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/s00120-025-02579-5
Viktoria Menzel, Livia Kontschak, Marcus Sondermann, Markus Grabbert, Angelika Borkowetz, Sherif Mehralivand, Nicole Eisenmenger, Johannes Huber, Christian Thomas, Daniela Schultz-Lampel, Martin Baunacke
{"title":"[Urodynamics in Germany: Indications and Application in Urological Hospital and Practice Settings].","authors":"Viktoria Menzel, Livia Kontschak, Marcus Sondermann, Markus Grabbert, Angelika Borkowetz, Sherif Mehralivand, Nicole Eisenmenger, Johannes Huber, Christian Thomas, Daniela Schultz-Lampel, Martin Baunacke","doi":"10.1007/s00120-025-02579-5","DOIUrl":"https://doi.org/10.1007/s00120-025-02579-5","url":null,"abstract":"<p><strong>Background: </strong>Urodynamic studies (UDS) are an established diagnostic tool in urology. However, international studies, including those from Germany, indicate a decline in their use. This trend may be attributed to guideline adjustments and changes in indications.</p><p><strong>Objective: </strong>The study aims to analyse the current practice and distribution of indications for UDS in urological clinics and practices in Germany.</p><p><strong>Materials and methods: </strong>Between March 2023 and October 2023, 259 urological clinics and a representative sample of 280 outpatient urologists nationwide were surveyed about their UDS procedures. Data on methods, personnel and indications were collected.</p><p><strong>Results: </strong>In all, 80% of clinics and 44% of practices participated. 58% of clinics performed fewer than 100 UDS annually. Only 15% of practices performed UDS themselves. Common procedures such as uroflowmetry (99%) and cystometry (98%) are widely implemented, whereas video urodynamics (53%) are less frequent. The most common indications in clinics are neurogenic bladder dysfunction (24%), overactive bladder (21%) and female stress incontinence (19%). Practices showed similar trends, with neurogenic bladder dysfunction (30%) and overactive bladder (26%) as primary indications. University hospitals and specialized centres performed UDS more often for complex conditions, while non-university clinics frequently addressed stress incontinence.</p><p><strong>Conclusion: </strong>Despite declining numbers, UDS remain central to urological diagnostics. Indication patterns vary by clinic type. These results provide insights into the application of UDS in Germany and underline its important role in urological diagnostics.</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":"144013816","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 : 2025-04-04DOI: 10.1007/s00120-025-02573-x
Stephan Degener, Nici Markus Dreger, Friedrich-Carl von Rundstedt, Marie-Therese Schmitz, Ulrich Grabenhorst, Oliver Schmalz, Klaus Weckbecker, Johannes Just
{"title":"[Specialized ambulatory palliative care for urological tumors].","authors":"Stephan Degener, Nici Markus Dreger, Friedrich-Carl von Rundstedt, Marie-Therese Schmitz, Ulrich Grabenhorst, Oliver Schmalz, Klaus Weckbecker, Johannes Just","doi":"10.1007/s00120-025-02573-x","DOIUrl":"https://doi.org/10.1007/s00120-025-02573-x","url":null,"abstract":"<p><strong>Background: </strong>Urologic tumors comprise about 20% of cancer diagnoses in Germany. To date, there are no studies with large datasets on the palliative situation of patients with urological tumors in the home environment, although dignified end-of-life care in the home environment is the wish of most cancer patients.</p><p><strong>Methods: </strong>Data from 5125 patients who received specialized outpatient palliative care (SAPV) with an underlying urological cancer between 2017 and 2021 were included in the analysis.</p><p><strong>Result: </strong>The analysis showed that 91.5% of patients died at home and the symptom burden remained stable or decreased slightly during treatment. The median survival time of patients receiving SAPV was 24 days. Factors such as age, performance status, loss of appetite, weakness, and pain at the start of treatment influenced the survival time of the patients. Relatives were largely very satisfied with the care provided.</p><p><strong>Conclusion: </strong>The study provides important insights into the palliative care of patients with urological tumors and underlines the importance of SAPV for dignified end-of-life care.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781519","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}
UrologiePub Date : 2025-04-01Epub Date: 2025-02-11DOI: 10.1007/s00120-025-02535-3
Michael Lindemann, Thorsten Ebermann
{"title":"[Sources of error in criminal proceedings against physicians].","authors":"Michael Lindemann, Thorsten Ebermann","doi":"10.1007/s00120-025-02535-3","DOIUrl":"10.1007/s00120-025-02535-3","url":null,"abstract":"<p><p>The Article highlights possible sources of error in criminal proceedings against physicians and shows approaches to a holistic defense. Behavior during a search and seizure is a particularly important practical area of criminal proceedings; in addition, advice is given with regard to statements of the accused and subordinate (practice) personnel in the presence of prosecuting authorities. In view of the decisive importance that is often attached to the medical expert opinion in criminal proceedings against physicians, the influence on the selection of the expert and the formulation of the expert opinion order is discussed as an essential task of the defense. Finally, defense strategies for the (rather rare) case of a main hearing are discussed as well as opportunities and risks of various forms of case resolution.</p>","PeriodicalId":29782,"journal":{"name":"Urologie","volume":" ","pages":"327-334"},"PeriodicalIF":0.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400296","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}