Aktuelle Urologie

Publisher: Thieme Publishing

Description

  • Impact factor
    0.47
  • 5-year impact
    0.30
  • Cited half-life
    5.40
  • Immediacy index
    0.09
  • Eigenfactor
    0.00
  • Article influence
    0.05
  • ISSN
    1438-8820
  • OCLC
    231865149
  • Material type
    Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Thieme Publishing

  • Pre-print
    • Author cannot archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Authors and Publishers version on author's personal web site
    • Institutional Repository (including PubMed Central) after 12 months
    • Publisher's version/PDF cannot be used
    • Publisher copyright and source must be acknowledged
    • Link to Publisher version (www.thieme-connect.com) must be included if article has been published online
  • Classification
    ​ blue

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Retropubic tumours without contact to bones or surrounding tissues are extremely rare with only 22 cases being reported in the literature. The majority of tumours described within these reports are osteochondromas in 17 cases, 2 cases of leiomyoma and one case of each fibroma, fibrosarcoma and nodular fasciitis. We now report the case of a 52-year-old-man with a retropubic ganglion cyst, which was resected "in toto" by laparoscopy.
    Aktuelle Urologie 08/2014;
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    ABSTRACT: The scrotal leiomyoma is a rare benign tumour, deriving from the smooth muscle. This tumour entity constitutes a differential diagnosis to malignant testicular tumours. Up to now, only 8 cases have been reported in the literature. We report on a 63-year-old European patient, presenting in our clinic for further treatment with a now monstrous mass of the left testis (about 8 kg) that has been growing for about 30 years, After partial scrotalectomy and orchiectomy pathological analysis confirmed a left-sided leiomyoma of the testicular/paratestical tissue. This case shows that even rare tumours should be included in the differential diagnosis of a testicular tumour.
    Aktuelle Urologie 07/2014; 45(4):293-295.
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    ABSTRACT: The prognosis of advanced penile carcinomas is extremely poor. Low numbers of available studies on chemotherapy over a long time, decentralized treatment as well as rareness of disease have not improved the prognosis. This article focuses on important clinical trials and developments for chemotherapy in penile cancer. Considering the latest study data there is a strong recommendation for multimodal approaches, including lymph node dissection and perioperative treatments with cisplatin/taxane-based chemotherapy. A systematic, centralized registration and evaluation by the "Rostocker-AUO-Register" for penile cancer should improve conditions for affected patients. Furthermore, molecular targeted therapy might be a promising therapeutic option but until now only very few case reports have been published. Further prospective clinical trials are necessary to establish these agents in the therapeutic landscape of penile cancer. Decision for palliative chemotherapy in advanced penile cancer should be well considered and depends on the patient's age and general condition particularly regarding possible adverse events of chemotherapy. Notably, best supportive care might be an important alternative for some patients and should be taken in consideration.
    Aktuelle Urologie 07/2014; 45(4):286-292.
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    ABSTRACT: Through the last decade considerations on the role of vitamins and antioxidants in the primary prevention of genitourinary tumors have changed dramatically. In spite of all efforts, the efficacy of a specific compound has not been proven so far. In consequence, recommendations to use vitamins or other supplements for the primary prevention of urological tumors should be avoided. However, there is some evidence that moderate food consumption, reduction of dairy products and an Asian or Mediterranean diet may not only prevent prostate cancer (PCA) but also harbour additional beneficial effects on general health. Although quantification of these findings may be difficult, it becomes evident that these measures will have additional synergistic effects on cardiovascular diseases. Considering the large number of PCA patients dying not cancer-related but from concomitant diseases, primary prevention in particular of PCA should always also consider the general health of the target population. More recent studies suggest a potential effect of nutritional compounds on biochemical tumour recurrence in PCA patients after definite therapy. These observations may serve as a starting point for validation within controlled clinical trials.
    Aktuelle Urologie 07/2014; 45(4):281-285.
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    ABSTRACT: The aim of this study is the construction of a questionnaire which determines uro-oncological patients' attitudes to their own bodies. The questionnaire will be tested by means of psychometric criteria for suitability. In this way, the emotional-affective and perceptual--cognitive characteristics of the body concept will be detected more effectively.For the construction, 12 interviews with patients were conducted and items from four body concept questionnaires were analysed. Subsequently, a draft version, containing 133 items, was written. A total of 305 participants (PCa n=205; healthy n=100) were questioned in 2 studies. Thereafter the suitability of the items could be checked by psychometric and factor analytical criteria.The psychometric testing of the statements led to a selection of the items. 40 items could be established as applicable and were therefore accepted for the final questionnaire.The indentified scales show good psychometric characteristics and also differentiate between the healthy and the clinical samples. Preliminary analyses prove the validity of the scales, although this should be subjected to further testing for assurance.
    Aktuelle Urologie 05/2014;
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    ABSTRACT: Prostate cancer is the most common malignancy in men, but only about 10% of patients die from that cancer. Recent studies suggest that not all patients benefit from a radical therapeutic approach. When prostate cancer is suspected, magnetic resonance imaging (MRI) can make an important contribution to cancer localization within the prostate. Many studies show that T2-weighted morphologic imaging should be supplemented by multiparametric MRI techniques including diffusion-weighted imaging, contrast-enhanced sequences, and MR spectroscopy. This approach detects aggressive prostate cancer with high sensitivity and specificity. The findings of multiparametric MRI additionally contribute information to the assessment of cancer aggressiveness. The use of these multiparametric MRI techniques will gain an increasing role in the clinical management of prostate cancer patients. They can help in establishing a definitive diagnosis with a minimum of invasiveness and may also contribute to optimal individualized treatment. This review article presents the different techniques of multiparametric MRI and discusses their contribution to the detection of prostate cancer. Moreover, this review outlines an objective approach to image interpretation and structured reporting of MRI findings using the PI-RADS criteria. The review concludes with an outline of approaches to prostate biopsy on the basis of MRI (transrectal ultrasound, direct MRI guidance of tissue sampling, and MRI-ultrasound fusion biopsy) and emerging future uses of MRI in the planning of focal treatment options and in the active surveillance of patients diagnosed with prostate cancer.
    Aktuelle Urologie 03/2014; 45(2):119-126.
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    ABSTRACT: A 48-year-old male presented with para-aortic lymph node metastases after surgical resection of a clear cell renal cell carcinoma. After first-line treatment with interferon alpha-2b, he was started on pazopanib and lapatinib. Blood pressure was well controlled with temocapril and amlodipine. Treatment had to be stopped 4 years and 8 months after initiation due to overt proteinuria. Then, sunitinib was started as third-line treatment. During the second cycle of sunitinib, he died due to a Stanford type A aortic dissection. Acute aortic dissection could be an adverse event associated with the long-term use of antiangiogenic tyrosine kinase inhibitors.
    Aktuelle Urologie 03/2014; 45(2):132-134.
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    ABSTRACT: Urinary tract infections (UTI) are amongst the most frequent bacterial infections and therefore responsible for a great amount of antibiotic administration. UTI may present as benign, uncomplicated cystitis or severe, life-threatening urosepsis. Due to the heterogeneity of UTI the European Section of Infections in Urology (ESIU) has introduced a phenotypical classification, based upon the clinical presentation, the risk factors and the antibiotic susceptibility of the causative pathogens. Antibiotic treatment of the UTI varies accordingly. In uncomplicated cystitis antibiotics with low potential for collateral damage are recommended, which are mainly indicated for these infections. In uncomplicated pyelonephritis fluoroquinolones and 3rd generation cephalosporines are recommended. Antibiotic treatment regimens of complicated UTI depend very much on the antibiotic susceptibility according to regional resistance statistics. In urosepsis an early diagnosis and therapy is mandatory. In this regard a procalcitonin level > 0.25 µg/l has a good sensitivity and acceptable specificity in predicting bacteremia. Apart from the early antibiotic therapy successful decompression of the obstructed urinary tract is a predictor of survival. In children UTI are also amongst the most important bacterial infections, although symptoms are frequently not characteristic. The correct sampling of urine for microbiological investigations is critical. Due to the increasing fluoroquinolone resistance, infectious complications after transrectal prostate biopsy are becoming more frequent. Strategies to decrease complications encompass, amongst others, microbiological screening of the faecal flora for fluoroquinolone resistance, administration of alternative antibiotics for prophylaxis and alternative techniques for biopsy, such as perineal prostate biopsy.
    Aktuelle Urologie 03/2014; 45(2):135-46.
  • Aktuelle Urologie 03/2014; 45(2):147-59.
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    ABSTRACT: Since the introduction of the percutanous nephrolitholapaxy (PNL), the instruments as well as the technique have experienced a tremendous modification. The miniaturisation of the instruments has led to a decreased hospital stay, reduced analgetic use as well as an extension of the indication for PNL. A nephrostomy tube was normally inserted to prevent urinoma and to provoke renal haemostasis. In 1997, the necessity for the regular use of a nephrostomy tube was first questioned. In a prospective study, the nephrostomy tube was successfully omitted in 50 selected patients. Since then, increasingly, the nephrostomy tube is omitted. Alternatively, different haemostatic substances are used for renal tract closure. The necessity for the use of these agents is still unclear.
    Aktuelle Urologie 02/2014;
  • Aktuelle Urologie 01/2014; 45(1):67-80.
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    ABSTRACT: Uterovesical fistulas are a rare cause of urinary incontinence. They are most frequently caused by repeated Caesarean sections and generally have to be closed by a transperitoneal approach in an interdisciplinary setting not only to regain continence but also to prevent infertility.
    Aktuelle Urologie 01/2014; 45(1):48-9.
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    ABSTRACT: Adequate and successful treatment of Hb-relevant macrohaematuria in bladder cancer pa-tients is a frequent problem in clinical routine. It is often not easy to identify a good treatment option for inoperable older patients. A possible option is transcatheter-based arterial embolisation of the vesical artery. Unfortunately there are only few publications about this procedure; a detailed analysis of bladder embolisation is difficult to find in the literature.Our report illustrates the embolisation of the vesical artery in an 84-year-old patient with bladder cancer with an Hb-relevant, transurethral non-curable macrohaematuria. Massive necrosis of the M. gluteus maximus developed after embolisation of the vesical artery. During the ensuing surgery, the entire musculature of the gluteal region was removed, and the N. ischiadicus was cut. The patient was supervised first in the intensive care and then in the palliative care ward. The patient's prognosis is unfavourable due to the localisation and size of the wound and consecutive life-long immobility. Embolisation of the vesical artery is a viable procedure, but only if alterna-tive therapeutic strategies are impossible. It should only be performed by an experienced radiologist and it is strongly recommended not to apply liquid embolisation agents. Inadequate embolisation of the vesical artery can lead to extensive necrosis. Radiological diagnostics help to identify the margins of the necrotic region. During the intervention, maximum attention should be paid to saving the entirety of N. ischiadicus, especially in patients with large necrotic areas.
    Aktuelle Urologie 01/2014; 45(1):50-3.
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    ABSTRACT: What is new in urooncology in the year 2013? This review gives a brief but comprehensive overview of new developments in diagnosis and treatment of localized as well as advanced prostate, bladder and kidney cancer which have been presented on the occasion of the annual meetings of the European and American urologic and oncological associations in 2013. Attention is particularly directed to those data and results from trials which might be of direct or indirect clinical relevance.
    Aktuelle Urologie 01/2014; 45(1):21-32.
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    ABSTRACT: Medical treatment of advanced urothelial carcinoma of the bladder consists of perioperative treatments as well as palliative chemotherapy in advanced stages. This article focuses on important clinical trials and developments of the last two years, with a review of literature and proceedings of the relevant meetings (ASCO, GU-ASCO, EAU, AUA). The general benefit of perioperative chemotherapy is confirmed. Chemotherapy with Gemcitabin/Cisplatin remains the therapy of choice in the palliative setting. So far, targeted therapies did not show convincing results.
    Aktuelle Urologie 01/2014; 45(1):55-65.
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    ABSTRACT: To investigate stoma-related complications in ileal conduits we present a series of 4 patients in whom we performed a transposition of the conduit to the contralateral side as a surgical solution for large parastomal hernias.4 patients presented between 1998 and 2009 with large parastomal hernias, all in the right hemi-abdomen. A transposition to the contralateral side was carried out.The postoperative course was uneventful in all patients. After a median follow-up of 30 months all patients were free of complaints regarding the new stoma site. No patient presented with peristomal ulcerations or a recurrent hernia during the entire time of follow-up.The transposition of an existing conduit and the creation of a new contralateral ostomy site is an effective solution for patients suffering from severe local ostomy complications that are not manageable otherwise.
    Aktuelle Urologie 12/2013;
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    ABSTRACT: Cryptorchidism, or undescended testis (UDT), occurs in 1-3% of male term infant births. At least two-thirds of UDTs will descend spontaneously, typically during the first 6 months of life. UDTs are associated with loss of spermatogenic potential and testicular malignancy in the long term. Orchiopexy performed prior to puberty may significantly reduce the malignant potential by up to 4-fold. Neoadjuvant hormonal therapy starting at 6 months of life has been shown to potentially improve the testicle's fertility index and should be part of the therapeutic concept. However, the use of hormonal treatment and HCG beyond the first year of life is to be challenged given a potentially negative impact on testicular function. Laparoscopic exploration and therapy is the method of choice for non-palpable testes. Ideally, surgical repair of the UDT should be completed by the age of 1 year.
    Aktuelle Urologie 11/2013; 44(6):445-451.
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    ABSTRACT: C-reactive protein (CRP) is an unspecific marker of systemic inflammation. It is known to be elevated in autoimmune disease, traumata and malignancies. Increased CRP levels have specifically been shown to be associated with disease progression and prognosis in various studies on renal cell carcinoma and transitional cell carcinoma. Although CRP, unlike PSA, is neither organ-specific nor tumour-specific, studies were able to show that increased CRP values are an independent prognostic marker for tumour-specific survival of patients with prostate cancer. In metastatic and castration-resistant prostate cancer elevated CRP levels have been approved as a useful marker to estimate the extent of disease and mortality. CRP measurements in serum are standardised worldwide and widely used in daily clinical routine. However, until CRP can be firmly established as a prognostic marker in daily routine, we need validation of its prognostic and predictive value with large and preferably prospective multicentre studies.
    Aktuelle Urologie 11/2013; 44(6):452-455.
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    ABSTRACT: In elderly and multimorbid pa-tients urosepsis is a particularly serious condition with a high mortality. Whether a secondary therapy for an underlying stone disease after -initial sepsis treatment improves the prognosis of these patients has not been systematically investigated. We retrospectively reviewed the clinical course of elderly and multimorbid patients with urosepsis regarding the frequency of rhospitalisation and sepsis recurrence after initial and subsequent therapy.Patients with and without urolithiasis and urosepsis were compared. Inclusion criteria were multimorbidity, defined by an ASA score (≥2) or a Charlson score (≥3) and age (≥60 years), and general sepsis features. Both groups (patients with urolithiasis [U+] and patients without urolithiasis [U-]) did not differ in terms of demographic data. We investigated the influence of the primary sepsis therapy and secondary stone treatment on the incidence of rehospitalisation and sepsis recurrence rate.The incidence of rehospitalisation in stone patients (U+) with and without therapy did not differ (22.1% vs. 21%), while the occurrence of urosepsis was lower in treated patients (0% vs. 8.7%). Rehospitalisation in stone patients was generally less common than in patients without urolithiasis (U+ 21.6%, U- 44.4%). Recurrences of sepsis were higher in patients without stone disease (U+ 4.35%, U- 8.9%). If the subpopulation with successful stone therapy was extracted from the U+ group, the difference disappeared (U+ 8.7%, U- 8.9%).Stone treatment after initial urosepsis therapy reduces the incidence of recurrent sepsis (0% vs. 8.7%). Patients without underlying urolithiasis (U-) have a similar risk of sepsis recurrence as urolithiasis patients without secondary stone treatment. A complete stone clearance should be pursued in multimorbid or elderly patients with urosepsis to reduce secondary morbidity.
    Aktuelle Urologie 11/2013; 44(6):456-461.
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    ABSTRACT: Nocturia - waking up during the night due to the urge to urinate and empty the bladder - is a serious problem for affected patients. In the past decades, nocturia has been primarily regarded as an irritative symptom of benign prostate hyperplasia (BPH). This symptom is however frequently not influenced by different BPH treatments. In the last couple of years one has come to the conclusion that the prostate is less involved and in part responsible for the symptoms since women are also frequently affected. For these reasons nocturia is looked at differently. It is a highly prevalent symptom which neither qualitatively nor quantitative differs between men and women. Many factors lead to nocturia. The following diseases are involved: coronary heart disease, diabetes mellitus or insipidus, lower urinary tract symptoms (LUTS), states of anxiety or insomnia as well as behavioural and environmental factors. Nocturia can be categorised in nocturnal polyuria (overproduction of nightly urine) or a diminished bladder capacity or a combination of both. These entities can be easily differentiated by arithmetic analysis, e.g., a 48-hour voiding diary. Only recently nocturia has been classified according to the aetiology and pathogenesis, making a differentiated treatment possible. However, even in the cases in which the underlying cause cannot be found behavioural changes can help. Nevertheless, pharmacological treatments are inevitable. Medical treatments include: desmopressin, anticholinergics and antimuscarinics, general-medical measures like support stockings, different time for the intake of diuretics or in specific cases the nasal CPAP artificial respiration (continuous positive airway pressure). In spite of the partly high effectiveness of these measures, treatment should be customised taking possible side effects in account.
    Aktuelle Urologie 11/2013; 44(6):465-76.

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