Urologie最新文献_第8页

[Clinical and practical aspects of multidrug-resistant pathogens]. [耐多药病原体的临床和实际方面]。

IF 0.4 4区医学

Urologie Pub Date : 2026-07-01 Epub Date: 2026-05-18 DOI: 10.1007/s00120-026-02838-z

Fabian P Stangl, Jennifer Kranz

引用次数: 0

[Reassessing androgen deprivation therapy (ADT) in older men with advanced prostate cancer: when to use, when to discontinue, and role as monotherapy?] [重新评估老年男性晚期前列腺癌的雄激素剥夺疗法（ADT）：何时使用，何时停止，以及作为单一疗法的作用？]］

IF 0.4 4区医学

Urologie Pub Date : 2026-07-01 Epub Date: 2026-05-19 DOI: 10.1007/s00120-026-02842-3

Martina Heller, Stefanie Zschäbitz

{"title":"[Reassessing androgen deprivation therapy (ADT) in older men with advanced prostate cancer: when to use, when to discontinue, and role as monotherapy?]","authors":"Martina Heller, Stefanie Zschäbitz","doi":"10.1007/s00120-026-02842-3","DOIUrl":"10.1007/s00120-026-02842-3","url":null,"abstract":"Background: Androgen deprivation therapy (ADT) remains the standard of care for the treatment of advanced and metastatic prostate cancer (PC). However, in older patients, the choice of treatment must be made carefully, as they often have comorbidities and are at risk of potential side effects. Newer hormonal therapies (androgen receptor pathway inhibitors, ARPIs) have expanded the treatment spectrum, raising questions about optimal therapy for older patients.Objective: This article provides an overview of the evidence-based use of ADT and ARPI in older patients, with a particular focus on relevant guideline recommendations and study results across different stages of prostate cancer. It also describes how individualized treatment decisions can be made in clinical practice.Materials and methods: Selective literature review on ADT and ARPI in older patients. Data from relevant clinical trials, current evidence, and recommendations from international and national guidelines (e.g., EAU, S3) are considered.Results: For metastatic hormone-sensitive prostate cancer (mHSPC), the combination of ADT and ARPI has proven beneficial, particularly for patients with a life expectancy of more than 1 year and a good performance status. Network meta-analyses show that dual- and triple-agent therapies improve overall survival in older patients, while side effects increase.Conclusion: The use of ADT + ARPI improves survival rates but requires a nuanced assessment of side effects and quality of life, particularly in very old patients. Geriatric assessment helps classify patients into different risk groups and plays a central role in treatment decisions.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"737-744"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975971","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

[Uncomplicated urinary tract infections: antibiotic-sparing approaches]. [无并发症尿路感染：免抗生素方法]。

IF 0.4 4区医学

Urologie Pub Date : 2026-07-01 Epub Date: 2026-05-04 DOI: 10.1007/s00120-026-02836-1

Sebastian Graf

引用次数: 0

[Oligometastatic hormone-sensitive prostate cancer: when can less be more?] 少转移性激素敏感性前列腺癌：何时能少即是多？］

IF 0.4 4区医学

Urologie Pub Date : 2026-07-01 Epub Date: 2026-05-18 DOI: 10.1007/s00120-026-02841-4

Richard Cathomas

{"title":"[Oligometastatic hormone-sensitive prostate cancer: when can less be more?]","authors":"Richard Cathomas","doi":"10.1007/s00120-026-02841-4","DOIUrl":"10.1007/s00120-026-02841-4","url":null,"abstract":"With the use of modern imaging technology such as prostate-specific membrane antigen positron emission tomography-computed tomography (PSMA PET-CT), compared to conventional imaging with CT and bone scan, in the primary staging of localized prostate cancer and in the setting of PSA failure after local therapy, an increasing number of men are being diagnosed with metastatic prostate cancer with a low tumor burden. At the same time, the combination of androgen deprivation therapy (ADT) with androgen receptor pathway inhibitors (ARPI) has significantly improved the response rate and prognosis in metastatic hormone-sensitive prostate cancer. As a result, interest has in recent years grown in optimizing treatment for patients with low tumor burden by reducing treatment intensity. Strategies under evaluation include metastasis-directed therapy (MDT), intermittent systemic therapy and combinations of both. To date, no randomized phase 3 trials have demonstrated a benefit of either MDT alone or in combination to standard treatment, nor of intermittent strategies in oligometastatic prostate cancer. Nevertheless, experts consider the use of MDT as well as intermittent treatment with ADT + ARPI to be justified in selected cases. For clinical practice, it is important that treatment decisions adhere to the definition of oligometastatic disease (maximum of 5 metastases in bone or lymph nodes on PSMA PET-CT) and take into account the biology of the disease (synchronous vs. metachronous). The concepts of MDT and intermittent systemic therapy appear promising and patient participation in ongoing clinical trials is crucial.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"728-736"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975990","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

[Stereotactic body radiotherapy without systematic therapy for oligometastatic cancer]. [少转移性肿瘤的立体定向全身放射治疗]。

IF 0.4 4区医学

Urologie Pub Date : 2026-07-01 Epub Date: 2026-05-27 DOI: 10.1007/s00120-026-02851-2

Barbara Nübel, Laura Bellut

引用次数: 0

[Validation of a new portable measurement method for home use-a feasibility study]. [一种新的家用便携式测量方法的验证-可行性研究]。

IF 0.4 4区医学

Urologie Pub Date : 2026-07-01 Epub Date: 2026-05-27 DOI: 10.1007/s00120-026-02855-y

Ulrike Wirth, Sigrun Holze, Christian Wagner, Alena Bonaventura, Stefan Siemer

{"title":"[Validation of a new portable measurement method for home use-a feasibility study].","authors":"Ulrike Wirth, Sigrun Holze, Christian Wagner, Alena Bonaventura, Stefan Siemer","doi":"10.1007/s00120-026-02855-y","DOIUrl":"10.1007/s00120-026-02855-y","url":null,"abstract":"Background: Lower urinary tract symptoms (LUTS), kidney, and bladder diseases are among the most common diseases in men. Despite numerous educational measures, men do not participate in preventive medical checkups or early detection measures. The current study aims to examine whether men can also carry out early detection measures in their home environment. Since men are particularly receptive to digital media, a digital measuring device for home use (the Streamcheck®, SC; Vierkirchen, Germany) was developed that includes important diagnostic measures such as uroflow, biomarkers, and standard questionnaires.Objective: The aim of the study was to evaluate SC in a clinical trial under home conditions.Materials and methods: A total of 92 men between the ages of 23 and 89 were included and examined with the SC. The urine flow curve, urine volume, micturition time, and biomarkers were recorded. Patient satisfaction was assessed using questionnaires.Results: The findings of 73 patients were evaluated. A urine flow curve was obtained for all men with comparable urine volumes (mean: SC = 360 ml, control = 364 ml) and micturition time (maximum difference 4.8%; n. s.). The biomarkers were detected with 100% sensitivity and >95% specificity. The men were very satisfied with the SC, with an average score of 4.04 points (1 = dissatisfied, 5 = very satisfied).Conclusion: The SC has been confirmed as a reliable measurement method for home use with high patient satisfaction. The extent to which the results influence patient behavior with regard to consulting a physician will be investigated in a subsequent study.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"756-762"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035945","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}

引用次数: 0

["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]. [“泌尿外科控制2026-掌握门诊护理的转变，确保质量，优化收入”：海德堡dgu医疗保健研究，质量和经济工作组研讨会]。

IF 0.4 4区医学

Urologie Pub Date : 2026-07-01 Epub Date: 2026-04-24 DOI: 10.1007/s00120-026-02833-4

Philipp Reimold, Johannes Huber, Christer Groeben

引用次数: 0

[Reducing overdiagnosis-how to do I correctly assess the indication for prostate biopsy?] 减少过度诊断——如何正确评估前列腺活检的适应症？］

IF 0.4 4区医学

Urologie Pub Date : 2026-07-01 Epub Date: 2026-05-07 DOI: 10.1007/s00120-026-02840-5

Felix Seelemeyer, Rouvier Al-Monajjed, Muammar Dib, Jale Lakes, Isabelle Busshoff, Analena Handke, Matthias Boschheidgen, Gerald Antoch, Peter Albers, Jan Philipp Radtke, Lars Schimmöller

{"title":"[Reducing overdiagnosis-how to do I correctly assess the indication for prostate biopsy?]","authors":"Felix Seelemeyer, Rouvier Al-Monajjed, Muammar Dib, Jale Lakes, Isabelle Busshoff, Analena Handke, Matthias Boschheidgen, Gerald Antoch, Peter Albers, Jan Philipp Radtke, Lars Schimmöller","doi":"10.1007/s00120-026-02840-5","DOIUrl":"10.1007/s00120-026-02840-5","url":null,"abstract":"The indication for prostate biopsy represents the key interface between prostate-specific antigen (PSA)-based early detection and primary diagnostic evaluation in patients with suspected prostate cancer. The aim is to reduce overdiagnosis while ensuring detection of clinically significant prostate cancer (csPCa; International Society of Urological Pathology [ISUP] grade ≥ 2). PSA remains the most important initial test but is limited by low specificity; digital rectal examination provides no relevant additional value. In cases of clinical suspicion, diagnostic work-up includes multiparametric magnetic resonance imaging (MRI) for risk stratification and reduction of unnecessary biopsies. Diagnostic performance depends on image quality and reader expertise. Biparametric MRI may be an alternative under appropriate conditions but does not match the full diagnostic scope of mpMRI. In the presence of suspicious MRI findings, the combination of targeted and systematic biopsy remains the reference standard, with higher detection rates for csPCa but also increased detection of clinically insignificant tumors. Alternative approaches such as perilesional sampling are under investigation. PSA density, serum biomarkers (e.g., 4KScore, Stockholm-3), and risk calculators may further improve prebiopsy selection. This review provides an evidence-based overview and outlines a guideline-conform, risk-adapted diagnostic pathway for biopsy indication.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"719-725"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843623","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

[Management of recurrent urolithiasis: indications for therapy escalation and discontinuation]. [复发性尿石症的处理：治疗升级和停药的适应症]。

IF 0.4 4区医学

Urologie Pub Date : 2026-07-01 Epub Date: 2026-05-19 DOI: 10.1007/s00120-026-02843-2

Roman Herout, Andreas Neisius

{"title":"[Management of recurrent urolithiasis: indications for therapy escalation and discontinuation].","authors":"Roman Herout, Andreas Neisius","doi":"10.1007/s00120-026-02843-2","DOIUrl":"10.1007/s00120-026-02843-2","url":null,"abstract":"Urolithiasis is a common condition characterized by a high recurrence rate and substantial clinical and economic impact. Stone formers are stratified into low- and high-risk groups based on stone analysis and basic diagnostic evaluation. Following a stone event (spontaneous passage or interventional treatment), all patients should receive general preventive measures, including increased fluid intake, dietary modification, and lifestyle changes. High-risk patients should additionally undergo extended metabolic evaluation (24 h urine analysis) and, if indicated, targeted pharmacological therapy. Therapeutic escalation is warranted in cases of recurrent stone formation, persistent metabolic abnormalities in 24 h urine, or high-risk stone types (e.g., brushite, cystine). The primary aim is correction of pathological urinary parameters by reducing lithogenic factors (calcium, oxalate, uric acid) and increasing inhibitors of stone formation (citrate, magnesium). Pharmacological treatment mainly includes alkaline citrates, thiazides, and xanthine oxidase inhibitors, initiated at low doses and adjusted according to urinary and, if necessary, serum parameters. Therapy de-escalation or discontinuation may be considered in patients with sustained stone-free status and stable metabolic findings, considering age, recurrence dynamics, and comorbidities (particularly hypertension, diabetes, and obesity). Individualized management in interdisciplinary collaboration with nephrology, primary care, and nutritional medicine is essential, as urolithiasis should be regarded as a complex metabolic disorder. Patient adherence remains a key determinant of long-term therapeutic success.","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"749-755"},"PeriodicalIF":0.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975993","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

[Process optimization in hospitals via agility]. [通过敏捷性优化医院流程]。

IF 0.4 4区医学

Urologie Pub Date : 2026-07-01 Epub Date: 2026-06-11 DOI: 10.1007/s00120-026-02856-x

Frederik Meilwes

引用次数: 0