Publications by authors named "Florian Wagenlehner"

Purpose: Sperm morphology and motility are major contributors to male-factor infertility, with many genes predicted to be involved. This study aimed to elucidate differentially expressed transcripts in human testis tissues of normal and abnormal spermatogenesis that could reveal new genes that may regulate sperm morphology and function.

Methods: Human testis biopsies were collected from men with well-characterized phenotypes of normal spermatogenesis, spermatid arrest, and Sertoli cell-only phenotype, and transcriptional differences were quantified by RNA-sequencing (RNA-Seq).

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Purpose: Robotic surgery is increasingly utilized in the treatment of urothelial carcinoma of the upper urinary tract (UTUC). This study investigates the advantages and burden of robot-assisted surgical treatment of the urothelial carcinoma of the upper urinary tract in a referral urological department, along with their functional and oncological results.

Methods: The study included 66 prospectively enrolled patients who were surgically treated by a single, robotically specialized surgeon between July 2019 and December 2023.

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Background And Objective: Urinary tract infections (UTIs) are some of the most encountered infections in clinical practice, exhibiting increasing antimicrobial resistance. Bacterial species identification and antimicrobial resistance testing at point of care (POCT) could improve adequate initial antibiotic therapy and antimicrobial stewardship. In this work, the Vivalytic UTI test, which represents a qualitative PCR-based microarray test, able to detect specific uropathogenic bacteria and associated antimicrobial resistance genes was evaluated at POCT.

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Article Synopsis
  • * The ORENUC criteria are used to evaluate the risk of complications during a UTI, while comprehensive diagnostics like imaging and clinical exams help manage severe cases.
  • * Treatment typically involves antibiotics, but resistance is growing, necessitating new drugs and strategies, alongside patient involvement in managing relapses.
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  • Urinary tract infections (UTIs) are common bacterial infections, but varying definitions in research complicate study comparisons, especially in light of rising antibiotic resistance.
  • A recent Delphi consensus study established a new standard definition for UTI that includes symptoms, pyuria, and urine culture results, moving away from the complicated vs. uncomplicated categorization.
  • Implementing this reference standard in research will enhance study design and interpretability, despite challenges in establishing sensitivity and specificity for different settings and potential issues with including "probable" and "possible" UTI cases in research outcomes.*
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Bacteria develop biofilms for protection and persistent colonization. Biofilms of pathogenic bacteria can lead to serious medical problems. Bacterial biofilms on catheters used in the treatment of urinary tract diseases represent a major challenge for antibiotic therapy.

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Antimicrobial peptides (AMPs) play a pivotal role in the innate immune system as a frontline defense against microbial threats. AMPs can serve as biomarkers and alternative antibiotics, overcoming mortality related to multidrug-resistant pathogens in urinary tract infections (UTIs). While the relevance of AMPs in UTIs has been validated and AMP drugs approved by the US Food and Drug Administration are in clinical use, information about their modification status, regulation, and mechanism of action remains sparse.

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Two novel antibiotics have been evaluated for the treatment of urinary tract infection (UTI). Gepotidacin was an efficacious first-in-class oral antibiotic in uncomplicated UTI in comparison to nitrofurantoin. Cefepime/taniborbactam was superior to meropenem in complicated UTI and acute pyelonephritis.

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Article Synopsis
  • Urinary tract infections (UTIs) are commonly caused by bacteria, particularly Escherichia coli, with kidney infections (pyelonephritis) being severe and difficult to treat due to the unique kidney microenvironment.
  • The study tested how factors like sodium chloride, urea, and pH levels affect the effectiveness of antibiotics (ertapenem, levofloxacin, and ceftriaxone) against E. coli strains in conditions mimicking the kidney.
  • Findings showed that pH significantly affects levofloxacin's effectiveness, while sodium chloride and urea impact various strains differently, highlighting the need for more research on other antibiotics and kidney conditions for better treatment strategies.
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Chronic prostatitis/chronic pelvic pain syndrome CP/CPPS is a rather common condition and in recent years many studies have shown contradictory results regarding its impact on semen quality. This prospective cohort study set out to investigate how CP/CPPS affected the parameters of semen in a prospective cohort of patients compared with the WHO 2021 reference group. From 2013 to 2022, a total of 1071 patients with suspicion of CP/CPPS received a comprehensive andrological examination.

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  • Urinary tract infections (UTIs) are common complications for kidney transplant recipients, with asymptomatic bacteriuria (ASB) potentially increasing the risk of both UTIs and graft rejection.
  • A systematic literature review was conducted analyzing studies that focused on the management of ASB after kidney transplantation, with specific attention to screening and treatment protocols during the first year post-transplant.
  • The review found no solid evidence indicating benefits from treating ASB, as studies showed no increased risk of UTIs, acute kidney problems, or mortality in patients who did not receive antibiotic treatment for ASB, likely due to unaccounted confounding factors in the studies.
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Unlabelled: CERTAIN-1 was a Phase 3, double-blind, randomized, parallel group study of the efficacy and safety of cefepime-taniborbactam versus meropenem in the treatment of adults with complicated urinary tract infection (cUTI), including acute pyelonephritis. We determined susceptibility of Enterobacterales and baseline pathogens to cefepime-taniborbactam and comparators and characterized β-lactam resistance mechanisms. Microbiologic response and clinical response were assessed in patient subsets defined by baseline pathogens that were of cefepime-, multidrug-, or carbapenem-resistant phenotype or that carried β-lactamase genes.

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Uncomplicated cystitis is affecting many women of all ages and has a great impact on the quality of life, especially in women suffering from recurrent, uncomplicated cystitis. By far the most frequent uropathogen, , may have acquired increasing resistance against a variety of oral antibiotics, which may differ between countries and regions. Therefore, local resistance data are important to be considered.

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The European Association of Urology Urological Infections Guidelines Panel is proposing a new classification scheme for categorizing urinary tract infections (UTIs) into uncomplicated and complicated types. This classification would provide clarity and facilitate effective clinical management of UTIs, and acknowledges the importance of addressing clinical and sex-specific nuances in the care of individual patients.

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Purpose: To provide a descriptive report of mortality and morbidity in the first 30 days of diagnosis of urosepsis. Secondary aim is to identify risk factors of unfavourable outcomes.

Methods: Prospective observational multicentre cohort study conducted from September 2014 to November 2018 in European hospitals.

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Article Synopsis
  • The review focuses on experimental research regarding Chronic Pelvic Pain (CPP) based on the Integral Theory Paradigm (ITP), indicating that CPP affects up to 20% of women and is often considered incurable.
  • The ITP suggests that CPP is primarily caused by weak uterosacral ligaments (USLs) that fail to support visceral nerve plexuses, leading to pain perceptions in the brain.
  • The "posterior fornix syndrome" (PFS) links CPP with other symptoms like bladder issues, and surgical repair of USLs may offer a potentially curative treatment, while non-surgical options like exercises and mechanical support also exist.
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Descending perineal syndrome (DPS) was described by Parks as descent of the anus on straining, typically 3-4 cm below a line drawn from the coccyx to the lower end of the. DPS is associated with obstructed defecation, with increased bulging of the perineum with straining, although perineal descent can also be seen at rest. In their review, Chaudhry and Tarnay stated: "".

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Background And Objective: Urological infections significantly impact the wellbeing and quality of life of individuals owing to their widespread occurrence and diverse clinical manifestations. The objective of the guidelines panel was to provide evidence-based guidance on the diagnosis, treatment, and prevention of urinary tract infections (UTIs) and male accessory-gland infections, while addressing crucial public health aspects related to infection control and antimicrobial stewardship.

Methods: For the 2024 guidelines on urological infections, new and relevant evidence was identified, collated, and appraised via a structured assessment of the literature.

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Background: Urinary tract infection has a one-year prevalence of 11% in women and ranges among the most common reasons for consulting a primary care physician and for receiving a prescription for antibiotics. In the case of recurrent urinary tract infection (rUTI), there are questions about the further work-up, treatment, and preventive measures.

Methods: The systematic literature search performed for the update of the German clinical practice guideline on uncomplicated urinary tract infection (043-044) (up to February 2022) was supplemented with a selective search for clinical trials (up to August 2023).

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Background And Purpose: With increasing life expectancy, benign prostatic hyperplasia (BPH) consequently affects more ageing men, illustrating the urgent need for advancements in BPH therapy. One emerging possibility may be the use of oxytocin antagonists to relax smooth muscle cells in the prostate, similar to the currently used (although often associated with side effects) α-adrenoceptor blockers.

Experimental Approach: For the first time we used live-imaging, combined with a novel image analysis method, to investigate the multidirectional contractions of the human prostate and determine their changes in response to oxytocin and the oxytocin antagonists atosiban and cligosiban.

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Priapism is defined as penile erection lasting more than four hours that is unrelated to sexual arousal. Priapism is classified based on the oxygenation of the penile tissue into ischemic and non-ischemic subtypes. As the most common form, ischemic priapism is usually associated with pain and carries a significant risk of permanent loss of erectile function; thus, rapid intervention is necessary.

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Background: Immune cell infiltration is heterogeneous but common in testicular germ cell tumors (TGCT) and pre-invasive germ cell neoplasia in situ (GCNIS). Tumor-infiltrating T cells including regulatory T (Treg) and follicular helper T (Tfh) cells are found in other cancer entities, but their contributions to TGCT are unknown.

Methods: Human testis specimens from independent patient cohorts were analyzed using immunohistochemistry, flow cytometry and single-cell RNA sequencing (scRNA-seq) with special emphasis on delineating T cell subtypes.

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