Goldstandard TUR-P: the bigger the volume, the higher the speed, but resected volumes of more than 60g are critical.

Background: According to the European Association of Urology guidelines, the limit for monopolar, transurethral resection (M-TURP) in BPH- therapy is a volume of 80 g. However, whether larger prostates can also be resected transurethrally might also depend on the experience of the surgeon and especially the resected volume and speed of the resection. Little is known about the latter, and this paper aims to these factors.

[Digitalization in urology-challenge and opportunity].

Digitalization is changing medicine. In Germany these changes are not highly accepted yet. Medical pathways should be supported and become safer by digital transformation.

ROK and RSK2-kinase pathways differ between senescent human renal and mesenteric arteries.

Objective: Small arteries from different organs vary with regard to the mechanisms that regulate vasoconstriction. This study investigated the impact of advanced age on the regulation of vasoconstriction in isolated human small arteries from kidney cortex and periintestinal mesenteric tissue.

Methods: Renal and mesenteric tissues were obtained from patients (mean age 71 ± 9 years) undergoing elective surgery.

[Experiences from the commission of experts].

The task of the commission of experts on medical errors is to provide a neutral and independent assessment of a treatment for which a physician is responsible and evaluate the liability issue. The objective evaluation is intended to make it easier for the person whose health has been damaged by a treatment error to assert justified claims and for the physician to reject unfounded accusations. The aim is to promote amicable dispute resolution.

[Where do dangers lurk in informed consent and documentation and what are common technical mistakes?].

In legal expert discussions, the following questions are usually raised: Is the procedure indicated? Have all diagnostic and therapeutic steps been carried out lege artis? Has sufficient informed consent been provided? Is there a diagnostic or treatment error? Did this cause any damage? Is the damage causally related to the error? Consideration of these fundamental questions in daily practice and good communication between patient-physician, physician-patient, and between physicians themselves is good protection in legal disputes.

[Fatal complications after urological interventions-connection between error, damage and causality].

Case studies from the clinic outline the connection between error, damage and causality. If the three "categories" mentioned are to be affirmed, recourse claims of the payers and the patients or their relatives are enforced in practice.

[Collecting duct carcinoma].

Collecting duct carcinoma (Bellini duct carcinoma) is a very rare disease with poor prognosis. Primary tumor surgery is not advisable, even though it is the therapy of choice for suspected malignant space-occupying renal masses. Chemotherapy seems to be inferior to new therapeutic concepts based on single case reports.

A Stent for Every Stone? Prestenting Habits and Outcomes from a German Multicenter Prospective Study on the Benchmarks of Ureteroroscopic Stone Treatment (BUSTER).

Introduction: Previous studies have shown that prestenting in ureterorenoscopic stone removal (URS) is carried out more frequently in Germany than in other countries.

Objective: This investigation evaluated the impact of high prestenting rates on outcomes as well as the influence of stone characteristics and treatment habits on prestenting.

Methods: The dataset from the BUSTER observational study was used.

Hospital volume in ureterorenoscopic stone treatment: 99 operations per year could increase the chance of a better outcome-results of the German prospective multicentre BUSTER project.

Background: Despite the high utilisation of ureterorenoscopy (URS) in interventional stone treatment, there is little evidence of any link between annual hospital volume and outcome.

Methods: From January to April 2015, data from 307 URS patients were prospectively recorded in the multicentre observational BUSTER-Trial (Benchmarks of ureterorenoscopic stone treatment-results in terms of complications, quality of life, and stone-free rates). The best threshold value for annual hospital volume with an independent effect on the outcome (measured on stone-free and complication rates) of our study group was established with logistic regression.

DEGUM Recommendations on Infection Prevention in Ultrasound and Endoscopic Ultrasound.

Microbial contamination of ultrasound probes for percutaneous or endoscopic use is common. However, infectious diseases caused by transmission of microorganisms by US procedures have rarely been reported. In Germany, legal regulations address hygiene in ultrasound procedures.

[The recommendations of the S2k guideline for the diagnosis, therapy and metaphylaxis of urolithiasis provide a safe course of action for ureterorenoscopic stone treatment - results of the BUSTER study].

Background:  Given the high incidence, prevalence and rate of recurrence, urolithiasis stone treatment at a high stone-free rate should have a low complication rate. The German S2k guideline (GS2k-GL) for the diagnostic testing, therapy and metaphylaxis of urolithiasis provides recommendations for the first and second choice for stone treatment, depending on stone location and size. Ureterorenoscopy (URS) is the treatment of first choice for most stones.

[Prostate biopsy: Procedure in the clinical routine].

Over the last decade there has been a 25% decrease in the mortality rates for prostate cancer. The reasons for this significant decrease are most likely associated with the application of urological screening tests. The main tools for early detection are currently increased public awareness of the disease, prostate-specific antigen (PSA) tests and transrectal ultrasound (TRUS) guided topographically assignable biopsy sampling.

[Economic implications of bedside communication errors].

Good communication can contribute significantly to avoiding expert disputes. An open and honest relationship in dealing with errors allows people to learn from them and avoid them in the future. This benefits both doctors and patients.

[Motivation and satisfaction of residents in urology].

To address the increasing shortage of qualified residents, which leads to further discontent and additional on-call rotations for the remaining physicians, an analysis of the current situation was performed. Stress in the daily working routine, not enough free time, too little pay, or too little compensatory time off for overtime as well as inadequate options for continuing education were reported to be the main elements of dissatisfaction. The economic pressure of day-to-day work continues to define the physician's role and places demands on the medical staff by burdening them with nonmedical and administrative tasks.

[Effects of the new further training regulations on the training behavior of assistant doctors].

During the 106th "Deutschen Arztetag" (German Medical Assembly) in 2003 new model further training regulations were finalized. Further training was to be more clearly arranged and the targets more clearly defined. There are no uniform training regulations for Germany.

[Bilateral intrauterine spermatic cord torsion with infarction].

Case report on an intrauterine torsion of the spermatic cord. The newborn was clinically in good condition, the enlarged and coarse scrotum being the only symptom. Surgery revealed necrosis of both testicles; their extirpation was mandatory.

Heterogeneous expression of MAGE-A genes in occult disseminated tumor cells: a novel multimarker reverse transcription-polymerase chain reaction for diagnosis of micrometastatic disease.

Systemically disseminated tumor cells have become the subject of intensive research as the presumed seminal precursors of later distant metastasis. We describe here a novel sensitive multimarker nested reverse transcription (RT)-PCR capable of detecting the individual expression of human MAGE-A genes MAGE-1, -2, -3/6, -4, and -12 by rare, disseminated tumor cells in bone marrow and blood of patients with many different types of cancer. We analyzed bone marrow aspirates from 106 patients with breast, lung, colorectal, and prostate cancer and with different sarcomas.

Estimation of total PSA with a supersensitive PSA-assay during neo-adjuvant-chemotherapy of prostate cancer before radical resection of prostate.

43 patients with untreated and clinically localised prostate carcinoma (cT1-3NoM0) were submitted to neo-adjuvant complete androgen deprivation treatment and radical prostatectomy. Hormonal treatment was given until PSA (supersensitive Immulite 3rd generation assay) reached a value of < 0.1 ng/ml or the nadir value.

Supersensitive PSA-monitored neoadjuvant hormone treatment of clinically localized prostate cancer: effects on positive margins, tumor detection and epithelial cells in bone marrow.

Objective: The present study was done to investigate the effects of supersensitive PSA-controlled inductive treatment on positive margins, detection of tumor and epithelial cells in bone marrow of 101 patients with untreated and clinically localized prostatic carcinoma (cT1-3N0M0).

Methods: Hormonal treatment was given until PSA (DPD Immulite(R) third-generation assay) reached <0.1 ng/ml or the nadir value, as shown by two consecutive measurements at monthly intervals.

Immunocytochemical monitoring of micrometastatic disease: reduction of prostate cancer cells in bone marrow by androgen deprivation.

Occult dissemination of tumor cells mainly determines the prognosis of patients with primary prostate cancer. The effect of androgen deprivation on micrometastatic tumor cells in these patients is currently unknown. We therefore used an immunocytochemical assay with monoclonal antibodies (MAbs) directed against epithelial cytoskeleton proteins (i.