Urologie最新文献

{"title":"[Prevention instead of remediation-screening, lifestyle factors, and prostate care 2.0-transition of urology to healthcare coach : Holistic approach to prostate health].","authors":"Fabian Falkenbach, Rouvier Al-Monajjed, Philipp Reimold, Johannes Huber, Sigrid V Carlsson","doi":"10.1007/s00120-026-02865-w","DOIUrl":"10.1007/s00120-026-02865-w","url":null,"abstract":"<p><strong>Background: </strong>Establishment of an organized, risk-adapted prostate cancer screening program in Germany could serve as a key entry point for preventive men's health.</p><p><strong>Objectives: </strong>How can the introduction of an organized, risk-adapted prostate cancer screening program in Germany shape preventive urology of the future?</p><p><strong>Materials and methods: </strong>This narrative review article is based on guidelines and expert consensus supported by a literature search in PubMed. The cited studies represent the most relevant work on this topic and were selected to illustrate developments and fundamental concepts; however, completeness is not claimed.</p><p><strong>Results: </strong>Serum prostate-specific antigen (PSA) levels and prostate MRI not only identify patients at increased risk for prostate cancer but also offer insights into other urological conditions, such as lower urinary tract symptoms and hypogonadism. In analogy to other early detection strategies, PSA testing at the age of 45-50 years could serve as a simple triage test to guide risk-adapted follow-up and timely referral to urological care. Lifestyle factors-including regular physical activity, a balanced diet, and pelvic floor training-may favorably influence urological health and related outcomes. While organized prostate cancer screening has already been shown to improve cancer-specific mortality to a level comparable to mammography, a more holistic approach may further enhance its overall benefit.</p><p><strong>Conclusion: </strong>Urology has significant opportunities to actively promote healthy behaviors among aging men. The establishment of an organized prostate cancer screening program provides an ideal entry point for this purpose. Modern screening concepts should incorporate holistic health promotion for aging men alongside direct oncological endpoints.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"842-848"},"PeriodicalIF":0.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340464","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":"[Environmental sustainability in urology].","authors":"Bernd Wullich, Holger Borchers, Christian Eggersmann, Maximilian Burger, Marlene Thöne","doi":"10.1007/s00120-025-02720-4","DOIUrl":"10.1007/s00120-025-02720-4","url":null,"abstract":"<p><p>Environmental sustainability has become increasingly important in recent years, not only in social discourse but also in the healthcare sector. The healthcare sector in Germany contributes significantly to total CO₂ emissions, accounting for over 5%, and consumes roughly the same amount of resources. Areas that are particularly relevant to urology, such as pharmaceuticals, medical devices, and instrument logistics, are among the most intensive consumers of resources, alongside construction measures, the operation of clinics and practices, and food supply. In light of this, the German Society of Urology (DGU) has recognized the urgency of the situation and developed a sustainability strategy that includes all sectors of the field and aims to provide concrete perspectives for the responsible use of existing resources.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"868-871"},"PeriodicalIF":0.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410416","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":"[Antibiotic stewardship in urology : Time to rethink?]","authors":"Fabian P Stangl, Giuseppe Magistro","doi":"10.1007/s00120-026-02876-7","DOIUrl":"10.1007/s00120-026-02876-7","url":null,"abstract":"<p><p>Urological infections are among the most frequent bacterial diseases and result in a correspondingly high consumption of antibiotics with the associated known increased risk for the development of multidrug-resistant pathogens. For this reason, the measures summarized under the term antibiotic stewardship (ABS) are becoming increasingly more important for a rational use of antibiotics, which are explicitly underlined in the current European and German guidelines on urological infections. Despite these clear guideline recommendations the use of antibiotics in the urological practice is often suboptimal, especially in the treatment of asymptomatic bacteriuria and the excessive use of fluoroquinolones. In this article the principles of ABS are illustrated based on the current guidelines, frequent false applications are described and practical recommendations are given for urologists when dealing with antibiotics in cases of urinary tract infections and urological interventions.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"883-890"},"PeriodicalIF":0.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362377","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":"[Urological training and job appeal for Generation Z-a rapid review].","authors":"Stefanie Cermak, Andreas Wencker, Lujza Brunaiova, Lukas Koneval, Beat Roth, Laila Schneidewind","doi":"10.1007/s00120-025-02742-y","DOIUrl":"10.1007/s00120-025-02742-y","url":null,"abstract":"<p><strong>Background: </strong>It is well known that Generation Z has different needs and expectations with regard to the world of work to previous generations.</p><p><strong>Objective: </strong>A rapid evidence analysis addressing Generation Z in medical education was conducted. The primary objective was to describe the characteristics of this generation in the context of medical education and the labor market.</p><p><strong>Materials and methods: </strong>The literature search was conducted in MEDLINE via PubMed for the period from January 2000 to the date of the last search (August 7, 2025). Only original articles and systematic reviews were used for the evidence synthesis.</p><p><strong>Results: </strong>The primary literature search yielded 1188 hits, but ultimately, only three studies could be included, two of which were surveys and one a systematic review. Generation Z attaches great importance to job satisfaction and wants long-term prospects. They are willing to work with a high degree of ethics for the benefit of others, while at the same time being prepared to take on challenges. They have a strong sense of responsibility and commitment to long-term goals. They have an essential desire for feedback and immediate response or proactive communication from supervisors. Digital solutions for learning, work, and communication are preferred.</p><p><strong>Conclusion: </strong>A secure working environment with long-term and sustainable prospects must be created for Generation Z. The integration of modern technologies into everyday working life is of enormous importance. Unfortunately, the current evidence base is limited, particularly in urology.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"861-867"},"PeriodicalIF":0.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709582","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":"[Androgen deprivation with definitive radiotherapy for localized prostate cancer: what is the optimal treatment duration?]","authors":"Henning Plage, Fabian Stangl","doi":"10.1007/s00120-026-02869-6","DOIUrl":"10.1007/s00120-026-02869-6","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"879-882"},"PeriodicalIF":0.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259832","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":"[Diagnosis and treatment of upper tract urothelial carcinoma: assessment of guideline compliance from 2011-2024].","authors":"Felix Pütz, Wiebke Müller, Axel Heidenreich, Pia Paffenholz","doi":"10.1007/s00120-026-02878-5","DOIUrl":"https://doi.org/10.1007/s00120-026-02878-5","url":null,"abstract":"<p><strong>Background: </strong>Upper tract urothelial carcinoma (UTUC) requires a complex, multimodal, and guideline-based therapeutic approach. However, due to the rarity of the disease, low case numbers, and diagnostic challenges, implementation of the annually updated European Association of Urology (EAU) guidelines in daily clinical practice is often difficult. The aim of this study was to evaluate guideline-compliant care and the influence of guideline-deviating treatment decisions on oncological outcomes.</p><p><strong>Materials and methods: </strong>In a retrospective analysis, 181 patients with UTUC who were treated at our clinic between 2011 and 2024 were examined. Diagnosis, therapy, and oncological outcome were evaluated based on the applicable EAU guidelines, and treatment courses were analyzed in relation to guideline adherence.</p><p><strong>Results: </strong>In all, 13% of patients received nonguideline-compliant diagnosis or therapy. The main causes were lack of bladder cuff resection (52%), lack of adjuvant chemotherapy (32%, 2020-2024), lack of interdisciplinary tumor board discussion (17%), and surgical undertreatment (5%). The lack of bladder cuff resection was associated with a significantly reduced overall survival (p = 0.047) and an increased recurrence rate (p = 0.038). In addition, there were repeated deviations in the comprehensive diagnostics for the correct classification of low-risk and high-risk patients.</p><p><strong>Conclusion: </strong>Despite clear recommendations from the EAU, their implementation in everyday clinical practice remains challenging. However, guideline-based care is essential, as deviations are associated with significantly poorer oncological outcomes.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550725","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":"Erratum zu: Androgendeprivation bei definitiver Radiotherapie des lokalisierten Prostatakarzinoms: Was ist die optimale Therapiedauer?","authors":"Henning Plage, Fabian Stangl","doi":"10.1007/s00120-026-02897-2","DOIUrl":"10.1007/s00120-026-02897-2","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473119","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":"[Perioperative and peri-interventional antibiotic prophylaxis: general and urology-specific recommendations from the German Interdisciplinary S3 guideline].","authors":"Katharina Hauner, Jennifer Kranz, Florian Wagenlehner, Sonja Hansen, Gernot Bonkat, Giuseppe Magistro, Matthias May","doi":"10.1007/s00120-026-02877-6","DOIUrl":"https://doi.org/10.1007/s00120-026-02877-6","url":null,"abstract":"<p><strong>Background: </strong>Perioperative and peri-interventional antibiotic prophylaxis (PAP) is a central instrument for the prevention of infectious complications, yet it has to consider concerns of individual and general patient safety, antibiotic stewardship, and antibiotic resistance dynamics. The interdisciplinary AWMF (Arbeitsgemeinschaft Medizinisch-Wissenschaftlicher Fachgesellschaften) S3 guideline finalized in 2024 (AWMF S3, 2024) provides a comprehensive, evidence-based framework for indication, substance selection, dosing, timing, and quality assurance of PAP across all surgical disciplines, with a dedicated chapter for preselected urological procedures.</p><p><strong>Methods: </strong>The guideline was developed in accordance with the AWMF standards, employing systematic literature searches with GRADE evaluation, operationalizing recommendations, statements, and expert consensus, and anchoring implementation in structure-, process-, and outcome-oriented quality indicators. Urological procedures were defined using the PICOS framework and furnished with evidence-based recommendations. In addition, the recommendations are compared with those of the 2025 EAU Guideline on Urological Infections.</p><p><strong>Results: </strong>General key statements are precise indication for antibiotic use, intravenous administration 30-60 min before incision, single-dose application for the majority of interventions, redosing only in case of extended operating time or major blood loss, and termination of PAP at the end of surgery. For urology, the following apply: for transrectal prostate biopsy, PAP shall be administered, ideally targeted according to rectal swab findings. For transperineal biopsy, PAP may be omitted if urinary tract infection has been excluded and adequate skin antisepsis ensured; in high-risk patients, PAP should be administered. For elective transurethral resection of the prostate (TURP), PAP is mandatory, whereas for transurethral resection of the bladder (TURB), prophylaxis is recommended only in patients at increased risk. For radical cystectomy, PAP shall be administered in all cases. For extracorporeal shock wave lithotripsy (ESWL), routine prophylaxis should not be used, although it may be considered in high-risk situations. For minimally invasive tumor ablations and interventional radiological procedures such as prostatic artery embolization (PAE) routine prophylaxis is not indicated, although selective use may be justified in patients at risk.</p><p><strong>Conclusion: </strong>The 2024 AWMF S3 guideline on PAP provides a robust foundation for interventional and operative urology, uniting infection prevention and antibiotic stewardship. It enables risk-adapted reduction of unnecessary antibiotic use without compromising safety and shows broad consistency with the EAU recommendations on prophylaxis in urological procedures.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413080","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":"Deeskalierende Therapiestrategien in der Urologie.","authors":"Axel Heidenreich, Steffen Krause","doi":"10.1007/s00120-026-02849-w","DOIUrl":"https://doi.org/10.1007/s00120-026-02849-w","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":"65 7","pages":"707-709"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340589","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":"[Clinical and practical aspects of multidrug-resistant pathogens].","authors":"Fabian P Stangl, Jennifer Kranz","doi":"10.1007/s00120-026-02838-z","DOIUrl":"10.1007/s00120-026-02838-z","url":null,"abstract":"<p><p>Multidrug-resistant pathogens are the result of cumulative risk constellations and inappropriate antibiotic use. Multidrug-resistant Gram-negative bacteria are of particular relevance, especially in patients with prior antibiotic therapy, recurrent hospitalization, urinary drainage devices or a high density of invasive procedures. A central element of clinical management is the strict distinction between asymptomatic bacteriuria and clinically manifested urinary tract infections. Antimicrobial therapy is justified exclusively in the presence of a clinically manifested infection and, even in the context of multidrug resistance, must primarily be guided by the severity of the disease and the infection focus. In urology, the diagnostic work-up of multidrug-resistant pathogens primarily serves the risk stratification and treatment planning. Therapeutically, the principle of an initial empirical approach followed by targeted adjustment and de-escalation also applies to infections caused by multidrug-resistant organisms. In the perioperative setting, a known colonization with multidrug-resistant pathogens requires a differentiated, guideline-based risk assessment.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"775-783"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965011","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}