[Risk-adapted early detection program for prostate cancer 2.0-position paper of the German Society of Urology 2024].

Background And Objective: Despite the proven effectiveness of organized PSA-based screening in reducing prostate cancer-related mortality, there is currently no program in Germany covered by statutory health insurance. In accordance with the EU Council Decision (2022/0290(NLE)), the German Society of Urology (DGU) has developed a concept for risk-adapted prostate cancer early detection.

Materials And Methods: Based on a literature review of current screening studies, an algorithm for PSA-based prostate cancer early detection was developed.

Declining utilization of urodynamic studies in urological care in Germany: time to say goodbye?

Introduction: The number of urodynamic studies (UDS) has been declining steadily in recent decades, yet the reasons behind this trend remain poorly understood. This study aims to investigate the structural aspects of UDS in urology and explore the factors contributing to this decline.

Material & Methods: We surveyed all urological departments performing UDS as well as a representative sample of private practices in Germany in 2023.

Do or Don't: Results of a Multinational Survey on Antibiotic Prophylaxis in Urodynamics.

Antibiotic prophylaxis contributes substantially to the increase in antibiotic resistance rates worldwide. This investigation aims to assess the current standard of practice in using antibiotic prophylaxis for urodynamics (UDS) and identify barriers to guideline adherence. An online survey using a 22-item questionnaire designed according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) was circulated among urologists and gynecologists in Austria, Germany, and Switzerland between September 2021 and March 2022.

Diagnosis and Therapy of Female Urinary Incontinence. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/091, January 2022): Part 2 with Recommendations on Interventional/Surgical Therapy of Overactive Bladder, Surgical Treatment of Stress Urinary Incontinence and Diagnosis and Therapy of Iatrogenic Urogenital Fistula.

This completely revised interdisciplinary S2k-guideline on the diagnosis, therapy, and follow-up care of female patients with urinary incontinence (AWMF registry number: 015-091) was published in December 2021. This guideline combines and summarizes earlier guidelines such as "Female stress urinary incontinence," "Female urge incontinence" and "Use of Ultrasonography in Urogynecological Diagnostics" for the first time. The guideline was coordinated by the German Society for Gynecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, DGGG) and the Working Group for Urogynecology and Plastic Pelvic Floor Reconstruction (Arbeitsgemeinschaft für Urogynäkologie und plastische Beckenbodenrekonstruktion e.

[Why outpatient surgery does not work in hospitals - or medical practices - as yet].

High costs in the German health care system and a lack of nursing staff make a shift from inpatient to outpatient treatment unavoidable. The new catalogue announced for outpatient surgical procedures will contain up to 50% of all procedures in urology. In anticipation of these major changes, neither hospitals nor medical practices are able to prepare adequately since the precise catalogue, the infrastructural changes required, and the rules of remuneration have not yet been clarified.

[The new guideline "Diagnosis and therapy of female urinary incontinence" AWMF register no.: 015-091-important to know].

Background: The new interdisciplinary S2k guideline "Female urinary incontinence" has been online since December 31, 2021 under the AWMF register number: 015-091. The guideline combines the two previously separately published guidelines "Urinary stress incontinence in women" and "Overactive bladder in women" and integrates the previously independent guideline "Sonography in the context of urogynaecological diagnostics".

Objectives: The focus is on the identification of the three most common types of urinary incontinence in women "stress incontinence", "urge incontinence" and "mixed incontinence" through appropriate diagnostics and their conservative and surgical therapy.

[Outpatient before inpatient treatment?-Reality of care and economic analysis for minor urological interventions in Germany between 2013 and 2018].

Background: Although outpatient provision of services is economically desirable, many minor urological interventions in Germany are currently carried out on an inpatient basis. The aim of our study is to investigate whether the current health policy framework contributes to more outpatient treatment.

Materials And Methods: We used a sample of 4.

[Diagnosis of interstitial cystitis: practice-orientated diagnostic work-up].

Interstitial cystitis is a chronic orphan disease of the urinary bladder characterised by its main symptoms of bladder pain, persistent urge to void and urinary frequency. Due to a variety of confusable diseases and different pathophysiologies, the diagnosis of IC is still a diagnosis of exclusion and remains a challenge for doctors and patients alike. Patients often experience misdiagnosis and unsuccessful treatment for years.

[Continence and pelvic floor centers-Meaningful certification requirements?].

As a consequence of the demographic change, the prevalence of female and male bladder and bowel dysfunction, functional pelvic floor disorders and pelvic organ prolapse are steadily increasing. Continence and pelvic floor centers are interdisciplinary facilities that focus on these functional disorders, including malformations, tumors and functional disorders resulting from neurogenic diseases, injuries or surgery. The affected patient clientele includes children, women, and men of all ages.

[Urinary diversion after uro-oncologic interventions in women: the right procedure for the right patient].

Bladder carcinoma is a relatively rare tumour in women. The even rarer constellation of an invasive carcinoma or a high-risk situation when cystectomy is indicated requires adequate urinary diversion.The individual underlying circumstances of tumour and patient and the experience and preferences of the surgeon determine the choice of urinary diversion.

[Stress urinary incontinence in men].

Male stress urinary incontinence is predominantly iatrogenic, whereby radical prostatectomy is the most frequent cause. The first-line treatment of postoperative stress urinary incontinence is physiotherapy, in which training of pelvic floor muscles and sphincter play a major role. If conservative treatment fails surgical treatment is recommended.

Urinary incontinence in children.

Background: Urinary incontinence (bedwetting, enuresis) is the commonest urinary symptom in children and adolescents and can lead to major distress for the affected children and their parents. Physiological and non-physiological types of urinary incontinence are sometimes hard to tell apart in this age group.

Methods: This article is based on selected literature retrieved by a PubMed search and on an interdisciplinary expert consensus.

Efficacy, tolerability and safety of propiverine hydrochloride in comparison to oxybutynin in children with urge incontinence due to overactive bladder: Results of a multicentre observational cohort study.

Objective: To compare, in a retrospective observational cohort study, the efficacy, tolerability and safety of propiverine and oxybutynin in children with urge incontinence (UI) due to overactive bladder.

Patients And Methods: Medical records were scrutinized for children with UI. As a primary efficacy outcome variable the achievement of continence after treatment with variable doses of propiverine or oxybutynin was assessed.

Propiverine vs oxybutynin for treating neurogenic detrusor overactivity in children and adolescents: results of a multicentre observational cohort study.

Objective: To compare, in a retrospective observational cohort study, the efficacy, tolerability, safety and clinical effectiveness of propiverine and oxybutynin in children and adolescents with neurogenic detrusor overactivity (NDO).

Patients And Methods: In all, 255 children and adolescents (aged 1-18 years) with NDO (199 myelomeningocele, 46 spinal cord injury, 10 other diagnoses) were enrolled at 14 study centres. To evaluate the efficacy of propiverine and oxybutynin, urodynamic and clinical variables were assessed before and after at least 12 month of the antimuscarinic agents administered at variable doses.