Aktuelle Urologie最新文献

{"title":"[Germ Cell Tumours of the Testis: Classification, Frozen Section Diagnostics, Sentinel Lymph Node Biopsy, and Special Biological Variants].","authors":"Alexander Fichtner, Yue Che, Daniel Nettersheim, Felix Bremmer","doi":"10.1055/a-2629-0269","DOIUrl":"https://doi.org/10.1055/a-2629-0269","url":null,"abstract":"<p><p>Germ cell tumours (GCTs) are the most common testicular neoplasms and are classified into type I, type II, and type III tumours depending on age of onset, molecular biology, and histomorphology. There are six histological subtypes, whose distribution varies among the three groups: seminomas, embryonal carcinomas, choriocarcinomas, yolk-sac tumours, teratomas, and spermatocytic tumours. The most common are malignant type II GCTs, typically treated with radical orchiectomy. In cases of small tumours where tumour dignity is uncertain - such as when serum markers are negative - initial enucleation followed by frozen section examination can be performed. This approach is particularly useful when benign tumours are suspected, including epidermal cysts, sex cord gonadal stromal tumours, adenomatoid tumours, or other testicular adnexal tumours, since testis-sparing tumour resection is sufficient for small benign tumours. The precise classification of GCTs is based on the histopathological assessment of morphological characteristics of the GCT subtypes and, in certain cases, is supplemented by immunohistochemical analyses. When examining resected specimens from metastatic sites (e.g., retroperitoneal lymph nodes), special biological variants of type II tumours, such as somatic malignancies or the so-called growing teratoma syndrome, may also be encountered. If somatic malignancies lack the characteristic histomorphological features of the typical GCT subtypes, the GCT origin can be confirmed molecular-pathologically by detecting isochromosome 12p or an amplification of chromosomal material on chromosome 12.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129796","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":"[Digital health for benign prostate syndrome].","authors":"Sandra Helen Schönburg","doi":"10.1055/a-2573-7302","DOIUrl":"10.1055/a-2573-7302","url":null,"abstract":"<p><p>In addition to drugs, remedies and medical aids, digital health applications are a new therapeutic area according to §33a SGB V. There are now 69 approved DiGA listed in the BfArM DiGA directory, 40 of them permanently. The approval and listing of a DiGA is the result of a randomised control trial (RCT) with corresponding proof of effectiveness. Kranus Lutera is the first approved DiGA for male lower urinary tract symptoms (LUTS). The BEST study provided proof of effectiveness. A total of 237 patients were randomised in this study. Compared to the control group, the intervention group showed a significant improvement in the primary endpoint IPSS (-7.0; 95% CI: -8.1; -5.9; p<0.0001) and the secondary endpoints OAB-q-SF part 1 (symptom burden: -18.6; 95% CI: -22.2; -15.0; p<0.0001) and part 2 (health-related quality of life: +17.2; 95% CI: 20.16; 14.8; p<0.0001). The two subgroups (BPH, OAB) benefited similarly.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"445-450"},"PeriodicalIF":0.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958765","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":"[Ex-vivo Comparative Study on the Morcellation Efficiency of Different Morcellators].","authors":"Benedikt Becker, Christopher Netsch, Andreas J Gross, Clemens Rosenbaum, Friedrich Otto Hartung, Simon Filmar, Sophia Hook","doi":"10.1055/a-2560-3827","DOIUrl":"10.1055/a-2560-3827","url":null,"abstract":"<p><p>Anatomical enucleation of the prostate (AEEP) is an established treatment option for benign prostatic hyperplasia (BPH), regardless of prostate size. While advancements in laser technology have significantly improved the enucleation phase, the morcellation process has remained relatively unchanged, with limited innovations in morcellation devices. This study aimed to compare the efficiency of two morcellators in an ex-vivo model: the Piranha morcellator (Richard Wolf GmbH, Knittlingen) and a newly introduced, yet-to-be-commercialized device, the ActiveCut morcellator (Active Fiber Systems GmbH, Jena).The two morcellators were tested in a newly developed ex-vivo model. In both groups, reusable blades were tested ten times at comparable speed settings. For each trial, 60 grams of raw bovine heart tissue were morcellated. The efficiency of the morcellation was then analyzed. Primary endpoints included morcellation efficiency (g/min) and an evaluation of blade deterioration over repeated use. The mean values of continuous variables were compared using a t-test with standard deviation.A total of ten consecutive morcellation trials were conducted with each device. The ActiveCut demonstrated higher morcellation rates at 12.43 g/min, compared to 7.09 g/min with the Piranha morcellator (p<0.05). However, the ActiveCut showed a decline in efficiency over ten trials. In two cases, tissue had to be manually removed from the blade coupling during morcellation, whereas the Piranha morcellator maintained consistent performance without malfunctions.In this ex-vivo study, comparing the ActiveCut and Piranha morcellators, the ActiveCut exhibited higher morcellation efficiency. However, as the ActiveCut has not yet undergone clinical testing, future clinical studies are necessary to assess its safety and potential malfunctions before clinical implementation.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"433-438"},"PeriodicalIF":0.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953540","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":"[Bladder neck contracture after surgery for benigne prostate hyperplasia].","authors":"Clemens Rosenbaum, Sophia Hook, Benedikt Becker, Christopher Netsch, Simon Filmar","doi":"10.1055/a-2645-6997","DOIUrl":"10.1055/a-2645-6997","url":null,"abstract":"<p><p>Bladder neck contracture (BNC) is a common complication following surgical treatment of benign prostatic hyperplasia (BPH), with incidence rates varying depending on the therapeutic approach. Numerous techniques for managing BNC have been described in the literature. For the initial presentation of BNC, endoscopic treatment is generally recommended as the first-line therapy. In cases of recurrent BNC, however, open surgical reconstruction, such as YV or T-plasty, is considered the preferred treatment option. Additionally, robot-assisted surgery is increasingly being integrated into the surgical management of BNC. Currently, no standardized treatment protocol exists for this condition. This review provides a systematic overview of bladder neck contracture and the current therapeutic strategies available.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"451-455"},"PeriodicalIF":0.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599094","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":"Benigne Prostatahyperplasie.","authors":"Benedikt Becker","doi":"10.1055/a-2517-3489","DOIUrl":"https://doi.org/10.1055/a-2517-3489","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 5","pages":"388-389"},"PeriodicalIF":0.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938952","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":"Kommentar zum Leserbrief.","authors":"","doi":"10.1055/a-2639-7539","DOIUrl":"https://doi.org/10.1055/a-2639-7539","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 5","pages":"430-431"},"PeriodicalIF":0.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938940","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":"Kommentar.","authors":"","doi":"10.1055/a-2604-8426","DOIUrl":"https://doi.org/10.1055/a-2604-8426","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 5","pages":"406-407"},"PeriodicalIF":0.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938978","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":"[Randomised comparison of different exit strategies in hydrocele resection].","authors":"Simon Filmar, Andreas Gross, Christopher Netsch, Clemens Rosenbaum, Benedikt Becker","doi":"10.1055/a-2159-1525","DOIUrl":"10.1055/a-2159-1525","url":null,"abstract":"<p><strong>Introduction: </strong>Adult hydrocele is a benign enlargement of the scrotum seen in approximately 60/100,000 men >18 years of age. Surgical resection of the hydrocele has been established as the gold standard for the treatment of symptomatic hydroceles. Postoperative complications are common with this surgery. Due to the lack of guidelines for the therapy of hydrocele, treatment is based primarily on clinical experience. The aim of the study was to conduct a randomised study on the influence of drains on complications in hydrocele resection according to von Bergmann.</p><p><strong>Material and methods: </strong>A total of 60 patients were prospectively randomised into three groups. The groups each received an Easy-Flow drainage, a Cuti-Med Sorbact drainage, or no drainage. Haematoma and swelling, postoperative bleeding, infection, epididymal injury and revision surgery were clinically diagnosed as complications.</p><p><strong>Results: </strong>A complication was observed in 31.6% (n=19/60) of all patients. The complication rate was 50% (n=10) for the easy-flow drainage, 30% (n=6) for the Cuti-Med-Sorbact and 15% (n=3) for the group without drainage. Overall, a haematoma with swelling was observed most frequently, in 20% (n=12) of the cases. Revision surgery was required in 5% (n=3) of cases. Epididymal injuries were found histologically in 10% (n=6). Comparing the collective with the Easy-Flow drainage with the collective without drainage, the occurrence of complications was observed significantly more frequently in the drainage group (p<0.018). A statistically significant correlation regarding complications between the group of Cuti-Med-Sorbact and no drainage could not be shown (p<0.25).</p><p><strong>Conclusions: </strong>Hydrocele resection is a complicated procedure. Based on the data presented here, the insertion of a drain is associated with an increased risk of postoperative complications. If the decision to insert a wound drainage is made intraoperatively, the Cuti-Med-Sorbact drainage appears to be associated with fewer complications.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"477-483"},"PeriodicalIF":0.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107589972","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":"Invasives Harnblasenkarzinom: Trimodale Therapie versus radikale Zystektomie.","authors":"","doi":"10.1055/a-2549-8807","DOIUrl":"https://doi.org/10.1055/a-2549-8807","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 5","pages":"407-409"},"PeriodicalIF":0.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938937","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":"Harnröhrenstriktur: Langzeitergebnisse nach perinealer Urethrostomie.","authors":"","doi":"10.1055/a-2549-8853","DOIUrl":"https://doi.org/10.1055/a-2549-8853","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 5","pages":"414-416"},"PeriodicalIF":0.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938949","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}