Aktuelle Urologie最新文献

{"title":"[Current Data from the National Registry for Urothelial Cancer (UroNAT) by d-uo].","authors":"Rolf Eichenauer, Manfred Johannsen, Jörg Klier, Frank König, Robert Schönfelder, Jörg Schröder, Elke Hempel, Christian Doehn","doi":"10.1055/a-2803-4004","DOIUrl":"10.1055/a-2803-4004","url":null,"abstract":"<p><strong>Introduction: </strong>The German Association of Uro-Oncologists (d-uo) aims to document the real-world care in patients with urological tumor diseases, as well as to scientifically analyze and publish these data, thereby improving the quality of outpatient care.</p><p><strong>Materials and methods: </strong>UroNAT is a non-interventional, prospective, multicenter national registry for urothelial carcinomas initiated by d-uo in October 2021. Its objectives are continuous documentation, scientific evaluation, and quality assurance of treatment for patients with urothelial carcinoma at all stages in office-based outpatient care. This registry captures the cross-sectoral quality of care for urothelial carcinoma of the bladder and upper urinary tract in Germany. Currently, data from 1531 of 2024 enrolled patients are available for analysis in UroNAT.</p><p><strong>Results: </strong>In 69% of patients, presentation was driven by a symptom, predominantly gross hematuria or microscopic hematuria. Tumors were located in the urinary bladder in 94.5% of cases, and in the ureter or renal pelvis in 2% each. A solitary tumor was observed in 65% of patients, 2-7 tumors in 33%, and more than 8 tumors in 2%. Histologically, non-invasive tumor stages predominated (57% Ta, 20% T1), while 23% presented with T2-T4 disease. High-grade (G3) tumors accounted for 50% of cases, G2 for 26%, and G1 tumors for 24%; pure carcinoma in situ (CiS) was present in 3.9%. Approximately 90% of patients underwent TURB or re-TURB; cystectomy was performed in 5.1%, and procedures on the upper urinary tract or radiotherapy were carried out in fewer than 5%.</p><p><strong>Conclusion: </strong>This nationwide registry allows all uro-oncological care providers from urology, oncology, and hospitals to participate via their outpatient clinics. With this national tumor registry, d-uo once again fulfills its commitment to comprehensive data collection in outpatient care research.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"266-269"},"PeriodicalIF":0.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589437","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":"[Cobb's collar … seek and you shall find!]","authors":"Evi Comploj, Christian Ladurner, Armin Pycha","doi":"10.1055/a-2466-6115","DOIUrl":"10.1055/a-2466-6115","url":null,"abstract":"<p><strong>Abstract: </strong>PURPOSE: Cobb's collar, also known as Moormann's ring, is a rare membranous stricture of the bulbar urethra. In contrast to the posterior urethral valve (PUV), Cobb's collar is not connected to the verumontanum. A simultaneous occurrence of PUV and Cobb's collar is even rarer. To the best of our knowledge, we report the third case in the literature of a child with coexistence of PUV and Cobb's collar.</p><p><strong>Abstract: </strong>CASE PRESENTATION: We present the case of a 3-year-old boy with a history of recurrent episodes of bladder outlet obstruction with residual urine volumes of up to 800 ml. An outward cystoscopy only revealed a bladder neck with a spastic appearance. A neuropediatric visit was unremarkable; magnetic resonance imaging (MRI) of the brain and spine was negative. After the positioning of a suprapubic catheter, cystoscopy was repeated, and a membranous stricture distal to the external sphincter - also known as Cobb's collar - was diagnosed and incised. After the procedure, the patient was able to urinate with residual volumes ranging from 40-50 ml. However, two weeks later, residual volumes increased again, and a second cystoscopy was performed. In addition to the open Cobb's collar, a PUV was detected, and both were incised with a cold hooked knife.</p><p><strong>Abstract: </strong>CONCLUSIONS: The diagnosis is difficult to make unless the urologist is aware of and actively looks for these rare congenital anomalies of the urethra, which present with variable clinical manifestations and degrees of obstruction.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"301-305"},"PeriodicalIF":0.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783852","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":"[Early Detection of Prostate Cancer: Current Real-World Data from the VERSUS Study by d-uo].","authors":"Christian Doehn, Frank König, Manfred Johannsen, Rolf Eichenauer, Robert Schönfelder, Michel L Doehn, Jörg Schröder, Elke Hempel, Jörg Klier","doi":"10.1055/a-2831-9081","DOIUrl":"10.1055/a-2831-9081","url":null,"abstract":"<p><strong>Introduction: </strong>Since 2018, members of Deutsche Uro-Onkologen (d-uo) have been documenting urological malignancies as part of the prospective VERSUS study. The cancer registry reporting system introduced in Germany in 2015 also includes an additional item for documenting the diagnostic context. We investigated whether differences exist between patients with early-detected and otherwise detected prostate cancer with respect to clinical parameters such as age, PSA, tumor stage, and ISUP grade groups at diagnosis.</p><p><strong>Materials and methods: </strong>The VERSUS study is a non-interventional, prospective, multicenter study for the documentation and evaluation of diagnostic procedures, treatment course, and follow-up care of patients with urological malignancies. The VERSUS study includes all patients with urological cancer from 200 member clinics of d-uo. Between May 2018 and August 2025, a total of 31,419 patients with a first diagnosis of urological cancer were documented.</p><p><strong>Results: </strong>In total, 20,253 patients (64.5%) had prostate cancer. The median age of these patients was 70.3 years (range 19.8-105.6 years). The median PSA value at diagnosis was 9 ng/ml (range 0-28,485 ng/ml).In 55% of patients with prostate cancer (median age 69.7 years, median PSA 8.2 ng/ml, 16.7% with a PSA >20 ng/ml), prostate cancer was detected as part of an early-detection program, whereas in 45% of all patients (median age 70.9 years, median PSA 11.0 ng/ml, 28.0% with a PSA >20 ng/ml), it was otherweise diagnosed. These differences are statistically significant.Patients with early-detected prostate cancer were more likely to present with a UICC I tumor stage (68.3% vs. 58.3%) and less frequently with a UICC IV tumor stage (7.8% vs. 16.4%), as well as less frequently with a tumor of ISUP grade groups IV and V (18.1% vs. 24.2%). These differences are statistically significant.</p><p><strong>Conclusion: </strong>Patients with prostate cancer diagnosed through early detection are slightly younger on average, have lower PSA levels, and present with more favorable tumor stages and ISUP grade groups than patients diagnosed through other means. The rate of primary metastatic disease is lower. These real-world data from the VERSUS study support the early detection of prostate cancer.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"253-259"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147508798","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":"[Androgen receptor-targeted therapies - avoid clinically relevant interactions].","authors":"Hans-Peter Lipp, Gunhild von Amsberg, Axel S Merseburger, Steffen Rausch, Tilman Schöning, Jörg Klier, Peter J Goebell","doi":"10.1055/a-2593-1605","DOIUrl":"10.1055/a-2593-1605","url":null,"abstract":"<p><strong>Abstract: </strong>Pharmacotherapy of older patients requires special attention to drug interactions, based on an increase in morbidity and elevated need for polypharmacy. Especially for drugs with a narrow therapeutic index, interactions may require dose adjustments, discontinuation or switching of co-medication. These interactions are frequently based on pharmacokinetic alterations of drug metabolism via the cytochrome P450 (CYP) enzyme system, mainly via CYP3A4. This isoform is involved in the metabolism of about half of therapeutically applied drugs, including many agents commonly used in patients with prostate cancer. As a consequence, an impressive decrease in plasma levels of coadministered drugs has to be expected during the use of the potent CYP3A4 inducers apalutamide as well as enzalutamide, in contrast to the mild CYP3A4 inducer darolutamide. Abiraterone is classified as a moderate inhibitor of the CYP2D6 isozyme, which catalyses the biotransformation of fewer drugs. As a consequence, abiraterone's spectrum of interaction has to be interpreted differently. As pharmacotherapy approaches, it is helpful to understand the drug biotransformation pathways in more detail, in order to assess the extent of possible interactions that may necessitate the intensification of therapeutic monitoring, or dose modification or any therapeutic switch in time.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"284-300"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13288287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kommentar.","authors":"","doi":"10.1055/a-2815-5968","DOIUrl":"https://doi.org/10.1055/a-2815-5968","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 3","pages":"242-244"},"PeriodicalIF":0.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148119","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":"3D-Modelle bei Nierenzellkarzinomen mit VTE verbessern Operationsergebnis.","authors":"","doi":"10.1055/a-2642-4598","DOIUrl":"https://doi.org/10.1055/a-2642-4598","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 3","pages":"244"},"PeriodicalIF":0.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148087","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":"[7-Year Data on Penile Carcinoma from the VERSUS Study by d-uo].","authors":"Jörg Klier, Frank König, Manfred Johannsen, Rolf Eichenauer, Robert Schönfelder, Jörg Schröder, Elke Hempel, Christian Doehn","doi":"10.1055/a-2815-3968","DOIUrl":"10.1055/a-2815-3968","url":null,"abstract":"<p><strong>Abstract: </strong>Since May 2018, all uro-oncological tumorentities have been prospectively recorded within the framework of the VERSUS study in a standardized and independent database of the German Uro-Oncologists (d-uo). Data collection is based on the legally mandated cancer registry reporting according to the ADT/GEKID dataset, which also constitutes the basis of the present analysis of penile carcinoma.A total of 182 patients with histologically confirmed penile carcinoma were included in the study. Compared with international registry data, the d-uo cohort demonstrates a comparable distribution with regard to patient age, TNM classification, and applied therapeutic approaches. Notably, a trend toward localized tumor stages (Ta/T1) was observed. In this subgroup, penile carcinoma was incidentally diagnosed in 16% of cases during routine preventive medical examinations. Overall, tumor detection occurred due to tumor-related symptoms in 36.8% of patients and through self-examination in 22.0%.Patients presenting with tumor-related symptoms more frequently exhibited TNM classifications associated with an increased risk of metastasis.In part, the therapies applied deviated markedly from the S3 guideline. This demonstrates an evident and significant need for additional training.These findings underscore the high value of national registry data for assessing real-world oncological care in uro-oncology. Moreover, they provide a robust foundation for future quality assurance initiatives and the design of clinical studies.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"275-283"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589412","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":"Vesikovaginale Fisteln: transperitonealer Zugang.","authors":"Isabelle-Joy Lang, Luis A Kluth, Margit Fisch","doi":"10.1055/a-2743-7066","DOIUrl":"https://doi.org/10.1055/a-2743-7066","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 3","pages":"310-318"},"PeriodicalIF":0.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148097","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-2785-0920","DOIUrl":"https://doi.org/10.1055/a-2785-0920","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 3","pages":"238-240"},"PeriodicalIF":0.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148084","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: Stockholm3-Test detektiert klinisch signifikante Tumore.","authors":"","doi":"10.1055/a-2642-4687","DOIUrl":"https://doi.org/10.1055/a-2642-4687","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 3","pages":"236-238"},"PeriodicalIF":0.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148150","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}