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1.
Urologe A ; 58(12): 1499-1510, 2019 Dec.
Artículo en Alemán | MEDLINE | ID: mdl-31741003

RESUMEN

The use of multiparametric magnetic resonance imaging (mpMRI) is becoming increasingly more important for the primary diagnostics of prostate cancer (PCa) and for monitoring under active surveillance. Current studies confirmed that the use of mpMRI can increase the detection of clinically significant PCa and reduce the detection rate of insignificant PCa as well as the rate of unnecessary biopsies. The information from mpMRI can be cognitively used for in-bore biopsy and using fusion biopsy systems. There are no clear recommendations on the access approach for fusion biopsy (e. g. transrectal or perineal), whereby higher rates of rectal bleeding and infections have been described for transrectal access compared to perineal access. The increasing rate of antibiotic resistance as well as restricted indications for the use of quinolones are a major challenge for transrectal biopsy.


Asunto(s)
Biopsia Guiada por Imagen , Neoplasias de la Próstata , Humanos , Imagen por Resonancia Magnética , Masculino , Estudios Prospectivos , Neoplasias de la Próstata/diagnóstico por imagen
3.
Urologe A ; 54(3): 378-84, 2015 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-25234950

RESUMEN

Condyloma acuminata are the most frequent cause of infections in the anal genital area. They are caused by the human papilloma virus (HPV). Risk factors are early onset of sexual activity, multiple sexual partners, a history of sexually transmitted disease, and immunosuppression. The urethra is afflicted in only 20% of cases; of these, 80% of the warts are at the meatus and 20% in the proximal urethra. This article reports on two cases with condyloma acuminata affection of the total urethra. The current diagnostic, different treatment modalities, and prophylaxis are reviewed.


Asunto(s)
Antivirales/uso terapéutico , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/tratamiento farmacológico , Enfermedades Uretrales/diagnóstico , Enfermedades Uretrales/tratamiento farmacológico , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Resultado del Tratamiento
4.
Urologe A ; 54(9): 1277-82, 2015 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-26223953

RESUMEN

BACKGROUND: Following its introduction in the 1980s extracorporeal shock wave lithotripsy (SWL) became the gold standard for therapy of ureteral and renal calculi. The research data published during the last decade suggest a paradigm shift to endourological techniques. OBJECTIVES: The purpose of this study was to compare whether the suggested loss of status for SWL corresponds with actual real-life treatment in Germany. A further aim was to assess the quality of SWL therapy in German hospitals. MATERIALS AND METHODS: The board of the German Society for Shock Wave Lithotripsy (DGSWL) sent a questionnaire to 306 urological departments in Germany, which encompassed medical, technical and organizational topics in the therapy of ureteral and renal calculi. A total of 99 (33%) questionnaires were returned. CONCLUSION: With the exception of a few departments, non-invasive SWL still plays a major role in the treatment of urolithiasis and a loss of the gold standard status is not in sight. The performance of SWL in German hospitals is carried out at a high level of quality. To maintain and optimize this status a structured SWL training and adherence to clinical practice guidelines are needed.


Asunto(s)
Encuestas de Atención de la Salud , Litotricia/estadística & datos numéricos , Litotricia/normas , Pautas de la Práctica en Medicina/estadística & datos numéricos , Urolitiasis/epidemiología , Urolitiasis/terapia , Alemania/epidemiología , Adhesión a Directriz/estadística & datos numéricos , Humanos , Pautas de la Práctica en Medicina/normas , Pautas de la Práctica en Medicina/tendencias
5.
Aktuelle Urol ; 44(5): 383-95; quiz 396-7, 2013 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-24043538

RESUMEN

In liability law, a medical review is considered to be an expert opinion that is provided at the request of those involved (patient or physician) of a course of treatment. It must be carried out according to defined criteria with the aim of providing a plausible basis for arbitration. This is achieved by means of an objective determination of the facts, a reasonable assessment of the error(s) and (where appropriate) a realistic description of the injury involved. The following fields should be covered in a concise review: conditions and procedures applied to the review, criteria to be used in the review, types of error that are possible during the treatment, assessment of the treatment errors committed, possible treatment errors that can occur in urology, conclusions to be drawn from the review. In summary, a medical assessment carried out in the course of claims for damages should provide a balanced assessment that takes into account the confidential relationship between the physician and patient. This means that the review procedure must be performed under the best possible conditions for professional standards and care.


Asunto(s)
Testimonio de Experto/legislación & jurisprudencia , Mala Praxis/legislación & jurisprudencia , Urología/legislación & jurisprudencia , Adolescente , Anciano , Compensación y Reparación/legislación & jurisprudencia , Confidencialidad/legislación & jurisprudencia , Errores Diagnósticos/legislación & jurisprudencia , Resultado Fatal , Femenino , Alemania , Adhesión a Directriz , Humanos , Masculino , Errores Médicos/legislación & jurisprudencia , Persona de Mediana Edad
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