Aktuelle Urologie最新文献

{"title":"Uropathologie.","authors":"Markus Eckstein","doi":"10.1055/a-2703-9449","DOIUrl":"https://doi.org/10.1055/a-2703-9449","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 1","pages":"1-2"},"PeriodicalIF":0.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206724","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-2702-6393","DOIUrl":"https://doi.org/10.1055/a-2702-6393","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 1","pages":"19-20"},"PeriodicalIF":0.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206750","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":"Prostatakarzinom: Was bringt ein individueller Survivorship-Care-Plan?","authors":"","doi":"10.1055/a-2642-4145","DOIUrl":"https://doi.org/10.1055/a-2642-4145","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 1","pages":"12"},"PeriodicalIF":0.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206700","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":"Prostata-Fusionsbiopsie: MRT- und Ultraschall-Volumendiskrepanzen problematisch.","authors":"","doi":"10.1055/a-2642-4236","DOIUrl":"https://doi.org/10.1055/a-2642-4236","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 1","pages":"14-16"},"PeriodicalIF":0.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206720","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":"[Current and future treatment stratification of metastatic urothelial carcinoma: a great opportunity for true precision oncology].","authors":"Günter Niegisch, Stefanie Zschäbitz, Niklas Klümper, Markus Eckstein","doi":"10.1055/a-2622-6243","DOIUrl":"10.1055/a-2622-6243","url":null,"abstract":"<p><p>For many decades, the treatment of metastatic urothelial carcinoma (mUC) has been dominated by platinum-containing chemotherapies. The latest version is the introduction of immune checkpoint inhibitors, especially in combination with modern antibody-drug conjugates (ADC) and FGFR3 inhibitors, but this therapeutic standard has been overtaken in some indications. Nevertheless, biomarker-guided therapy decisions have rarely been used to date. However, the biomarkers available to date have only helped in isolated therapeutic situations. For ADCs, however, this could change substantially when there is high expression variability of various targets such as NECTIN-4, Her2neu, EGFR and TROP2. The presence of activating FGFR3 mutations or fusions also opens up a clearly defined, albeit small, therapeutic niche that could possibly become larger in the future for localised stages of urothelial carcinoma. Biomarker stratification of tumours will presumably become indispensable in the future if we are to control and use these therapeutic innovations in a targeted and precise manner. Current developments therefore possess great potential for genuine precision oncology.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"46-51"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537703","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":"[Comparison of Ultrasound and Magnetic Resonance Imaging in Diagnosing a Penile Fracture: A Retrospective Data Analysis].","authors":"Svenja K Morische, Alexander Fürschke, Nils Gilbert, Daniar Osmonov, Axel S Merseburger, Silvia Brozat-Essen","doi":"10.1055/a-2606-4501","DOIUrl":"10.1055/a-2606-4501","url":null,"abstract":"<p><p>A \"penile fracture\" is a rare urological emergency. According to international literature, a clinical diagnosis is considered sufficient if the patient's history and clinical appearance are characteristic. Imaging modalities such as sonography, cavernosography, and MRI are appropriate diagnostic tools. Sonography is a fast, inexpensive and widely used imaging method; however, MRI offers a higher resolution. The current literature recommends timely surgical treatment.This is a retrospective, single-centre cohort study including all patients who presented at the University Hospital of Lübeck with a suspected penile fracture between 01 January 2018 and 30 September 2024.Sixteen patients were analysed. Eight patients presented on the day the trauma occurred.MRI morphology confirmed a rupture of the corpora cavernosa in 13 of 16 patients. The suspicion was not confirmed in 3 patients. Sonographic and MRI morphological findings correlated in 11 patients, sonography was false negative in 2 patients and false positive in 2 others. In 1 patient, both sonography and MRI yielded inconclusive results.Clinically, a deviation of the penis was seen in about 23% of fractures, 92% showed a haematoma, and about 23% of the patients with a rupture reported that they had heard a \"cracking sound\".The diagnosis can be established clinically, sonographically, and via MRI. Sonography is suitable for the initial assessment of whether there is an interruption in the continuity of the tuniga albuginea. In the hands of experienced examiners, this may be sufficient to precisely localize the defect. However, in rare cases where sonographic expertise is limited, MRI serves as a more sensitive imaging technique that can rule out differential diagnoses and localize defects.In summary, according to the literature, an MRI is helpful for treatment planning, but not necessary for surgical treatment. With a correlation of sonography and MRI in 69% of the cases we examined, sonography is a sufficient diagnostic tool for determining the indication for surgery. Based on our data, we consider a positive sonography to be sufficient for the initiation of further therapy. However, based on our evaluation, we would recommend MRI in cases of negative ultrasound findings with persistent clinical suspicion.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"102-107"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172169","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":"S2k-Leitlinie Hilfsmittelberatung bei Harninkontinenz der DGU – red flags, Qualifikation Beratender, Kosten.","authors":"Andreas Wiedemann, Andreas Manseck, Joachim Stein, Ruth Kirschner-Hermanns, Michael Froehner, Marius Butea-Bocu, Christian Fiebig, Alexander Piotrowski, Jochen Gleißner, Clemens Linne, Timo Liebald, Heribert Schorn, Arnold Wagner, Volker Moll","doi":"10.1055/a-2607-5293","DOIUrl":"10.1055/a-2607-5293","url":null,"abstract":"<p><p>Counselling regarding a planned provision of medical aids is currently neither reimbursed nor regulated in Germany. It is offered by a range of providers with employees with varying levels of qualification and may be provided in a personal conversation, by phone, or remotely. In many cases, counselling is omitted entirely between the prescription and trial use or delivery of the product. The quality of medical aids counselling, which plays a key role in temporary, supportive or palliative care for urinary incontinence, is therefore considered problematic.In 2019, the working group \"Geriatric Urology\" of the German Society for Urology published the first guideline on the counselling process related to the provision of medical aids. An updated version is currently available and has been listed by the Association of the Scientific Medical Societies. The underlying idea was to define quality standard in Germany for the individual components of the counselling process - from identifying the type of incontinence and its severity to product trial use, the counselling setting, the counselling itself, the qualification of the counselling personnel, and the communication between prescribing physicians, service providers, and patients.This article presents the guideline sections regarding \"red flags\" - clinical conditions/symptoms, for which medical consultation should take precedence over medical aids counselling - as well as the qualifications required of the counselling personnel, and counselling costs.As medical aids counselling is expected to be financed from the low reimbursement rates provided by statutory health insurers for what is defined as an \"appropriate and sufficient\" supply - typically amounting to less than EUR 15 a month - more and more providers are withdrawing entirely from the sector of medical aids provision. Others continue to supply medical aids but offer no counselling at all or only to a very limited extent. The guideline \"Medical Aids Counselling for Urinary Incontinence\" developed by the working group \"Geriatric Urology\" of the German Society for Urology is meant to define quality standards, also with a view to a political discussion on reimbursement rates.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 1","pages":"108-112"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206742","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":"Erstlinientherapie beim Urothelkarzinom des oberen Harntrakts.","authors":"","doi":"10.1055/a-2703-9422","DOIUrl":"https://doi.org/10.1055/a-2703-9422","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 1","pages":"21-22"},"PeriodicalIF":0.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206680","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":"[Penile carcinoma: the importance of histological classification and new treatment strategies].","authors":"August Fiegl, Jan Niklas Mink, Kerstin Junker, Johannes Linxweiler, Arndt Hartmann","doi":"10.1055/a-2638-4574","DOIUrl":"10.1055/a-2638-4574","url":null,"abstract":"<p><p>Penile carcinoma is a rare malignancy, predominantly derived from squamous epithelium, with a partially aggressive clinical course. The 2022 WHO classification distinguishes HPV-associated (HPV(+)) and HPV-independent (HPV(-)) subtypes, a differentiation that bears significant prognostic and therapeutic implications. HPV(-) carcinomas often develop as result of chronic inflammation, e.g. lichen sclerosus. While HPV(+) tumours, such as the warty subtype, often exhibit an indolent course, basaloid and sarcomatoid variants are associated with poor prognosis and an increased risk of metastasis.The prognostic value of HPV status alone is still inconsistent across studies. In contrast, p16 overexpression as surrogate marker for HPV infection, has been linked to improved survival outcomes. A combined assessment of HPV and p16 status is therefore recommended, particularly for therapeutic decision-making. In HPV(-) tumours, additional analysis of p53 expression is advisable, as TP53 mutations - frequently observed in this group - are associated with more aggressive tumour biology.Beyond conventional platinum-based chemotherapy, targeted therapies are gaining attention. Antibody-drug conjugates (ADCs), such as enfortumab vedotin (targeting Nectin-4) and sacituzumab govitecan (targeting Trop-2) have shown promising efficacy in other tumour types. Both targets are also expressed in penile carcinoma, and early clinical trials are underway. HER2 is expressed in a relevant proportion of cases and may be an additional therapeutic target.Immune checkpoint inhibitors like atezolizumab have so far demonstrated limited efficacy in penile cancer, despite high rates of PD-L1 expression. This discrepancy may be attributed to the immunosuppressive tumour microenvironment. EGFR-targeted monoclonal antibody therapies are also a potential treatment option.Accurate histopathological and molecular characterisation is critical for personalised treatment approaches and should become an integral component of the clinical management of penile carcinoma.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"28-37"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726471","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":"[ISUP 1 Prostate Carcinoma Controversy: Is the Term Carcinoma Justified - Clinical or Anatomical Definition?]","authors":"Glen Kristiansen, Marit Bernhardt, Phillip Krausewitz, Manuel Ritter","doi":"10.1055/a-2728-9305","DOIUrl":"10.1055/a-2728-9305","url":null,"abstract":"<p><p>The designation of Gleason score 6 (ISUP Grade Group 1) prostate cancer as \"cancer\" has become increasingly controversial. Despite its excellent prognosis and minimal risk of metastasis, the diagnosis often leads to emotional distress and potential overtreatment. The question of whether a less alarming nomenclature might be more appropriate is gaining relevance. This review analyses the arguments for and against renaming ISUP Grade Group 1 prostate cancer and explains why the definition of indolence cannot be based solely on histological criteria. Drawing on current literature and consensus statements from international pathology societies (ISUP/GUPS), this article critically evaluates pathological, clinical, molecular, and imaging criteria used to define tumour indolence. Neither morphological characteristics, nor molecular markers, nor imaging alone can reliably identify indolent cancers in biopsy specimens. Diagnostic uncertainty is further amplified by significant interobserver variability. Multidisciplinary approaches that integrate clinical, radiological, molecular, and histopathological parameters appear necessary to accurately detect and classify indolent tumours. Simply renaming GG1 prostate cancer using a less threatening term is insufficient. Instead, individualised, multidimensional risk stratification is essential. The debate underscores that the responsibility for defining indolent prostate cancer cannot rest solely with pathology.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"88-95"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145779855","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}