[Pain therapy in urology-overview of current S3 guideline recommendations]. / Schmerztherapie in der Urologie ­ Überblick zu aktuellen Empfehlungen der S3-Leitlinen.

Dealing efficiently with patients suffering from pain is a central medical task. Pain, as an important function in developmental physiology, warns against damage to the body caused by external noxious agents as well as internal malfunctions and requires special attention in modern medicine. Peri- and postoperative pain is known to have a negative influence on postoperative convalescence. Treatment of tumor-related pain represents another relevant challenge in uro-oncology and palliative medicine. The updated guideline on perioperative pain therapy and palliative medicine for patients with incurable diseases or cancer is dedicated to these two topics.

Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology.

BACKGROUND AND OBJECTIVE: Most patients with neurourological disorders require lifelong medical care. The European Association of Urology (EAU) regularly updates guidelines for diagnosis and treatment of these patients. The objective of this review is to provide a summary of the 2024 updated EAU guidelines on neurourology. METHODS: A structured literature review covering the timeframe 2021-2023 was conducted for the guideline update. A level of evidence and a strength rating were assigned for each recommendation on the basis of the literature data. KEY FINDINGS AND LIMITATIONS: Neurological conditions significantly affect urinary, sexual, and bowel function, and lifelong management is required for neurourological patients to maintain their quality of life and prevent urinary tract deterioration. Early diagnosis and effective treatment are key, and comprehensive clinical assessments, including urodynamics, are crucial. Management should be customised to individual needs and should involve a multidisciplinary approach and address sexuality and fertility. Lifelong monitoring and follow-up highlight the importance of continuous care for neurourological patients. CONCLUSIONS AND CLINICAL IMPLICATIONS: The 2024 EAU guidelines on neurourology provide an up-to-date overview of available evidence on diagnosis, treatment, and follow-up for neurourological patients. PATIENT SUMMARY: Neurological disorders very frequently affect the lower urinary tract and sexual and bowel function and patients need lifelong management. We summarise the updated European Association of Urology guidelines on neurourology to provide patients and caregivers with the latest insights for optimal health care support.

[The urological case reports of the Hippocratic Corpus : Medical practice in classical Greece]. / Die urologischen Fallberichte des Corpus Hippocraticum : Medizinische Praxis im klassischen Griechenland.

OBJECTIVE: Which theoretical and practical competences do the urologic case histories of the Hippocratic Corpus convey? MATERIALS AND METHODS: The 431 Hippocratic case histories have been studied for reports and communication on diagnostic methods, treatment, and prognosis related to urologic diseases. RESULTS: Within the seven books of the Hippocratic Epidemics, a total of 69 patients with urologic symptoms are described; in 21 cases the urologic disease is dominant. The leading clinical signs were urine discoloration and urinary sediment, polyuria, testicular swelling and pain, hematuria, stranguria, anuria, and renal pain, the most frequent diseases were nephritis and urolithiasis. Most patients were men in juvenile and adult age; 33 sick persons are named. The statements of patients regarding the course of their illness were often sparse. Diagnostic tests were restricted to inspection and palpation. Otherwise, treatment was confined to conservative measures. The dietary decisions for treatment of nephritis were differentiated but nonuniform. CONCLUSION: The Hippocratic physician diagnosed and treated diseases of the urinary tract. Inflammatory conditions and traumatic lesions are described in detail. Highest priority was awarded to uroscopy. Nephritis was a widespread disorder und usually associated with other symptoms, above all fever. The urinary tract was often regarded as an indicator of physical and mental health. Conservative treatment measures dominate in the case reports.

[Urology in Upper Palatinate-what archeology, historical research, and historiography reveal : Part 1: from Roman Antiquity to the late Middle Ages]. / Urologie in der Oberpfalz ­ Was uns Archäologie, historische Forschung und Geschichtsschreibung verraten : Teil 1: von römischer Antike bis Spätmittelalter.

Since 1924, it has been possible to qualify as a specialist in urology in Germany. The first hospital departments for the treatment of urological conditions were established as early as the end of the German Empire and the Weimar Republic. However, the beginning of specialist medical care in the Bavarian administrative district of Upper Palatinate, often known as the "poorhouse" of Germany until the second half of the last century, was much later. Nevertheless, the lineage of "urological" activity here can be traced back to much earlier eras. Of course, it must be accepted that the evidence from times long past is weak. This is especially applicable when it comes to a topic such as the treatment of the sick and the preservation of health, which is not only considered a science but also often a central focus of life for us today, because in history it was often only mentioned in the fight against epidemics and in anecdotal descriptions. This is a circumstance which, when looking at the history of urology, gives rise to the hope of finding one or two interesting sources. This article not only aims to trace the history of the development of urology in a rural area from contemporary history to the present day, but also to explore the treatment of urological diseases in this region since late antiquity. Furthermore, we invite readers to look at other places of urological remembrance in a similar way.

[Urological emergencies in two university hospitals in Douala: a retrospective study (2016-2020)]. / Les urgences urologiques dans deux hôpitaux universitaires de Douala: une étude rétrospective (2016-2020).

Introduction: urological emergencies are critical situations that require rapid response by a qualified urology health care professional. The purpose of this study was to highlight the profile of urological emergencies in two university hospitals in the city of Douala by assessing emergency management. Methods: we conducted a retrospective study of the urological emergencies in two reference hospitals in the city of Douala: the Laquintinie Hospital and the General Hospital. Files were collected over a period of 5 years (January 1st, 2016 to December 31st, 2020). All emergency consultations in the Emergency Unit as well as all clinical and therapeutic data from the on-call list during the study period were included. We excluded all emergencies (consultations during the study period) not recorded in the emergency registry. Results: we conducted a study of 364 patients with an average age of 43 ± 8.34 years; 92.58% (n=337) of patients were male. The most common urological emergencies included: urinary retention (45.05%, n=164), renal colic (15.33%, n=56) and haematuria (13.18%, n=48). The most common cause of urinary retention was prostate tumors, renal colic was mainly due to renal lithiasis (96.45%, n=159) and hematuria was due to tumor in 68.75% (n=33) of patients. Therapeutic management was based on urinary catheterization (39.01%, n=142), medical treatment was associated with monitoring (27.47%, n=100) and suprapubic cystostomy (10.71%, n=39). Conclusion: acute urinary retention due to prostate tumors is the most common urological emergency in the university hospitals in the city of Douala. Early and optimal management of prostate tumors is therefore essential.

[Structure of outpatient urology care in Germany]. / Versorgungsstruktur der ambulanten Urologie in Deutschland.

BACKGROUND: Although urological specialist practices are central pillars of outpatient care, there is a lack of current data on the care structure of these practices. A description of the structures in large cities versus rural areas as well as gender effects and generational differences is needed not only as a baseline measure for further studies. MATERIALS AND METHODS: The survey includes data from the physician directory of the Stiftung Gesundheit as well as from the German Medical Association and the Federal Statistical Office. Colleagues were divided into subgroups. Based on the different subgroup sizes, statements about the care structure of outpatient urology in Germany can be made. RESULTS: While the majority of urologists in larger cities work in professional practice groups and care for fewer patients on average, in rural areas there is a particularly high proportion of individual practices with more inhabitants to be cared for per urologist. Female urologists work more frequently in the context of inpatient care. When female urology specialists choose to establish themselves, they are more likely to do so in practice groups and in urban areas. In addition, there is a shift in gender distribution: the younger the age subgroup considered, the higher the proportion of female urologists among all colleagues. CONCLUSIONS: This study is the first to describe the current structure of outpatient urology care in Germany. Future trends are already emerging that will significantly influence our way of working and the care of patients in the coming years.

Quality Indicators in the Clinical Specialty of Urology: A Systematic Review.

CONTEXT: In health care, monitoring of quality indicators (QIs) in general urology remains underdeveloped in comparison to other clinical specialties. OBJECTIVE: To identify, synthesise, and appraise QIs that monitor in-hospital care for urology patients. EVIDENCE ACQUISITION: This systematic review included peer-reviewed articles identified via Embase, MEDLINE, Web of Science, CINAHL, Global Health, Google Scholar, and grey literature from 2000 to February 19, 2021. The review was carried out under the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines and used the Appraisal of Indicators through Research and Evaluation (AIRE) tool for quality assessment. EVIDENCE SYNTHESIS: A total of 5111 articles and 62 government agencies were screened for QI sets. There were a total of 57 QI sets included for analysis. Most QIs focused on uro-oncology, with prostate, bladder, and testicular cancers the most represented. The most common QIs were surgical QIs in uro-oncology (positive surgical margin, surgical volume), whereas in non-oncology the QIs most frequently reported were for treatment and diagnosis. Out of 61 articles, only four scored a total of ≥50% on the AIRE tool across four domains. Aside from QIs developed in uro-oncology, general urological QIs are underdeveloped and of poor methodological quality and most lack testing for both content validity and reliability. CONCLUSIONS: There is an urgent need for the development of methodologically robust QIs in the clinical specialty of general urology for patients to enable standardised quality of care monitoring and to improve patient outcomes. PATIENT SUMMARY: We investigated a range of quality indicators (QIs) that provide health care professionals with feedback on the quality of their care for patients with general urological diseases. We found that aside from urological cancers, there is a lack of QIs for general urology. Hence, there is an urgent need for the development of robust and disease-specific QIs in general urology.

Fetal uropathies: pre- and postnatal imaging, management and follow-up.

Congenital uropathies are the most common fetal anomalies. They include a wide spectrum of anomalies ranging from mild pelvis dilation to complex urinary tract malformations. Prenatal imaging not only allows for their diagnosis but, in experienced hands, it can differentiate obstructive from refluxing or malformative uropathies. Such precise prenatal information allows for intervention before birth in select cases or for adapting the postnatal workup to provide a better long-term outcome. For the different types of congenital uropathies, we describe their prenatal presentations on US and the complementary role of fetal MRI where indicated. We correlate these findings with postnatal workup and summarize the updated neonatal diagnostic and clinical/surgical management.

Applications of Platelet Rich Plasma in Urology.

INTRODUCTION: Platelet rich plasma is a product obtained from vein whole blood sample, with a high concentration of growth factors, which have been reported to be beneficial for tissue regeneration. In the last few years, several assays that pretend to demonstrate the efficacy of platelet rich plasma in many disciplines, including urology, have been published. AIM AND METHODS: The aim of this assay is to develop a bibliographic review of the publications available about platelet rich plasma and urology. The search was based on PubMed database. CONCLUSIONS: Platelet rich plasma has demonstrated to be a safe and easy to obtain product, and it has also shown promising results in terms of efficacy in urology. However, it is necessary to conduct large, placebo-controlled, studies that can confirm or deny the effectiveness of platelet rich plasma before it can be used on urological conditions.

Applications of Platelet Rich Plasma in Urology

Introduction: Platelet rich plasma is a product obtained from vein whole blood sample, with a high concentration of growth factors, which have been reported to be beneficial for tissue regeneration. In the last few years, several assays that pretend to demonstrate the efficacy of platelet rich plasma in many disciplines, including urology, have been published. Aim and Methods: The aim of this assay is to develop a bibliographic review of the publications available about platelet rich plasma and urology. The search was based on PubMed database. Conclusions: Platelet rich plasma has demonstrated to be a safe and easy to obtain product, and it has also shown promising results in terms of efficacy in urology. However, it is necessary to conduct large, placebo-controlled, studies that can confirm or deny the effectiveness of platelet rich plasma before it can be used on urological conditions (AU)

Exosomes in urological diseases - Biological functions and clinical applications.

Exosomes are extracellular vesicles with a variety of biological functions that exist in various biological body fluids and exert their functions through proteins, nucleic acids, lipids, and metabolites. Recent discoveries have revealed the functional and biomarker roles of miRNAs in urological diseases, including benign diseases and malignancies. Exosomes have several uses in the diagnosis, treatment, and monitoring of urological diseases, especially cancer. Proteins and nucleic acids can be used as alternative biomarkers for detecting urological diseases. Additionally, exosomes can be detected in most body fluids, thereby avoiding pathogenesis. More importantly, for urological tumors, exosomes display a higher sensitivity than circulating tumor cells and tumor-derived DNA in body fluid biopsies because of their low immunogenicity and high stability. These advantages have made it a research hotspot in recent years. In this review, we focus on the biological characteristics and functions of exosomes and summarize their advantages and the latest progress in the diagnosis and treatment of urological diseases.

Various aspects of transition of care for adolescents with urological conditions.

Transition into adulthood is a common issue in many disciplines. However, urology faces additional difficulties due to different models of care and training as well as a wide diversity of pathologies. The goal of this paper is to discuss various aspects of the transition of urological care. This review provides some examples of pathologies that might require special attention of specialists. Most patients with rare diseases must be closely followed up in the long term. However, high-volume conditions may also have a huge impact on the well-being and quality of life in adulthood. Children who are cured due to oncological conditions will probably need additional attention in adulthood. The urological care during childhood is provided by a pediatric urologist, a pediatric surgeon or a urologist, depending on the local regulations and the organization of care. All patients are subsequently referred to a general urologist. Nowadays, a multidisciplinary approach is recommended in many cases, with a pediatric urologist as one of the team members. The patient, caregivers and healthcare professionals must be fully involved and focused on close cooperation to make the transition process smooth and successful.

Is "Benign" Urology Benign?

Use of the word "benign" for all diseases that are not cancerous may suggest to patients that a life-threatening urologic condition is "innocuous" or even "harmless". We invite readers to propose alternative language that accurately describes the field of nononcologic adult urology, reflects the expertise of practitioners, and remains sensitive to the experience of patients.