Aktuelle Urologie最新文献

{"title":"Offene versus roboterassistierte Nierentransplantation.","authors":"","doi":"10.1055/a-2874-4801","DOIUrl":"https://doi.org/10.1055/a-2874-4801","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 5","pages":"436-438"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863397","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":"Einsatz des [18F]PSMA-1007 PET/CT beim neu diagnostizierten Hochrisko-Prostatakarzinom.","authors":"","doi":"10.1055/a-2914-0768","DOIUrl":"https://doi.org/10.1055/a-2914-0768","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 5","pages":"448-451"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863369","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":"Prostatektomie: Schnittrandbeurteilung mittels konfokaler Fluoreszenzmikroskopie.","authors":"","doi":"10.1055/a-2874-3174","DOIUrl":"https://doi.org/10.1055/a-2874-3174","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 5","pages":"440-442"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863390","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":"Zweitlinientherapie des high-risk NMIBC nach BCG-Gabe.","authors":"","doi":"10.1055/a-2861-3056","DOIUrl":"https://doi.org/10.1055/a-2861-3056","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 5","pages":"444-446"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863434","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":"[Focal Therapy for Prostate Cancer in Germany: Progress or Illusion?]","authors":"Martin Schostak, Angelika Borkowetz","doi":"10.1055/a-2915-1395","DOIUrl":"https://doi.org/10.1055/a-2915-1395","url":null,"abstract":"<p><strong>Abstract: </strong>Over the past two decades, focal therapy for localized prostate cancer has evolved from an experimental approach into a structured treatment option within the framework of risk-adapted prostate cancer management. The aim of this article is to provide a critical appraisal of the current role of focal therapy in light of contemporary guidelines, available evidence, and health-economic considerations. The introduction of multiparametric MRI and MRI-targeted fusion biopsy has substantially improved the accurate identification of clinically significant index lesions, thereby establishing the technical foundation for selective ablative approaches. Despite these advances, the evidence base remains heterogeneous, and large randomized comparative trials are still lacking. The largest comparative study to date (HIFI trial) demonstrated oncological non-inferiority compared with radical prostatectomy, albeit with important methodological limitations, while achieving superior functional outcomes. Initial randomized data from the FARP trial has so far been presented only in abstract format at scientific meetings, and a full peer-reviewed publication is pending. Within the contemporary therapeutic landscape, active surveillance, focal therapy, and radical treatments should not be viewed as strictly competing strategies but rather as components of a risk-adapted continuum. While active surveillance remains the standard of care for patients with low-risk disease, focal therapy may represent a suitable option for carefully selected patients with a clearly localized, biologically relevant index lesion and a strong preference for functional preservation. Optimal outcomes depend on rigorous patient selection using modern imaging, fusion biopsy techniques, and structured follow-up protocols. At the same time, considerable structural disincentives persist: pretherapeutic precision diagnostics are frequently inadequately reimbursed, and hospital reimbursement for focal procedures remains substantially lower than for radical standard treatments. In summary, focal therapy should no longer be regarded primarily as an experimental approach but as a selective component of a differentiated precision oncology concept. Its appropriate application remains indication-dependent and requires further high-quality prospective studies as well as supportive structural and economic frameworks.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 5","pages":"471-478"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863266","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-2891-9803","DOIUrl":"https://doi.org/10.1055/a-2891-9803","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 5","pages":"442"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863399","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":"Sekundäre Anastomoseninsuffizienz nach Roboter-assistierter radikaler Prostatektomie (RARP).","authors":"Mikolaj Mendrek, Maximilian Haas, Christian Wagner","doi":"10.1055/a-2894-6768","DOIUrl":"https://doi.org/10.1055/a-2894-6768","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 5","pages":"452-456"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863406","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":"Perkutane Nephrolitholapaxie (PCNL).","authors":"Axel Häcker","doi":"10.1055/a-2743-7122","DOIUrl":"https://doi.org/10.1055/a-2743-7122","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 5","pages":"494-502"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863433","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":"[From Opportunistic PSA Testing to Individualized, Risk-Adapted Early Detection of Prostate Cancer in Germany].","authors":"Matthias May, Maximilian Burger, Ingmar Wolff, Kay-Patrick Braun, Maximilian Haas, Stephan Siepmann, Christian Gilfrich, Steffen Lebentrau","doi":"10.1055/a-2897-1642","DOIUrl":"10.1055/a-2897-1642","url":null,"abstract":"<p><strong>Abstract: </strong>Early detection of prostate cancer in Germany remains predominantly opportunistic. An organized, quality-assured, invitation-based program has not yet been established. Instead, current practice is characterized by heterogeneous prostate-specific antigen (PSA) testing, variable counseling, and inconsistent downstream diagnostic pathways. However, both the evidence base and the guideline landscape have evolved substantially. The updated German S3 guideline recommends a PSA-based, risk-adapted early detection strategy from the age of 45 years following informed, non-directive counseling. This approach includes a baseline PSA measurement, interval-based reassessment, and a clearly defined diagnostic workup. The 2026 European Association of Urology guidelines follow the same overarching principle of individualized, risk-adapted early detection, but adopts a more conservative starting age of 50 years for men without additional risk factors. The key question is therefore no longer whether unselected annual PSA testing for all men is justified, but whether Germany should now consistently transition from opportunistic testing to a structured, individualized, and quality-assured early detection strategy. There are compelling arguments in favor of initiating this pathway at the age of 45 years with structured counseling and a baseline PSA measurement, not as an invitation to overtesting, but as the entry point to a strategy that can subsequently be de-intensified according to individual risk. Such an approach is clinically plausible, epidemiologically well founded, increasingly supported by contemporary German and European data, and more convincing from a health policy perspective than perpetuating the current gray zone between statutory early detection based on digital rectal examination and the de facto opportunistic use of PSA testing.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"479-486"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410223","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":"[HIFU: Best Practices for Optimal Performance].","authors":"Georg Salomon, Neele Heckmann, Jan Lukas Hohenhorst, Jonas Ekrutt, Jan Palec, Yamini Nagaraj","doi":"10.1055/a-2919-7470","DOIUrl":"10.1055/a-2919-7470","url":null,"abstract":"<p><strong>Background: </strong>High-intensity focused ultrasound (HIFU) is a minimally invasive treatment option for selected patients with localized prostate cancer. This article is not intended as an original outcome study but as a practice-oriented expert review and institutional experience report on focal and hemiablative HIFU.</p><p><strong>Material and methods: </strong>We describe patient selection, preoperative diagnostic assessment and biopsy mapping, intraoperative planning, safety margins, HIFU ablation using EDAP/Focal One(R), the double tap strategy, documentation and follow-up. Institutional practice is explicitly distinguished from evidence-based standards and consensus recommendations.</p><p><strong>Results: </strong>Reproducible outcomes require concordance between imaging and histological findings, an adequate safety margin around the index lesion, structured intraoperative documentation and a follow-up strategy including PSA kinetics, mpMRI and biopsy when indicated. The double tap strategy is presented as an institutionally established technical modification, with a brief summary of the available group data.</p><p><strong>Conclusion: </strong>HIFU can be performed safely when carried out in a standardized manner. Treatment quality depends substantially on patient selection, treatment planning, technical execution, and post-treatment follow-up.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 5","pages":"465-470"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863449","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}