UrologiePub Date : 2025-05-01Epub Date: 2025-02-28DOI: 10.1007/s00120-025-02552-2
Daniela Roschütz, Jens-Uwe Stolzenburg, Nikolaus von Dercks
{"title":"[Outpatient care in urology-an economic impact assessment].","authors":"Daniela Roschütz, Jens-Uwe Stolzenburg, Nikolaus von Dercks","doi":"10.1007/s00120-025-02552-2","DOIUrl":"10.1007/s00120-025-02552-2","url":null,"abstract":"<p><strong>Background: </strong>The expansion of the AOP (ambulatory operation procedure) catalog according to § 115 b SGB V in the years 2023 and 2024, as well as the introduction of hybrid-DRGs (disease-related groups) according to § 115 f SGB V, poses significant planning challenges for clinics. These regulatory changes are accompanied by significant financial uncertainties for clinics, thus, necessitating careful planning. The need to treat patients in an outpatient setting forces hospitals to adjust their operational processes. The aim of this study is to analyze the impact on revenue in the urology department of a maximum care provider.</p><p><strong>Methods: </strong>Data selection is made from the entire dataset of the urology department from the year 2023, including all procedures from the AOP catalog, applying context verification. From this, three risk groups (RG) are formed: 1) all cases that remain after context verification but still contain other procedures than only AOP procedures, 2) cases that contain only AOP procedures, and 3) a RG of the hybrid-DRG. An analysis of individual epidemiological parameters and a cost simulation were carried out.</p><p><strong>Results: </strong>RG 1, with a share of 28.1% of the total number of cases, shows the greatest risk with 701 cases amounting to € 1,742,819 when treated in an outpatient setting. With 3.8%, RG 2 results in a significantly lower risk on revenue with 91 cases amounting to € 161,479 or € 106,071 after the cost-revenue simulation. RG 3 of the hybrid-DRG represents the lowest revenue risk with 24 cases amounting to € 10,880. The cost simulation shows a negative result for RG 3 accounting to € 18,925.</p><p><strong>Conclusion: </strong>Transferring inpatient operations of urological patients to outpatient treatment is associated with a decline in revenue in urology. RG 2 and 3 show certainly calculable declines in revenue. Hospitals must analyze the loss of revenue and develop solution strategies.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"462-468"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524722","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}
UrologiePub Date : 2025-05-01Epub Date: 2025-03-25DOI: 10.1007/s00120-025-02570-0
Quynh Chi Le, Jens Westphal, Axel Heidenreich, Max Tüllmann
{"title":"[Cross-sectoral urological training].","authors":"Quynh Chi Le, Jens Westphal, Axel Heidenreich, Max Tüllmann","doi":"10.1007/s00120-025-02570-0","DOIUrl":"10.1007/s00120-025-02570-0","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"447-452"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711503","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}
UrologiePub Date : 2025-05-01Epub Date: 2025-04-29DOI: 10.1007/s00120-025-02576-8
Frank Kunath, Axel Heidenreich
{"title":"[The future of urological training: challenges, expectations, and innovations].","authors":"Frank Kunath, Axel Heidenreich","doi":"10.1007/s00120-025-02576-8","DOIUrl":"https://doi.org/10.1007/s00120-025-02576-8","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":"64 5","pages":"415-417"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018964","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}
UrologiePub Date : 2025-05-01DOI: 10.1007/s00120-025-02586-6
{"title":"Mitteilungen der DGU.","authors":"","doi":"10.1007/s00120-025-02586-6","DOIUrl":"https://doi.org/10.1007/s00120-025-02586-6","url":null,"abstract":"","PeriodicalId":29782,"journal":{"name":"Urologie","volume":"64 5","pages":"501-505"},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040086","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}
UrologiePub Date : 2025-04-24DOI: 10.1007/s00120-025-02584-8
Leonhard Buck, Hans Christoph von Knobloch, Jakob Kohler, Fatih Yalcin, Christiane Maria Stuhlmann-Laeisz, Severin Rodler, Jonas Jarczyk, Philipp Nuhn
{"title":"[First diagnosis of renal cell carcinoma via a testicular metastasis].","authors":"Leonhard Buck, Hans Christoph von Knobloch, Jakob Kohler, Fatih Yalcin, Christiane Maria Stuhlmann-Laeisz, Severin Rodler, Jonas Jarczyk, Philipp Nuhn","doi":"10.1007/s00120-025-02584-8","DOIUrl":"https://doi.org/10.1007/s00120-025-02584-8","url":null,"abstract":"<p><p>This case report describes a rare case of testicular metastasis from renal cell carcinoma, which led to first diagnosis of the primary. The patient presented with a progressive painless swelling of the left testicle. After initial suspicion of a testicular tumor, inguinal excision of the testis was performed, which confirmed the presence of a clear cell carcinoma. Further investigations revealed evidence of a primary carcinoma on the left-lower pole of the kidney, which was removed by partial nephrectomy. Histopathologically, clear cell renal cell carcinoma was confirmed. Treatment was supplemented by adjuvant immunotherapy with pembrolizumab. Postoperative follow-up has shown no evidence of recurrence to date.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064853","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}
UrologiePub Date : 2025-04-14DOI: 10.1007/s00120-025-02578-6
Clarissa Wittler, D Engeler, J Rührup
{"title":"[Occlusive azoospermia in unilateral cystic alteration of the seminal vesicle and contralateral seminal vesicle agenesis-case report].","authors":"Clarissa Wittler, D Engeler, J Rührup","doi":"10.1007/s00120-025-02578-6","DOIUrl":"https://doi.org/10.1007/s00120-025-02578-6","url":null,"abstract":"<p><p>A 29-year-old man with primary infertility for 2 years presented for further evaluation. Repeated spermiograms showed azoospermia and an acidic pH. Sonographically, both testes showed normal size and parenchyma, but the vas deferens was bilaterally not palpable. Magnetic resonance imaging showed a cystically dilated left vas deferens and a dilated left seminal vesicle. The right vas deferens could not be visualized. Testicular sperm extraction (TESE) was successful and showed only slight impairment of the spermatogenesis with a Johnson score of 9.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043419","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}
UrologiePub Date : 2025-04-02DOI: 10.1007/s00120-025-02574-w
Susanne Jung, Jonas Heitmann, Martin Pflügler, Gundram Jung, Steffen Rausch, Helmut Salih
{"title":"[Bispecific antibodies in prostate cancer therapy].","authors":"Susanne Jung, Jonas Heitmann, Martin Pflügler, Gundram Jung, Steffen Rausch, Helmut Salih","doi":"10.1007/s00120-025-02574-w","DOIUrl":"https://doi.org/10.1007/s00120-025-02574-w","url":null,"abstract":"<p><p>Prostate cancer (PC) is the second most common cancer in men. As soon as androgen deprivation therapy fails, treatment options are limited. Despite intense efforts, hardly any of the T cell-based immunotherapeutic strategies that have revolutionized oncological treatment in other cancer entities are yet established for the treatment of PC. This includes immune checkpoint inhibition, which generally reinforces T cell-immunity but failed to achieve broad activity in PC, as well as chimeric antigen receptor T (CART) cells and bispecific antibodies (bsAbs), which specifically mobilize T cells against tumor cells. Compared to CART cells, bsAbs have the advantage of being readily available \"off-the-shelf\" reagents. Currently several bispecific constructs are in development for PC. While development of some was discontinued due to substantial side effects or development of anti-drug antibodies, others have yielded promising results. These include in particular bsAbs directed against six-transmembrane epithelial antigen of the prostate 1 (STEAP1) and prostate-specific membrane antigen (PSMA), which are currently being evaluated in both patients with metastasized disease and biochemical relapse. The concepts underlying the different constructs, the current status of clinical development, and future perspectives are discussed.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765291","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}