases with the patient's specific needs.</p><p><strong>Conclusion: </strong>AI applications in medicine and urology are inevitable. Their integration into the care of the particularly complex and vulnerable geriatric patient requires careful consideration: What information is needed regarding the patient, their illness, therapy, and therapy risks, and how can this information be applied? The question of whether AI is a curse or a blessing can perhaps currently be rephrased as \"opportunities, but also risks.\"</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"950-958"},"PeriodicalIF":0.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621633","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":"[\"Do you still have sex, or do you already play golf?\"-Sex lives in comparison: golfers, physically active and physically inactive middle aged men].","authors":"Victoria A Göldner, Jürgen E Gschwend, Kathleen Herkommer","doi":"10.1007/s00120-026-02910-8","DOIUrl":"https://doi.org/10.1007/s00120-026-02910-8","url":null,"abstract":"<p><strong>Background: </strong>In Germany, the phrase \"Do you still have sex, or do you already play golf?\" ironically reflects the stereotype that golf serves as a substitute for sexual activity in older age and conveys the assumption that sexuality becomes irrelevant in later life.</p><p><strong>Objectives: </strong>The aim of this study was to compare the sex lives of golfers, physically active men, and physically inactive men, focusing on sexual activity, the perceived importance of sexuality, and sexual satisfaction.</p><p><strong>Materials and methods: </strong>The analysis included 50-year-old men participating in the Bavarian Men's Health (BMH) study between April 2020 and March 2025. Standardized questionnaires were used to assess sociodemographic data, lifestyle factors, and parameters of sex life. Participants were categorized into three groups: golfers, physically active (nongolfers), and physically inactive men. Group comparisons regarding sociodemographic, lifestyle, and sexual parameters were conducted using χ² and Fisher's exact tests, as appropriate.</p><p><strong>Results: </strong>Among 8062 men (mean age 50.3 ± 0.58 years), 1.6% identified as golfers, 63.2% as physically active, and 35.2% as inactive. Both golfers and physically active men were significantly more likely to be sexually active compared to inactive men, reported more than one sexual partner within the past year, and indicated higher sexual desire as well as greater importance of sexual life (all p < 0.001). Moreover, they achieved significantly higher International Index of Erectile Function-Erectile Function domain (IIEF-EF) scores and Erection Hardness Scores (EHS; both p < 0.001). No differences were observed regarding sexual satisfaction, masturbation frequency, or the desire to change sexual activity.</p><p><strong>Conclusion: </strong>The findings indicate that playing golf and maintaining an active sexual life are by no means mutually exclusive. On the contrary, golfers demonstrated, on average, higher levels of sexual activity than comparison groups.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798640","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":"[Sustainability in urology: from vision to implementation : Results from a member survey conducted by the German Society of Urology].","authors":"Marlene Thöne, Bernd Wullich, Anna Heinrichs, Carolin Siech, Christian Eggersmann, Mareike Ahlers","doi":"10.1007/s00120-026-02906-4","DOIUrl":"10.1007/s00120-026-02906-4","url":null,"abstract":"<p><p>Healthcare is closely linked to climate change: on the one hand, climate change has negative effects on (urological) health; on the other hand, resource intensive patient care has negative effects on global warming. Currently, there is a lack of data on current status, potential benefits, barriers, and expectations regarding environmental sustainability among urologists practicing in Germany. Thus, a survey was conducted among members of the German Society of Urology (Deutsche Gesellschaft für Urologie e. V., DGU). The 339 participants consider sustainability to be relevant. While sustainable urology is associated with more efficient use of resources, cost reductions, and a stronger contribution to societal responsibility, the main barriers identified are low prioritization in daily practice, lack of clarity regarding ecological effects of individual measures, and insufficient personnel and financial resources. Members of the DGU who took part in the survey consider sustainability to be an important area of action that has seen little practical implementation to date. They call for support from professional associations, industry, politics, and research in terms of education, strategies, prioritization, and financing for sustainable action in urology.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722548","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":"Transformation im Gesundheitswesen – Chancen für die Urologie von morgen.","authors":"Axel Belusa","doi":"10.1007/s00120-026-02871-y","DOIUrl":"https://doi.org/10.1007/s00120-026-02871-y","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":"65 8","pages":"815-820"},"PeriodicalIF":0.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580357","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":"[Health care under pressure: what the primary health care system must provide].","authors":"Ellen Lundershausen","doi":"10.1007/s00120-026-02873-w","DOIUrl":"10.1007/s00120-026-02873-w","url":null,"abstract":"<p><p>Our health care system is under considerable pressure to change. With the planned introduction of a primary care system, the German government is exerting an influence on the central domains of outpatient care. The aims of the primary health care system are improved timely and needs-oriented coordinated care from a single provider, via which patients are systematically supported and accompanied in an increasingly complex health care system. Digital instruments will be important for rationally supporting health care and rendering processes more efficient. Suggestions are required from the fields of politics, self-government, and science regarding how high-quality nationwide care can be sustainably ensured against the background of limited personnel and financial recourses. A national public health strategy with clear structures for collaboration at the federal, state, and municipality levels as well as with other relevant stakeholders in the sense of \"health in all policies\" is needed.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"837-841"},"PeriodicalIF":0.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399529","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":"[Between catheters and artificial intelligence: High-tech urology-where manual skills meet digital expertise].","authors":"Annemarie Uhlig, Igor Tsaur, Konstantin Nikolaou, Johannes Uhlig","doi":"10.1007/s00120-026-02867-8","DOIUrl":"10.1007/s00120-026-02867-8","url":null,"abstract":"<p><p>Artificial intelligence (AI) in urology has evolved from an experimental technology to a relevant component of clinical processes. While early applications in imaging and robotic surgery are already established, decision-support systems, molecular analyses, and applications in practice management are increasingly gaining importance. The clinical benefit lies particularly in the integration of heterogeneous data, the reduction of variability, and the relief of healthcare personnel in an increasingly strained healthcare system. At the same time, substantial challenges remain regarding data quality, validation, transparency, and implementation within existing structures. This article analyzes current applications using concrete examples, evaluates their benefits in the context of real-world healthcare conditions, and discusses strategic perspectives for the sustainable integration of AI into urology.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"828-836"},"PeriodicalIF":0.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309678","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":"[Beyond the bladder-a specialty rediscovering itself: Outpatient. Networked. Digital].","authors":"Theodor Klotz, Bernhard Ralla","doi":"10.1007/s00120-026-02864-x","DOIUrl":"10.1007/s00120-026-02864-x","url":null,"abstract":"<p><strong>Background: </strong>Urology is undergoing a fundamental transformation characterized by increasing outpatient care, digitalization, and cross-sectoral networking.</p><p><strong>Objective: </strong>The aim of this review is to analyze current developments and to show how outpatient surgery, telemedicine structures, artificial intelligence (AI)-based decision support, and networked care models are transforming urological practice.</p><p><strong>Materials and methods: </strong>Narrative review based on current literature and healthcare policy developments in Germany, particularly the introduction of hybrid-diagnosis-related groups (DRG).</p><p><strong>Results: </strong>The introduction of hybrid-DRG from 2024 represents a healthcare policy turning point. Outpatient urological procedures show comparable outcomes to inpatient treatment with higher cost-efficiency when structured pathways are implemented. Telemedicine has been established as an integral tool, with hybrid care models meaningfully complementing personal physician-patient contact. AI systems achieve high diagnostic accuracies in urological imaging and increasingly support clinical decision-making. Patient-reported outcomes are gaining importance for patient-centered care. Central challenges remain balancing digital innovation with reduction of bureaucracy and ensuring data interoperability.</p><p><strong>Conclusion: </strong>Urology is particularly well-positioned for transformation due to its technological affinity, standardizable processes, and established outpatient structures. The presented developments indicate that urology has the potential to become one of the pioneers of modern, hybrid, digitally supported patient care, provided that this transformation is actively shaped.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"821-827"},"PeriodicalIF":0.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309722","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":"[Shaping transformation-incorporating education].","authors":"Nadim Moharam, Anna Heinrichs, Lucie Telemann, Marcus Sondermann, Anna-Sophie Strauß, Markus Murnik","doi":"10.1007/s00120-026-02866-9","DOIUrl":"10.1007/s00120-026-02866-9","url":null,"abstract":"<p><p>The transformation of the German healthcare system is fundamentally changing urological training. Ambulatory care, centralization, and increasing efficiency pressure are shifting learning environments, challenging surgical training, and making cross-sector rotations and reliable quality assurance essential. From the German Society of Residents in Urology (GeSRU) perspective, residency training must be considered an integral part of every structural reform in order to prevent loss of competence and actively shape the future of urology.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"849-854"},"PeriodicalIF":0.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309657","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 chapter on the properties of stones (Minerologica) from the Ephemeris by the Ulm city physician Johannes Franc].","authors":"Vincenzo Damiani, Hans-Joachim Winckelmann","doi":"10.1007/s00120-025-02736-w","DOIUrl":"10.1007/s00120-025-02736-w","url":null,"abstract":"<p><p>The article examines the Mineralogica chapter of the Ephemeris by the Ulm city physician Johannes Franc (1645-1725), in which mineralogical observations, early modern natural philosophy and Franc's practical experience with urinary stones intersect. In his daily practice, Franc treated numerous patients suffering from urolithiasis, employing plant-, animal- and mineral-based remedies, while surgical interventions remained the responsibility of specialised lithotomists. His interest in mineral structures was sparked by the discovery of a naturally occurring stone shaped like an orchid, which reminded him of a finger-shaped urinary stone painfully expelled by his patient Litzelhirn in 1679. This analogy prompted Franc to interpret natural and pathological stone formations in parallel. In his theoretical reflections he draws on Paracelsian models, which assign kidneys and bladder to the influence of Venus (copper), as well as on G.B. de Saint-Romain's descriptions of crystalline structures in antimony regulus. On this basis, he seeks to integrate the formation of secondary concretions of the excretory organs - including kidney stones, bladder stones and other gastroliths - into a cosmological and metallurgical framework. A particular focus lies on bezoars and uroliths. Using excerpts from Robert Boyle's Exercitationes, Franc discusses the actual medical efficacy of these concretions. Boyle reports on stones removed from human bladders, to which - despite their low esteem - a pronounced diuretic and sudorific effect was attributed (urinam et sudores ciere). Franc employs these observations to reflect both on the possible therapeutic relevance of bladder stones and on their supposedly \"planetarily\" influenced structure and formation.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"872-878"},"PeriodicalIF":0.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669994","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":"[Far more than a dress code: more women, new leadership styles : Rethinking leadership in medicine-perspectives of the German Medical Women's Association].","authors":"Barbara Puhahn-Schmeiser, Jana Pannenbäcker","doi":"10.1007/s00120-026-02868-7","DOIUrl":"10.1007/s00120-026-02868-7","url":null,"abstract":"<p><strong>Background: </strong>The transformation of the healthcare system requires fundamental rethinking of medical leadership. Despite rising numbers of female physicians in both education and practice, their presence in leadership roles remains significantly underrepresented.</p><p><strong>Objectives: </strong>This article examines this structural discrepancy from the perspective of the German Medical Women's Association (DÄB). It argues that gender equality is not merely a question of fairness, but a decisive factor for the quality, innovation, and sustainability of medical care.</p><p><strong>Methods: </strong>Analysis of current literature.</p><p><strong>Results: </strong>Diverse leadership teams make more informed decisions, act with greater resilience, and demonstrably contribute to improved outcomes. Traditional role models, nontransparent selection processes, and inadequate structural conditions often prevent female physicians from gaining equal access to leadership positions.</p><p><strong>Conclusion: </strong>Innovative leadership and working models, such as top-level sharing, tandem structures, and part-time leadership, enhance both work-life balance and the attractiveness of medical careers. Mentoring, transparent career development, and the early promotion of leadership skills also contribute. Participation of patients, interprofessionalism, and digital skills are becoming increasingly important. The DÄB sees these developments as an opportunity to redefine leadership-as cooperative, diverse, and forward-looking. This requires structural reforms that systematically support female physicians and involve them in key decision-making processes.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"855-860"},"PeriodicalIF":0.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406114","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}