M Goepel

Klinik Hirslanden, Zürich, Zurich, Switzerland

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Publications (174)276.85 Total impact

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    ABSTRACT: Zur Zertifizierung eines Prostatazentrums nach den Richtlinien des DVPZ e.V. (Dachverband Prostatazentren) ist ein Zusammenschluss von mindestens 5 niedergelassenen Urologen mit einer urologischen Hauptabteilung einer Klinik, sowie weiteren Kooperationspartnern für die interdisziplinäre Betrachtung des Prostatakarzinoms erforderlich. Das DVPZ-Zertifikat umfasst neben dem Prostatakarzinom auch das benigne Prostatasyndrom (BPS) und die Prostatitis – es handelt sich somit um ein echtes Organzertifikat im urologischen Sinn. Ziel des DVPZ-Zertifikates ist die integrierte interdisziplinäre und interinstitutionelle Versorgung von Patienten mit Prostataerkrankungen.
    Der Urologe 03/2013; 52(3). · 0.44 Impact Factor
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    ABSTRACT: For certification of a prostate center according to the guidelines of the Governing Body of Prostate Centers (DVPZ) an amalgamation of at least five practicing urologists with a main urology department of a hospital and further cooperation partners for the interdisciplinary approach to prostate cancer is necessary. The DVPZ certificate incorporates benign prostatic syndrome and prostatitis in addition to prostate cancer and is therefore a real organ certificate in the urological sense. The aim of the DVPZ certificate is the integrated, interdisciplinary and interinstitutional treatment of patients with diseases of the prostate.
    Der Urologe 02/2013; · 0.44 Impact Factor
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    ABSTRACT: Based on the measurement of simple physiological parameters urodynamic testing can reproduce clinical symptoms in a quantitative way, associates changes in physiological parameters to pathophysiological conditions and helps to establish a diagnosis in numerous lower urinary tract dysfunctions. Furthermore, urodynamic testing allows lower urinary tract dysfunctions to be classified as storage failure, voiding failure or combined storage and voiding failure. Therapeutic decision-making is based on this classification.
    Der Urologe 01/2013; · 0.44 Impact Factor
  • M Goepel
    Der Urologe 11/2012; 51(11):1507-1508. · 0.44 Impact Factor
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    ABSTRACT: Patients with newly diagnosed early stage prostate cancer (PCa) face a difficult choice of different treatment options with curative intention. They must consider both goals of optimising quantity and quality of life. The quality of life (QoL) is a psychometric outcome which is measured using validated questionnaires. Only few data are published concerning pre - and postoperative QoL. This study investigated pre perative QoL of 185 patients who consecutively underwent open radical retropubic prostatectomy for organ-confined PCa to postoperative QoL of another 185 patients. The EORTC QLQ-C30, EORTC QLQPR25 module and 24 h ICS pad test were used (mean follow-up 28.6 months). The examined symptom scores of the EORTC QLQ-PR25 were on lowest level. In the dyspnoea symptom score differences of age emerged: the amount of patients who are short of breath rose significantly in older patients after surgery (p < 0.05 paired, two-tailed student's t-test).. Lastly, the urinary symptom score was found postal-therapeutically low; this fact was age independent. The results of sexual symptom score need to be taken into consideration, since prostatectomy resulted in a significant reduction of sexual activity independent of age. All functioning scales postoperatively reached high values without significant changes (p > 0.05 student's t-test ), which implies a high QoL after surgery. A reliable and satisfying status of continence was found in our patients after retropubic prostatectomy. A high rate of patients (89.2%) would choose retropubic prostatectomy again. Retropubic prostatectomy represents a reliable and accepted procedure in the treatment of organ-confined PCa. For the first time it could be shown that patients` QoL remained on a high level after retropubic prostatectomy. Nevertheless, the primary avoidance or postoperative therapy of erectile dysfunction should be in the focus of surgeons.
    Health and Quality of Life Outcomes 11/2011; 9:93. · 2.10 Impact Factor
  • R Stein, A Schröder, M Goepel
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    ABSTRACT: Evidence-based medicine is established by conducting high-quality, well-structured, and ideally prospective randomized trials. The initiation and performance of such studies pose a challenge to pediatric urology. Several randomized studies on vesicoureteral reflux, stone treatment, and urinary incontinence in childhood have been published in recent years. In addition, relevant guidelines on the topic of vesicoureteral reflux and phimosis were issued. Comprehensive up-to-date data are also available on undescended testicles and correction of hypospadias from which a recommended course of action can be derived.
    Der Urologe 09/2011; 50 Suppl 1:201-7. · 0.44 Impact Factor
  • R. Stein, A. Schröder, M. Goepel
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    ABSTRACT: Die evidenzbasierte Medizin basiert auf der Durchführung qualitativ hochwertiger, strukturierter und idealerweise prospektiv-randomisierter Studien. Diese zu initiieren und durchzuführen stellt eine Herausforderung in der Kinderurologie dar. In letzter Zeit wurden mehrere randomisierte Studien zum vesikoureteralen Reflux, der Steintherapie und der Harninkontinenz im Kindesalter publiziert. Zudem wurden aktuelle Leitlinien zum Thema vesikoureteraler Reflux und Phimose veröffentlicht. Ausführliche aktuelle Daten bestehen auch zu Hodenhochstand und Hypospadiekorrektur. Hieraus können aktuelle Handlungsempfehlungen abgeleitet werden. Evidence-based medicine is established by conducting high-quality, well-structured, and ideally prospective randomized trials. The initiation and performance of such studies pose a challenge to pediatric urology. Several randomized studies on vesicoureteral reflux, stone treatment, and urinary incontinence in childhood have been published in recent years. In addition, relevant guidelines on the topic of vesicoureteral reflux and phimosis were issued. Comprehensive up-to-date data are also available on undescended testicles and correction of hypospadias from which a recommended course of action can be derived. SchlüsselwörterEvidenzbasierte Medizin–Vesikoureteraler Reflux–Steintherapie–Harninkontinenz–Phimose KeywordsEvidence-based medicine–Vesicoureteral reflux–Stone treatment–Urinary incontinence–Phimosis
    Der Urologe 09/2011; 50:201-207. · 0.44 Impact Factor
  • M. Goepel, D. Schultz-Lampel
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    ABSTRACT: Zusammenfassung Die überaktive Blase (OAB) wird symptomatisch durch imperativen Harndrang mit oder ohne Dranginkontinenz, Pollakisurie und Nykturie bestimmt. Diagnostisch stehen zunächst nicht oder wenig invasive Verfahren im Vordergrund. In der Therapie führen die oralen antimuskarinisch wirksamen Pharmaka wie Darifenacin, Fesoterodin Oxybutynin, Propiverin, Solifenacin, Tolterodin, Trospiumchlorid. Erst nach erfolgloser Anwendung mehrerer Substanzen kann eine minimal-invasive Therapie mit „electomotive drug administration“ (EMDA-Therapie) oder Botulinumtoxin intramural erwogen werden. Der vorgelegte Reviewartikel gibt einen Überblick über die vorliegende Studienlage und stellt verschiedene Substanzen und Therapieverfahren im Head-to-head-Vergleich vor.
    Der Urologe 07/2011; 50(7):802-805. · 0.44 Impact Factor
  • M Goepel, D Schultz-Lampel
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    ABSTRACT: Overactive-bladder syndrome is characterized by the symptoms pollakisuria, nocturia and urgency with and without urge incontinence. The primary diagnostic procedure includes noninvasive or minimally invasive techniques. Antimuscarinic drugs lead within the therapeutic cascade. Only after unsuccessful use of several antimuscarinics should further treatment options such as electromotive drug administration or infiltration of the detrusor muscle with botulinum toxin A be discussed. The presented review article tries to give an overview by including the existing head-to-head-studies in this field.
    Der Urologe 06/2011; 50(7):802-5. · 0.44 Impact Factor
  • I Rübben, M Goepel, J D van Gool
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    ABSTRACT: Various types of bladder dysfunction are associated with urinary tract infection, renal damage and vesicoureteral reflux (VUR). In this article the influence of functional bladder disturbances such as detrusor instability (overactive bladder, OAB) and bladder sphincter dyssynergia (dysfunctional voiding), on the resolution of vesicoureteral reflux are reviewed. In summary, it is important to distinguish between children with dysfunctional voiding (increased activity of the pelvic floor during voiding) and those with OAB (detrusor overactivity during filling) because the latter has less effects on VUR.
    Der Urologe 05/2011; 50(5):551-6. · 0.44 Impact Factor
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    ABSTRACT: Zusammenfassung Blasenfunktionsstörungen begünstigen Harnwegsinfektionen, sind häufig assoziiert mit einem vesikoureteralen Reflux und begleitenden renalen Parenchymschäden. Die vorliegende Arbeit möchte einen Überblick geben, in welcher Weise Blasenfunktionsstörungen, differenziert in Störungen der Speicherphase (Drangsyndrom, OAB) und Störungen der Entleerungsphase (Detrusor-Sphinkter-Dyskoordination, dysfunktionelle Entleerung), die Refluxmaturationsrate beeinflussen. Zusammenfassend sollten Funktionsstörungen der Speicher- von Funktionsstörungen der Entleerungsphase unterschieden werden, da das OAB bezogen auf einen VUR eine günstigere Prognose hat.
    Der Urologe 05/2011; 50(5):551-556. · 0.44 Impact Factor
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    ABSTRACT: Urinary incontinence is a common and distressing complaint in the elderly. Its causes include structural changes in vesical muscle as well as impaired neural control and age-related changes of the lower urinary tract. Incontinence can also be a side effect of medication. The PubMed database was selectively searched for publications containing the terms "urinary incontinence" and "elderly." Studies with a high level of evidence were chosen as the main basis for this review. The individualized diagnostic evaluation of the incontinent elderly patient should generally be non-invasive. The evaluation may reveal urinary incontinence of several different types: stress incontinence, overactive bladder, and mixed incontinence. The treatment generally involves medication, such as anti-muscarinic agents, alpha-receptor blockers, and/or serotonin/noradrenalin reuptake inhibitors, combined with modifications of personal behavior, such as bladder training, altered fluid intake, and pelvic floor contraction. A number of minimally invasive surgical techniques can be useful for patients in operable condition, whenever such an operation seems reasonable in view of the patient's overall situation. Urinary incontinence in the elderly can be readily evaluated, and the currently available forms of treatment often bring satisfactory relief with an economical use of medical resources and with little or no additional discomfort for the patient.
    Deutsches Ärzteblatt International 07/2010; 107(30):531-6. · 3.61 Impact Factor
  • D. Betz, P. Bach, C. Gozzi, M. Goepel
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    ABSTRACT: Auch wenn der artifizielle Sphinkter nach wie vor das Standardverfahren in der operativen Therapie der männlichen Belastungsharninkontinenz darstellt, sind durch die Entwicklungen in den letzten Jahren zahlreiche Methoden eingeführt worden, die zunehmend minimal-invasiver werden und dabei akzeptable Ergebnisse erzielen. Die suburethralen Schlingenplastiken sind in die Leitlinien zur Behandlung der männlichen Belastungsharninkontinenz der EAU aufgenommen worden. Eine differenzierte Auswahl von Patient und Therapieverfahren bietet hierbei insgesamt die höchsten Chancen auf Erfolg. Neben den adjustierbaren komprimierenden Schlingen bietet die Advance®-Schlinge als nicht adjustierbare und nicht komprimierende Schlinge möglicherweise einen funktionalen Therapieansatz. Eine kritische Prüfung der verschiedenen Operationsmethoden bleibt essentiell und es fehlen prospektive Daten, die die einzelnen Methoden gegen einander randomisieren. Even though the artificial sphincter is still the treatment of choice in the surgical therapy of male stress urinary incontinence, recent developments have introduced numerous minimally invasive treatment options with acceptable clinical results. The male slings have been included into the EAU guidelines for treatment of male stress urinary incontinence. A distinct choice of patients and treatment options will lead to the highest chance of success. Besides the adjustable compressive slings, the non-adjustable and non-compressive AdVance® Sling offers a possible option for a functional approach to treatmentratio. A critical assessment of all these methods remains essential and prospective randomized trials are still missing. SchlüsselwörterInkontinenz des Mannes-Suburethrale Schlinge-Minimal-invasives Operationsverfahren-Artifizieller Sphinkter KeywordsMale stress urinary incontinence-Male sling-Minimally invasive treatment-Artificial sphincter
    Der Urologe 04/2010; 49(4):504-510. · 0.44 Impact Factor
  • D Betz, P Bach, C Gozzi, M Goepel
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    ABSTRACT: Even though the artificial sphincter is still the treatment of choice in the surgical therapy of male stress urinary incontinence, recent developments have introduced numerous minimally invasive treatment options with acceptable clinical results. The male slings have been included into the EAU guidelines for treatment of male stress urinary incontinence. A distinct choice of patients and treatment options will lead to the highest chance of success. Besides the adjustable compressive slings, the non-adjustable and non-compressive AdVance Sling offers a possible option for a functional approach to treatmentratio. A critical assessment of all these methods remains essential and prospective randomized trials are still missing.
    Der Urologe 03/2010; 49(4):504-10. · 0.44 Impact Factor
  • D. Betz, M. Goepel
    European Urology Supplements 09/2009; 8(8):620-620. · 3.37 Impact Factor
  • M Goepel, S Bross
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    ABSTRACT: Open Burch colposuspension has been the gold standard for many years in therapy for stress urinary incontinence and still has a major position in this field by virtue of its excellent long-term results. Tension-free transvaginal tapes nowadays also achieve the same success rates and replace the Burch operation due to less invasiveness of the procedure (1). Burch colposuspension is still used in cases of recurrence and as a combination procedure for stress urinary incontinence and vaginal prolapse. The laparoscopic Burch procedure has been increasingly performed in recent years.Fascial sling procedures are used primarily for recurrence of female stress urinary incontinence and intrinsic sphincter deficiency. The treatment principle is based on repositioning both the urethra when it has descended and the bladder neck as well as increasing the reduced outlet resistance. This approach is still employed today to treat stress urinary incontinence in women.
    Der Urologe 06/2009; 48(5):487-90. · 0.44 Impact Factor
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    M. Goepel, S. Bross
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    ABSTRACT: Die offene Kolposuspension nach Burch war über viele Jahre der Goldstandard der Inkontinenzoperationen bei Belastungsinkontinenz der Frau und besitzt auch heute noch einen festen Stellenwert in der operativen Therapie. Dies ist auf sehr gute Langzeitergebnisse mit Erfolgsraten um 80% zurückzuführen. Neuere Therapieverfahren wie die Implantation von spannungsfreien Bändern (TVT, TOT) haben inzwischen jedoch die gleichen Langzeitergebnisse erbracht. Aufgrund der geringeren Invasivität der Operationsmethode haben diese Techniken inzwischen an Bedeutung gewonnen und stellen eine neue Standardmethode bei weiblicher Belastungsinkontinenz ohne wesentlichen vaginalen Deszensus dar. Die Bedeutung der Burch-Kolposuspension liegt heute eher im Bereich der Rezidiveingriffe nach fehlgeschlagener Primäroperation und in Kombinationseingriffen bei Belastungsinkontinenz und gleichzeitigem Descensus vaginae. In den letzten Jahren wird die Burch-Operation auch vermehrt laparoskopisch durchgeführt. Die Faszienzügelplastik ist ein Operationsverfahren, welches hauptsächlich in Rezidivsituationen bei weiblicher Harninkontinenz und intrinsischer Sphinkterinsuffizienz eingesetzt wird. Das Therapieprinzip beruht auf einer Replatzierung der deszendierten Harnröhre und des Blasenhalses sowie einer Erhöhung des in dieser Situation erniedrigten Auslasswiderstands. Auch dieses Verfahren wird heute weiterhin zur Therapie der Belastungsinkontinenz der Frau eingesetzt. Open Burch colposuspension has been the gold standard for many years in therapy for stress urinary incontinence and still has a major position in this field by virtue of its excellent long-term results. Tension-free transvaginal tapes nowadays also achieve the same success rates and replace the Burch operation due to less invasiveness of the procedure (1). Burch colposuspension is still used in cases of recurrence and as a combination procedure for stress urinary incontinence and vaginal prolapse. The laparoscopic Burch procedure has been increasingly performed in recent years. Fascial sling procedures are used primarily for recurrence of female stress urinary incontinence and intrinsic sphincter deficiency. The treatment principle is based on repositioning both the urethra when it has descended and the bladder neck as well as increasing the reduced outlet resistance. This approach is still employed today to treat stress urinary incontinence in women.
    Der Urologe 05/2009; 48(5):487-490. · 0.44 Impact Factor
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    ABSTRACT: Electromotive drug-administration (EMDA) represents a minimal-invasive method of intravesical instillation of therapeutic agents. We examined the therapeutic effect of EMDA in patients suffering from therapy-resistant idiopathic detrusor overactivity (IDO) with respect to urodynamics, micturition charts and quality of life (Kings Health Questionnaire). Patients suffering from urge syndrome with and without urge incontinence and non-responding to oral anticholinergic drugs underwent EMDA therapy (2000 mg lidocaine-HCl 4% (50 ml), 2 mg epinephrine [1:1000] (2 ml), 40 mg dexamethason-21-dihydrogen phosphat (10 ml) in a total volume of 100 ml). Over a 27 months period, 84 patients (median age 63.1 years; 72 female, 12 male) with urge syndrome and urodynamically-proven idiopathic detrusor overactivity (IDO) were treated with EMDA. Following urodynamic measurements, quality of life (QoL) was evaluated using Kings Health Questionnaire (KHQ) and a micturition chart over 48 h, EMDA was performed once in four weeks for a period of three months. Patients continued to document drinking and micturition data during this time. Before each EMDA session urodynamic examination and KHQ were repeated. All treated patients suffered from urge syndrome (25.6% OAB wet, 20.0% OAB dry and 54.4% mixed urinary incontinence). Mean daytime frequency (DF) was 14.1 +/- 7.7 per day and nocturia (N) 5.1 +/- 5.1 per night before EMDA. After two EMDA sessions, daytime frequency (DF) decreased to 9.4 +/- 6.2 per day (P < 0.0001) and 2.5 +/- 2.4 per night (P = 0.035). The use of pads could be lowered from 4.5 +/- 4.1 per 24 h to 1.8 +/- 2.4 (P < 0.0074). The first desire to void volume (FDV) assessed by urodynamics started at 94.0 +/- 60.5 ml before treatment and changed to 142.2 +/- 79.6 ml (P = 0.0064) after two sessions. Strong desire to void volume (SDV) was noticed at 155.6 +/- 84.8 ml filling of the bladder; after two EMDA sessions at 199.5 +/- 97.3 ml (P = 0.001). Uninhibited detrusor contractions (UIC) were seen in all patients before treatment and were reduced to 46.4% after two EMDA sessions (P < 0.001). Maximal cystometric bladder capacity (MCBC) increased from 192.3 +/- 106.6 ml to 239.6 +/- 114.9 ml (P = 0.018). Patient-documented bladder capacity (BC) as micturition volume increased from 186.0 +/- 108.7 ml to 234.2 +/- 134.2 ml (P = 0.043). A reduction of impact of Quality of Life (QoL) was observed from 11.8 +/- 0.4 to 7.0 +/- 0.3 (P < 0.001) during treatment. A fraction of 53.6% (45/84) of all patients reported a completely withdrawal of symptoms and 28.6% (24/84) indicated a remarkable reduction. Only 10.7% (9/84) of patients did not continue therapy after two sessions. EMDA significantly improves urodynamic parameters, QoL and pad usages in patients with urge syndrome and therapy-resistant IDO. Therefore we offer EMDA therapy as an alternative treatment modality to the standard approaches.
    Neurourology and Urodynamics 03/2009; 28(3):209-13. · 2.67 Impact Factor

Publication Stats

1k Citations
276.85 Total Impact Points

Institutions

  • 2013
    • Klinik Hirslanden
      Zürich, Zurich, Switzerland
  • 2006–2011
    • Johannes Gutenberg-Universität Mainz
      • • Abteilung Kinderurologie
      • • Department of Urology
      Mainz, Rhineland-Palatinate, Germany
    • Klinikum Darmstadt
      Darmstadt, Hesse, Germany
    • Evangelisches Krankenhaus Oberhausen
      Oberhausen, North Rhine-Westphalia, Germany
    • University of Innsbruck
      Innsbruck, Tyrol, Austria
    • Ruhr-Universität Bochum
      Bochum, North Rhine-Westphalia, Germany
  • 1991–2011
    • University of Duisburg-Essen
      • Department of Internal and Integrative Medicine
      Essen, North Rhine-Westphalia, Germany
  • 1995–2008
    • University Hospital Essen
      • Clinic for Urology
      Essen, North Rhine-Westphalia, Germany
  • 2004
    • University of Amsterdam
      Amsterdamo, North Holland, Netherlands
  • 2000
    • The University of Sheffield
      • Department of Biomedical Science
      Sheffield, ENG, United Kingdom