M Goepel

Johannes Gutenberg-Universität Mainz, Mayence, Rheinland-Pfalz, Germany

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Publications (195)303.66 Total impact

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    ABSTRACT: Bei den meisten Erkrankungen spielt die Zeit eine wichtige Rolle. So ist es auch bei der Meningomyelozele — genauer gesagt bei der Blasenfunktionsstörung, die sie auslösen kann. Deren Typ kann sich im Laufe der Zeit ändern. Das beeinflusst den Zeitpunkt diagnostischer und therapeutischer Maßnahmen.
    No preview · Article · Dec 2015
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    ABSTRACT: In prostate centers of the Governing Body of German Prostate Centers (DVPZ, Dachverband der Prostatazentren Deutschlands e.V.) treatment data from 3 university clinics, 21 treatment clinics, 3 private clinics and 330 general practitioners incorporated under 22 certificates are collated, in order to document the quality and type of cross-sectoral and interdisciplinary treatment, in particular of prostate cancer (PCA) patients. This analysis is based on the DVPZ UroCloud data sets from 20 July 2015. The UroCloud reflects the web-based chronological disease development and quality parameters. For the descriptive analysis of particular key figures, available complete data sets were selected. Of the centers 22 held a valid certificate and fulfilled all required case numbers and structural prerequisites at the primary certification or recertification. In three cases a reauditing led to requirements before certification. Since 2005 a total of 9650 PCA patients have been pseudonymized and followed up (41,247 follow-up forms, 4.3 forms per patient). In 2014 the median number of newly documented PCA patients was 61 per center (minimum 7 and maximum 295). Radical prostatectomy (RP) dominated with 4491 (56 %) cases followed by primary hormonal therapy (1210 cases, 15 %), irradiation (809, 10 %) and non-interventional therapy, such as active surveillance (AS) or watchful waiting (WW) in 760 cases (10 %). A prostate-specific antigen (PSA) reduction was documented in 50 % of the patients with a preoperative PSA value > 20, in 60 % of pT4 tumors and in 50 % of patients with a tumor Gleason score of 9-10. A positive incision margin (R+) was found in in 15 % of pT2 stages, 41 % of pT3 stages and 85 % of pT4 stages. A secondary intervention was documented in 6.5 % of RP. The DVPZ certificate reflects the complete spectrum of treatment of PCA patients. The strength of the certificate lies in the documentation of patient development and a simultaneous collation of quality parameters.
    No preview · Article · Oct 2015 · Der Urologe
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    ABSTRACT: The treatment of children and adolescents with meningomyelocele has experienced a clear change in the last 30 years. The establishment of pharmacotherapy, clean intermittent catheterization (CIC) and infection prophylaxis have improved the prognosis for patients and have led to new therapeutic strategies. The interdisciplinary cooperation between neonatologists, neurosurgeons, pediatric neurologists, pediatric urologists, pediatric nephrologists, pediatric orthopedists and pediatric surgeons leads to optimization of individualized therapy. These guidelines present definitions and classifications, investigations and timing which are described in detail. The conservative and operative therapy options for neurogenic bladder function disorders are described and discussed with reference to the current literature. The brief overview provides in each case assistance for the treating physician in the care of this patient group and facilitates the interdisciplinary cooperation.
    No preview · Article · Feb 2015 · Der Urologe
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    ABSTRACT: Die α1-Blocker haben sich als medikamentöse BPH-Therapie etabliert. Vier Präparate sind für diese Therapieindikation in Deutschland zugelassen: Alfuzosin, Doxazosin, Terazosin und Tamsulosin, wobei Doxazosin und Terazosin auch für die Behandlung der arteriellen Hypertonie eingesetzt werden können.Tamsulosin zeichnete sich in placebo-kontrollierten Doppelblindstudien neben der ebenfalls guten Wirkung auf die symptomatische BPH besonders durch seine Verträglichkeit aus. Gegenüber Placebo zeigten sich in solchen Studien keine erhöhten Nebenwirkungsraten. Von anderen a-Blockern ist aber bekannt, daß ihre Verträglichkeit insbesondere bei bestehenden Begleiterkrankungen oder antihypertensiver Komedikation eingeschränkt sein kann.
    No preview · Article · Dec 2014 · Der Urologe B

  • No preview · Dataset · Mar 2014

  • No preview · Dataset · Dec 2013
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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.
    No preview · Article · Mar 2013 · Der Urologe
  • B Brehmer · R Berges · T Ebert · M Goepel · A Heidenreich
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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.
    No preview · Article · Feb 2013 · Der Urologe
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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.
    Full-text · Article · Jan 2013 · Der Urologe
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    M Goepel

    Preview · Article · Nov 2012 · Der Urologe
  • R Tunder · M Goepel

    No preview · Article · Dec 2011 · Der Urologe
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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.
    Preview · Article · Nov 2011 · Health and Quality of Life Outcomes
  • 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
    No preview · Article · Sep 2011 · Der Urologe
  • 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.
    No preview · Article · Sep 2011 · Der Urologe
  • 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.
    No preview · Article · Jul 2011 · Der Urologe
  • 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.
    No preview · Article · Jun 2011 · Der Urologe
  • I. Rübben · M. Goepel · J. D. van Gool
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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.
    No preview · Article · May 2011 · Der Urologe
  • 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.
    No preview · Article · May 2011 · Der Urologe
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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.
    Full-text · Article · Jul 2010 · Deutsches Ärzteblatt International
  • 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
    No preview · Article · Apr 2010 · Der Urologe

Publication Stats

2k Citations
303.66 Total Impact Points

Institutions

  • 2006-2015
    • Johannes Gutenberg-Universität Mainz
      • • Abteilung Kinderurologie
      • • Department of Urology
      Mayence, Rheinland-Pfalz, 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
  • 2013
    • University Hospital RWTH Aachen
      Aachen, North Rhine-Westphalia, Germany
  • 1991-2011
    • University of Duisburg-Essen
      • Department of Internal and Integrative Medicine
      Essen, North Rhine-Westphalia, Germany
  • 2003
    • University of Amsterdam
      Amsterdamo, North Holland, Netherlands
  • 1991-2001
    • University Hospital Essen
      • Clinic for Urology
      Essen, North Rhine-Westphalia, Germany
  • 1999
    • Berufsgenossenschaftliche Unfallklinik Murnau
      Murnau, Bavaria, Germany
  • 1998
    • University of Turku
      Turku, Province of Western Finland, Finland