Aktuelle Urologie最新文献

{"title":"S2k-Leitlinie „Harninkontinenz bei geriatrischen Patienten“ – Teil 5: Verhaltensintervention, Toilettentraining, physiotherapeutische und physikalische Interventionen.","authors":"Klaus Becher, Barbara Bojack, Claudia Drews, Ruth Kirschner-Hermanns, Andreas Wiedemann","doi":"10.1055/a-2316-3350","DOIUrl":"10.1055/a-2316-3350","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 2","pages":"170-178"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778828","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":"[Fertility preservation in persons with gender incongruence and male-assigned sex at birth].","authors":"Florian Josef Schneider, Bettina Scheffer, Sabine Kliesch, Jann-Frederik Cremers","doi":"10.1055/a-2490-4059","DOIUrl":"10.1055/a-2490-4059","url":null,"abstract":"<p><p>According to current guidelines, patients with gender incongruence seeking treatment must receive appropriate education and counselling from healthcare professionals on the various options for fertility preservation. Gender-affirming hormonal treatment leads in persons assigned male at birth to a reduction of LH, FSH, and testosterone, which is associated with a regression of spermatogenesis (up to complete loss) and subsequent testicular atrophy. Individuals starting gender-affirming hormonal treatment after having experienced male puberty may provide an ejaculate sample for sperm cryopreservation. In cases where no sperm is detected in the ejaculate due to gender-affirming hormonal treatment, or if the sampling of ejaculate is no longer possible or causes excessive psychological distress, (microsurgical) testicular sperm extraction [(m)TESE] should be offered. Electroejaculation under anaesthesia is rarely effective, as hormonal treatment impairs spermatogenesis. Similarly, microsurgical epididymal sperm aspiration (MESA) is not typically effective for the same reason. If adolescents with gender incongruence undergo puberty blockade and/or gender-affirming hormonal treatment at an early stage of puberty (possible from Tanner stage 2), this prevents the maturation of spermatogonial stem cells into mature sperm. Puberty blockade with GnRH reduces the secretion of LH and FSH by the pituitary gland, which, in turn, suppresses the production of testosterone in the Leydig cells and the stimulation of spermatogenesis in the testicles. In such cases, the cryopreservation of spermatogonial stem cells is possible, similar to how it is offered in some countries for peri-pubertal patients prior to necessary germ cell-toxic treatments. In Germany, there is a relevant network (Androprotect), which was founded in Münster in 2012. Via Androprotect, this procedure is also offered for adolescent individuals with gender incongruence. This approach is considered experimental as no established treatment exists for the refertilisation of affected adults at a later stage, although several procedures for in-vitro sperm maturation and tissue transplantation are under development. The care of patients with gender incongruence should include individual counselling provided by experienced professionals in an interdisciplinary treatment team. Individual treatment approaches should be offered to facilitate shared decision-making (based on informed consent) to ensure that each individual can make an informed and appropriate decision regarding fertility preservation.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"150-157"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254175","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":"Antwort.","authors":"","doi":"10.1055/a-2315-3978","DOIUrl":"https://doi.org/10.1055/a-2315-3978","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 2","pages":"191"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778818","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":"Große Sprachmodelle zur schnellen Vereinfachung der Eingabe von Qualitätssicherungsdaten: Kommentar.","authors":"","doi":"10.1055/a-2315-3530","DOIUrl":"https://doi.org/10.1055/a-2315-3530","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 2","pages":"190"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778823","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-2502-8524","DOIUrl":"https://doi.org/10.1055/a-2502-8524","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 2","pages":"122-124"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778826","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: Vibegron bei Drangbeschwerden effektiv und sicher.","authors":"","doi":"10.1055/a-2438-3752","DOIUrl":"https://doi.org/10.1055/a-2438-3752","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 2","pages":"121-122"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778819","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":"[Gender Disparities in Urolithiasis with a Special Focus on Oxalate Metabolism in the Liver].","authors":"Roman Herout, Sven Oehlschläger","doi":"10.1055/a-2528-0260","DOIUrl":"10.1055/a-2528-0260","url":null,"abstract":"<p><p>The incidence and prevalence of urolithiasis are increasing in industrialized countries. In particular, an increase has been observed among young adults and women. The gender gap is closing, and gender equality (1:1) with regard to urolithiasis has already been documented for the USA. Studies have demonstrated that women have higher urine pH values than men, which promotes calcium phosphate crystallization. The tendency for men to develop calcium oxalate and uric acid stones is caused by the comparatively lower urine pH values. Malnutrition combined with a lack of exercise and the occurrence of metabolic syndrome with its underlying diseases (insulin resistance, type 2 diabetes mellitus, obesity, dyslipidaemia) are discussed as the causes of the increase in upper tract stone disease in industrialized countries. Non-alcoholic fatty liver disease (NAFLD), as the most common liver disease, is considered one of the complications of metabolic syndrome, with a prevalence of approximately 23% in Germany. Animal experiments and clinical studies have demonstrated a connection between NAFLD and increased oxalate excretion in urine. Based on the literature, NAFLD represents a possible cross-gender risk factor for kidney stone formation and is therefore considered to be a generally modifiable risk factor for recurrent urolithiasis. Simple recommendations concerning NAFLD should complement the general and metabolic workup in everyday clinical practice.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"145-149"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612771","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":"[Management of complications after feminising genital reassignment surgery].","authors":"Johannes Moltrecht, Malte W Vetterlein, Tim Ludwig, Margit Fisch, Armin Soave","doi":"10.1055/a-2511-9862","DOIUrl":"10.1055/a-2511-9862","url":null,"abstract":"<p><p>In recent years, transgender healthcare has played an increasingly important role both in social discourse as well as in medical research and the clinical context. When looking at the medical aspect of transgender care, the triad of sexual medical/psychotherapeutic support, endocrinological therapy and surgical interventions to improve or establish gender identity play a decisive role. In this article, we will focus on the management of complications after feminising male-to-female genital reassignment surgery (vaginoplasty). The current literature supports the benefits of gender reassignment surgery in adequately selected patients. Most complications can be treated non-surgical and in an ambulant setting. The complication rates are similar to those of comparable surgical procedures outside the transmedical context 1 2 3.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"56 2","pages":"135-144"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778816","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":"Benign and Inflammatory Lesions of the Human Female Prostate: A Narrative Review of Diagnostic and Therapeutic Approaches.","authors":"Radion Garaz, Arnulf Stenzl, Igor Tsaur, Niklas Harland, Bastian Amend","doi":"10.1055/a-2546-1307","DOIUrl":"https://doi.org/10.1055/a-2546-1307","url":null,"abstract":"<p><p>Skene's glands are recognised as the female equivalent of the male prostate gland. They can be affected by a variety of benign, inflammatory, or malignant conditions.This review critically analyses the current literature on the diagnosis and management of non-malignant lesions associated with Skene's gland.A comprehensive search of Scopus, Web of Science, and PubMed/MEDLINE was conducted, focusing on non-malignant lesions of Skene's gland while excluding studies involving newborns and animals.Sixty relevant articles were identified, primarily comprising small case series. The benign lesions reviewed include cysts, hyperplasia, tubular-squamous vaginal polyps, leiomyomas, adenofibromas, and Skene's gland lithiasis. Inflammatory conditions such as abscesses and female prostatitis were also analysed.Physical examination, ultrasound, cystoscopy, MRI, and micro-ultrasound are essential diagnostic modalities for evaluating Skene's gland pathologies. Timely conservative or surgical interventions can effectively manage benign conditions, with treatment options typically guided by the severity of symptoms. This review underscores the necessity for further research into the biology of Skene's gland, particularly regarding potential diagnostic and therapeutic implications, and emphasizes the importance of a routine evaluation of Skene's gland in urological and gynaecological practice.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708085","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":"[Indications for performing PSMA-PET-CT as part of prostate cancer diagnostics].","authors":"Philipp Krausewitz","doi":"10.1055/a-2523-5885","DOIUrl":"10.1055/a-2523-5885","url":null,"abstract":"<p><p>Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) is increasingly being applied in the diagnostic landscape of prostate cancer. This study aims to elucidate and assess both established and emerging indications for PSMA-PET/CT imaging. Current evidence on PSMA-PET/CT is summarised, with relevant guideline recommendations and enhanced by recent study findings. PSMA-PET/CT demonstrates superiority over conventional imaging techniques and can be applied either complementarily or substitutively across all stages of prostate cancer based on clinical indications. It offers advantages in terms of reduced time and radiation exposure. PSMA-PET/CT use enables a more accurate assessment of disease status and facilitates optimised treatment planning. Applications span from initial cancer suspicion through diagnosis, staging, and therapeutic planning in cases of biochemical recurrence and metastatic prostate cancer. However, evidence for the prognostic value of PSMA-PET/CT-guided therapy decisions is currently limited. PSMA-PET/CT provides substantial diagnostic and therapeutic benefits for nearly all subgroups of prostate cancer patients. Its use supports the evaluation of possible intensification or de-escalation strategies, thereby enabling personalised treatment planning.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655980","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}