{"title":"[Male Incontinence - An Overview and its Relationship to Benign Prostatic Enlargement].","authors":"Benedikt Kranzbühler","doi":"10.1024/0040-5930/a001426","DOIUrl":"https://doi.org/10.1024/0040-5930/a001426","url":null,"abstract":"<p><p>Male Incontinence - An Overview and its Relationship to Benign Prostatic Enlargement <b>Abstract:</b> Male urinary incontinence is a common disease in elderly men and can lead to a significantly reduced quality of life. Reported prevalence of urinary incontinence increases up to 32% in men over 85 years. Risk factors for urinary incontinence are prostate surgery, advanced age, immobility, urinary tract infections, diabetes mellitus, cognitive disorders, and neurological disease. Urinary incontinence is divided into three subtypes: stress urinary incontinence, urge urinary incontinence, and mixed urinary incontinence. Benign prostatic obstruction can lead to a detrusor overactivity and a further urge incontinence. However, iatrogenic injury or a preexisting weakness of the external urinary sphincter are more common and can lead to stress urinary incontinence in men following prostate surgery. A correct treatment can significantly improve symptoms in men suffering from urinary incontinence. Though, every treatment plan must be tailored to the individual patient.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 3","pages":"133-139"},"PeriodicalIF":0.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9343145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Robot-assisted Simple Prostatectomy (RASP)].","authors":"Orlando Burkhardt, Christian Padevit, Hubert John","doi":"10.1024/0040-5930/a001429","DOIUrl":"https://doi.org/10.1024/0040-5930/a001429","url":null,"abstract":"<p><p>Robot-assisted Simple Prostatectomy (RASP) <b>Abstract:</b> Surgical treatment of large adenomas of the prostate (> 80g) in men suffering from symptomatic prostate hyperplasia is challenging. Transurethral resection of the prostate (TUR-P), known as the operative gold standard, is not a safe option in large adenomas due to prolonged resection time and the consecutive increased complication rate. For decades, large adenomas were surgically treated by open enucleation. Although the procedure has still its role in surgical treatment of large glands, the perioperative morbidity and complications can be severe. In view of this fact, several new and minimal invasive techniques such as transurethral procedures, mainly using laser technologies (Holmiun-Laser Enucleation, HoLEP and KTP-Laser vaporization, Greenlight™ Laser), have been invented. In addition, the traditional open enucleation of the prostate was performed and evaluated by using conventional laparoscopy and finally by robot-assisted laparoscopy. Meanwhile robot-assisted simple prostatectomy (RASP) and especially its modification with an extraperitoneal extravesical access and intraprostatic reconstruction of the prostatic urethra in order to exclude the prostatic wound bed from the urinary tract with consecutive lower perioperative complication rates are well established procedures to treat large adenomas.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 3","pages":"158-164"},"PeriodicalIF":0.2,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9343147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Reactive arthritis].","authors":"Mihaela Stegert","doi":"10.1024/0040-5930/a001404","DOIUrl":"https://doi.org/10.1024/0040-5930/a001404","url":null,"abstract":"<p><p>Reactive arthritis <b>Abstract.</b> Reactive Arthritis is a sterile, inflammatory arthritis that is typically preceded by a bacterial gastrointestinal or urogenital infection occurring one to four weeks previously. The typical pattern is an asymmetric oligoarthritis most common affecting the lower extremities. Similar to other spondyloarthropathies, enthesitis, dactylitis, and sacroiliitis can occur as well as extra-articular manifestations, such as conjunctivitis, anterior uveitis, oral ulcers, circinate balanitis, and keratoderma blennorrhagicum. The treatment of \"triggering\" infection with antibiotics is the first therapeutic goal, especially for Chlamydia trachomatis. For arthritis NSAIDs are the treatment of first choice, followed by intraarticular or oral glucocorticosteroids. DMARDs (Sulfasalzine, TNF-alpha inhibitors) are reserved for refractory cases. Over 50% of the patients have a self-limited course lasting two to six months, 30% have recurrent episodes, and 10-20% have a chronic course requiring immunosuppressive therapy.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 1","pages":"34-38"},"PeriodicalIF":0.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9398162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Osteoarthritis - Therapy and Management].","authors":"Philipp Rossbach","doi":"10.1024/0040-5930/a001401","DOIUrl":"https://doi.org/10.1024/0040-5930/a001401","url":null,"abstract":"<p><p>Osteoarthritis - Therapy and Management <b>Abstract.</b> Osteoarthritis as the most prevalent degenerative joint disorder is a leading cause of disability and source of substantial societal cost in older adults. With the ageing and increasingly obese population, this disorder and its associated problems become much more prevalent than in previous decades. It is a problem that every general practitioner and rheumatologist will encounter in daily practice. The current therapeutic guidelines provide a good overview over the existing treatment modalities. Special focus should be placed on core treatments, including self-management and education, exercise, and weight loss as relevant. But it's important that management is tailored to the presenting individual. Besides the existing routine medications there have been many trials in the last years that showed a negative outcome. Nevertheless, there are potential candidates on the horizon that could fill the existing gap as a \"Disease modifying Osteoarthritis Drug\".</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 1","pages":"11-15"},"PeriodicalIF":0.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9398160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Rheumatoid Arthritis].","authors":"Julia Lehmann, Diego Kyburz","doi":"10.1024/0040-5930/a001403","DOIUrl":"https://doi.org/10.1024/0040-5930/a001403","url":null,"abstract":"<p><p>Rheumatoid Arthritis <b>Abstract.</b> Rheumatoid Arthritis (RA) is the most frequent chronic inflammatory joint disease with a prevalence of approximately 1% worldwide. The pathogenesis is a complex interplay of genetic, epigenetic, and environmental factors, which are still incompletely understood. The disease is characterized by a polyarticular synovitis with symmetrical involvement of small and large joints. The majority of patients has detectable autoantibodies in the serum, rheumatoid factor and anti-CCP antibodies which are specific for RA. The uncontrolled chronic joint inflammation results in destructive changes of joint cartilage and bone. An early diagnosis and initiation of treatment is therefore of central importance. Disease-modifying anti-rheumatic drugs (DMARD) are able to inhibit joint destruction and should be started as soon as possible. Therapy should be targeted to reach a state of remission. The introduction of highly effective biologic and targeted synthetic DMARD has allowed to reach this goal of therapy in many patients and to prevent disability. However, risks of medication need to be considered, as well as comorbidities.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 1","pages":"27-33"},"PeriodicalIF":0.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9398164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Periarthropathies].","authors":"Peter Voss","doi":"10.1024/0040-5930/a001400","DOIUrl":"https://doi.org/10.1024/0040-5930/a001400","url":null,"abstract":"<p><p>Periarthropathies <b>Abstract.</b> The term \"periarthropathy\" stands for various pathologies \"around\" the joint and its structures, without a clear and generally accepted definition. This article tries to outline this theme and offers some examples in the section \"ausgewählte Krankheitsbilder\".</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 1","pages":"3-9"},"PeriodicalIF":0.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9398163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Update Gout].","authors":"Barbara Ankli, Thomas Daikeler","doi":"10.1024/0040-5930/a001402","DOIUrl":"https://doi.org/10.1024/0040-5930/a001402","url":null,"abstract":"<p><p>Update Gout <b>Abstract.</b> Gout, the most frequent arthritis worldwide, is seldomly considered a serious chronic disease. Cardiovascular morbidity and allover mortality are increased in gout patients. Prevalence of gout is very variable in different countries and is estimated to be 2.6% overall. Men are overrepresented (3:1 to 4:1). Environmental factors, such as diet and alcohol intake, are still important, but the genetic influence, e.g., in early-onset gout, gets more and more attention. Despite the broad range of therapeutic options outcomes are poor, and the disease often leads to disabling structural damages, not only in joints. Patients' education, and the involvement of trained general practitioners and nurses will hopefully improve the outcomes of this treatable disease.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 1","pages":"17-26"},"PeriodicalIF":0.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9398165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Florian A Frank, Neris Peduzzi, Robin Brugger, Mario Morgenstern, Dieter Cadosch, Martin Clauss
{"title":"[Septic arthritis].","authors":"Florian A Frank, Neris Peduzzi, Robin Brugger, Mario Morgenstern, Dieter Cadosch, Martin Clauss","doi":"10.1024/0040-5930/a001405","DOIUrl":"https://doi.org/10.1024/0040-5930/a001405","url":null,"abstract":"<p><p>Septic arthritis <b>Abstract.</b> A painful, red, and swollen joint may have different causes. Septic arthritis is one of the most serious conditions and should be diagnosed and treated right away. In the native joint, an infection can damage the cartilage within the first 24 hours with impacts on joint function including lingering joint problems leading to possible future joint destruction. An interdisciplinary approach is essential for achieving optimal results. Most infections are caused by bacteria from the patient's own microbiome. In general, the incidence of native joint infections is growing, whether it is due to more appropriate diagnostics, or an actual increase cannot be determined at this point. In case of an acute infection, the patients usually describe a relatively short and acute period of pain, redness, and swelling of the affected joint. For diagnostic purposes the common blood serum laboratory work-up serves as a basis, complemented by puncture of the affected joint. Cell count and cell differentiation in the synovial liquid, microbiological and histopathological workup serve as gold standard in detecting septic arthritis. Septic arthritis lacks a distinctive presentation and other inflammatory conditions, like CPPD and gout must be considered. Prior to antibiotic therapy, joint lavage is the most important method to reduce bacterial load, leading to an improved outcome. Prognosis is determined by a swift diagnosis and initiation of therapy. The patient's comorbidities are significant, especially immunocompromising factors such as rheumatoid arthritis, diabetes or immunomodulating therapy. In case of a second focus of infection, chronic kidney disease or older age, patients are at greater risk for an inferior outcome.</p>","PeriodicalId":44874,"journal":{"name":"THERAPEUTISCHE UMSCHAU","volume":"80 1","pages":"39-44"},"PeriodicalIF":0.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9398161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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