Aktuelle Urologie最新文献

{"title":"Hodentorsion: Wie präzise ist die Ultraschalldiagnose?","authors":"","doi":"10.1055/a-2642-5058","DOIUrl":"https://doi.org/10.1055/a-2642-5058","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 2","pages":"140"},"PeriodicalIF":0.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637636","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":"Aufklärung und Informed Consent: Einfluss von Simulation und Multimedia.","authors":"","doi":"10.1055/a-2549-9012","DOIUrl":"https://doi.org/10.1055/a-2549-9012","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 2","pages":"148-149"},"PeriodicalIF":0.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637647","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-2749-9562","DOIUrl":"https://doi.org/10.1055/a-2749-9562","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 2","pages":"144-146"},"PeriodicalIF":0.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637705","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":"[Image-Guided Irreversible Electroporation for the Treatment of Localized Prostate Cancer].","authors":"Federico Collettini, Timo Alexander Auer, Carsten Stephan, Thomas Fischer, Bernhard Gebauer","doi":"10.1055/a-2821-6685","DOIUrl":"10.1055/a-2821-6685","url":null,"abstract":"<p><p>Focal treatment has emerged as a precision-oriented alternative to whole-gland treatment approaches for localized prostate cancer. It aims to selectively destroy clinically significant tumor foci while preserving surrounding structures that are essential for urinary continence and sexual function. Irreversible electroporation (IRE) is a relatively new and increasingly investigated focal treatment modality. By delivering short high-voltage pulses, IRE creates permanent nanopores in cell membranes and induces cell death predominantly through non-thermal mechanisms.This theoretical advantage - tissue ablation with relative preservation of the collagen-rich extracellular matrix - has heightened interest in IRE, particularly for tumors located near sensitive structures such as the neurovascular bundles, the urethral sphincter complex, and the rectal wall.In this review, we outline key procedural and technical aspects and summarize the clinical evidence for IRE in localized prostate cancer. Data from both prospective and retrospective case series demonstrate encouraging early and intermediate-term oncologic outcomes, although patterns of recurrence and the need for retreatment vary between cohorts and depend on the respective follow-up protocols. Functional outcomes are consistently excellent: continence is preserved in the vast majority of patients, and potency preservation is often high, typically ranging from approximately 75 to 95% among men who were potent prior to treatment.Despite these promising findings, widespread adoption in routine clinical practice is limited by the lack of robust long-term endpoints and the absence of randomized comparisons with established standards such as radical prostatectomy, radiotherapy, or risk-adapted active surveillance. While prospective comparative studies are highly challenging as they require large sample sizes, long follow-up periods, and careful endpoint definition, they are essential to clarify the role of irreversible electroporation within treatment algorithms, optimize patient selection, standardize follow-up and salvage strategies, and ultimately confirm durable tumor control with a sustained functional benefit.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 2","pages":"184-190"},"PeriodicalIF":0.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637485","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":"[Drug-Drug Interactions as a Challenge in the Monotherapy of Advanced or Metastatic Clear-Cell Renal Cell Carcinoma with VEGFR-Associated Tyrosine Kinase Inhibitors].","authors":"Hartmut Reinbold, Peter J Goebell, Axel S Merseburger","doi":"10.1055/a-2775-6922","DOIUrl":"https://doi.org/10.1055/a-2775-6922","url":null,"abstract":"<p><p>Vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) play a central role in the treatment of advanced or metastatic clear-cell renal cell carcinoma (mRCC) - either in combination therapy or, in selected cases, as monotherapy. However, due to their mechanisms of action, these therapeutic agents may induce typical adverse drug reactions (ADRs), commonly referred to as class effects. The use of multiple medications, particularly in older patients with comorbidities, can further increase the risk of ADRs through potential drug-drug interactions. Managing VEGFR-TKI-related adverse effects in the context of patient co-/multimorbidity and possible drug-drug interactions represents a substantial challenge for both clinicians and patients. This article provides practical recommendations for side-effect and medication management, with a particular focus on pharmacokinetic and pharmacodynamic drug-drug interactions. Tivozanib, a potent VEGFR-TKI, is well-suited and recommended as a first-line treatment option for mRCC due to its comparatively favorable safety profile and beneficial interaction potential.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123595","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":"Korporoplastik bei Induratio penis plastica.","authors":"Markus Giessing, Peter Albers","doi":"10.1055/a-2743-6553","DOIUrl":"https://doi.org/10.1055/a-2743-6553","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 1","pages":"114-121"},"PeriodicalIF":0.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206691","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":"[Therapy-Associated Neuroendocrine Prostate Cancer (tNEPC): A Diagnostic and Therapeutic Challenge in Uro-Oncology with Emerging Clinical Implications].","authors":"Gunhild von Amsberg, Arndt Hartmann, Markus Eckstein, Isabel Heidegger","doi":"10.1055/a-2768-8830","DOIUrl":"10.1055/a-2768-8830","url":null,"abstract":"<p><p>Therapy-associated neuroendocrine prostate cancer (tNEPC) is a rare, prognostically unfavourable variant of castration-resistant prostate cancer that typically arises under conditions of androgen deprivation or androgen receptor signalling inhibition. The underlying process of transdifferentiation is promoted by genetic alterations - most notably the loss of TP53, RB1, and PTEN - as well as epigenetic reprogramming and influences from the tumour microenvironment. Clinically, tNEPC is characterised by aggressive behaviour, the development of visceral and osteolytic metastases, lack of correlation between PSA levels and tumour burden, and PSMA-negative imaging findings. The updated German S3 guideline recommends histological re-biopsy in appropriate clinical scenarios.Histologically, tNEPC is categorised into three subtypes: small-cell neuroendocrine carcinoma (SCNEC), large-cell neuroendocrine carcinoma (LCNEC), and mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) with both neuroendocrine and adenocarcinomatous components. In its fifth edition, the WHO formally recognised tNEPC as a distinct pathological entity. Immunohistochemical diagnosis relies on the detection of markers such as synaptophysin, chromogranin A, CD56, and INSM1.In addition to histology, [¹⁸F]-FDG and DOTA-based PET/CT imaging modalities, as well as emerging liquid biopsy approaches (e.g., circulating tumour cells, cfDNA methylation), are increasingly relevant for diagnostic and disease-monitoring purposes. At present, platinum-based chemotherapy remains the standard treatment. Novel therapeutic approaches target molecular structures such as AURKA, EZH2, and DLL3. In selected cases, peptide receptor radionuclide therapy (PRRT) may be considered in patients with positive somatostatin receptor expression. Due to biological heterogeneity and limited evidence, tNEPC requires individualised, interdisciplinary management. This review summarises current insights into the pathogenesis, diagnosis, and therapeutic strategies of tNEPC and provides an outlook on future developments.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"78-87"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028050","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 des CRPC mit positivem PSMA PET CT.","authors":"","doi":"10.1055/a-2768-7852","DOIUrl":"https://doi.org/10.1055/a-2768-7852","url":null,"abstract":"","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":"57 1","pages":"24"},"PeriodicalIF":0.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206744","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":"[Molecular Tumour Boards for Urological Tumours: Hope or Disappointment?]","authors":"Nadine Therese Gaisa, Markus Eckstein, Jozefina Casuscelli, Charis Kalogirou, Stefanie Zschäbitz, Nicole Dörffer, Henning Reis","doi":"10.1055/a-2651-1738","DOIUrl":"10.1055/a-2651-1738","url":null,"abstract":"<p><p>In addition to the traditional, evidence-based, guideline-driven 'one-size-fits-all' treatment approach, personalised oncological therapy has been gaining increasing importance over the past decade. The central element in this process is a comprehensive molecular pathological analysis of the patient's tumour tissue, followed by interdisciplinary evaluation of the results and their translation into a patient-specific, therapeutic strategy within the framework of the molecular tumour board. These specialised molecular tumour boards are associated with substantial financial, time and personnel resources, as well as highly specialised expertise, and are therefore typically established only at university hospitals or major cancer centres. Despite the high prevalence of urological tumours, very few uro-oncological patient cases are discussed in the molecular tumour boards. In addition, the balance between the resources required and the benefits is often viewed critically. This review article aims to outline the target group, purpose, funding, and operational structure of molecular tumour boards in order to critically assess the situation and effectiveness in uro-oncology.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"96-101"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820287","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":"[Pathological Risk Stratification of Non-Muscle-Invasive and Muscle-Invasive Urothelial Carcinoma for Optimal Therapeutic Decision-Making].","authors":"Fabienne Lange, Nadine Therese Gaisa, Christian Bolenz, Niklas Klümper, Florian Roghmann, Markus Eckstein","doi":"10.1055/a-2714-2306","DOIUrl":"10.1055/a-2714-2306","url":null,"abstract":"<p><p>The treatment of urothelial carcinoma is undergoing rapid change. For both non-muscle-invasive urothelial carcinoma (NMIBC) and muscle-invasive urothelial carcinoma (MIBC), state-of-the-art substances are being tested in various therapy concepts to reduce the risk of recurrence and progression and to increase bladder preservation rates (particularly in muscle-invasive urothelial carcinoma and BCG-refractory high/very high-risk pT1 carcinoma). Antibody-drug conjugates such as enfortumab vedotin, as well as new immunotherapies, play a key role in this context. However, it remains controversial according to which criteria patients with NMIBC should undergo early cystectomy and patients with MIBC should receive bladder-preserving therapy. This paper attempts to discuss the current treatment standards in this controversial context and to address possible histopathological and molecular stratification tools that could improve or guide this selection in the future.</p>","PeriodicalId":7513,"journal":{"name":"Aktuelle Urologie","volume":" ","pages":"52-59"},"PeriodicalIF":0.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353383","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}