[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.

Permanent interstitial low-dose-rate brachytherapy for patients with localised prostate cancer: a systematic review of randomised and nonrandomised controlled clinical trials.

Context: Prostate cancer (PCa) is the most common cancer in men. Permanent interstitial low-dose-rate brachytherapy (LDR-BT) is a short-distance radiation therapy in which low-energy radioactive sources are implanted permanently into the prostate.

Objective: To assess the effectiveness and safety of LDR-BT compared to treatment alternatives in men with localised PCa.

Low-dose rate brachytherapy for men with localized prostate cancer.

Background: Localized prostate cancer is a slow growing tumor for many years for the majority of affected men. Low-dose rate brachytherapy (LDR-BT) is short-distance radiotherapy using low-energy radioactive sources. LDR-BT has been recommended for men with low risk localized prostate cancer.

Prostate-specific antigen kinetics following external-beam radiotherapy and temporary (Ir-192) or permanent (I-125) brachytherapy for prostate cancer.

Background And Purpose: The aim of the study was the evaluation of PSA kinetics after different radiotherapy methods.

Materials And Methods: Two-hundred and ninety five patients received external-beam radiotherapy (EBRT; 70.2 Gy; n=135), Ir-192 brachytherapy as a boost to EBRT (HDR-BT; 18 Gy+50.

Rectal morbidity after permanent interstitial brachytherapy for prostate cancer--impact of day 1 vs. day 30 computed tomography-based postimplant dosimetry.

Purpose: The aim of the study was to evaluate bowel quality-of-life changes after prostate brachytherapy and the impact of Day 1 vs. Day 30 postimplant dosimetry.

Methods And Materials: In 61 patients, computed tomography (CT) scans were performed at Days 1 and 30 after (125)I brachytherapy.

Impact of age and comorbidities on health-related quality of life for patients with prostate cancer: evaluation before a curative treatment.

Background: Interpretation of comparative health-related quality of life (HRQOL) studies following different prostate cancer treatments is often difficult due to differing patient ages. Furthermore, age-related changes can hardly be discriminated from therapy-related changes. The evaluation of age-and comorbidity-related changes was in focus of this study.

Rectourethral fistula following LDR brachytherapy.

Modern LDR brachytherapy has drastically reduced rectal toxicity and decreased the occurrence of rectourethral fistulas to <0.5% of patients. Therefore, symptoms of late-onset sequelae are often ignored initially.

Rectal dosimetry following prostate brachytherapy with stranded seeds--comparison of transrectal ultrasound intra-operative planning (day 0) and computed tomography-postplanning (day 1 vs. day 30) with special focus on sources placed close to the rectal wall.

Background And Purpose: The aim of the study was to compare intra-operative and postplanning at different intervals with special focus on sources placed close to the rectal wall.

Materials And Methods: In 61 consecutive patients, CT scans were performed on day 1 and day 30 after an I-125 implant with stranded seeds. The number of sources < or =7 mm to the rectal wall was determined, and displacements were analyzed.

Health-related quality of life after permanent I-125 brachytherapy and conformal external beam radiotherapy for prostate cancer--a matched-pair comparison.

Background And Purpose: The aim of the study was to compare quality of life after permanent I-125 brachytherapy (BT) and external beam radiotherapy (EBRT) for prostate cancer.

Materials And Methods: A group of 104 patients (52 in each group) have been surveyed prospectively before EBRT/BT (time A), at the last day of EBRT (70.2-72.

Seed displacements after permanent brachytherapy for prostate cancer in dependence on the prostate level.

Purpose: To evaluate seed displacements after permanent prostate brachytherapy considering different prostate levels.

Patients And Methods: In 61 patients, postimplant CT scans were performed 1 day and 1 month after an implant with stranded seeds. Seed and prostate surface displacements were determined relative to pelvic bones.

Evaluation of source displacement and dose--volume changes after permanent prostate brachytherapy with stranded seeds.

Background And Purpose: The aim of the study was to analyze source displacements and dose-volume changes in the first month after a permanent implant.

Materials And Methods: In 51 consecutive patients, CT scans were performed at the postoperative day (day 1) and one month (day 30) after an (125)I implant with stranded seeds. Seed positions were determined relative to pelvic bones for five seeds at the base and five seeds at the apex for each patient (n=510) and compared.

Prostate-specific antigen kinetics after brachytherapy or external beam radiotherapy and neoadjuvant hormonal therapy.

Objectives: To characterize the kinetics of prostate-specific antigen (PSA) after radiotherapy (RT) and neoadjuvant hormonal therapy (NHT) for localized prostate cancer.

Methods: The PSA kinetics of 75 consecutive patients who had undergone RT and NHT (median time 4 months) were followed up for a minimum of 24 months after treatment. RT included a permanent iodine-125 implant (n = 29), a temporary iridium-192 implant as a boost to external beam RT (n = 21), and sole external beam RT (n = 25).

Health-related quality of life after permanent interstitial brachytherapy for prostate cancer: correlation with postimplant CT scan parameters.

Purpose: To determine dosimetric risk factors for increased toxicity after permanent interstitial brachytherapy for prostate cancer.

Patients And Methods: Quality of life questionnaires (Expanded Prostate Cancer Index Composite) of 60 and 56 patients were analyzed after a median posttreatment time of 6 weeks (A-acute) and 16 months (L-late). The corresponding CT scans were performed 30 days after the implant.

Changes of dose delivery distribution within the first month after permanent interstitial brachytherapy for prostate cancer.

Purpose: To evaluate changes of dose distribution for both the prostate and the surrounding tissues after permanent brachytherapy as monotherapy for prostate cancer.

Patients And Methods: In 35 patients, CT scans were performed before, 1 day after (day 1) and 1 month after the implantation (day 30). Changes of prostate volume, dosimetric parameters, and distances between posterior prostate contour and rectal wall as well as prostate contour and prescription isodose were analyzed.

Association of neoadjuvant hormonal therapy with adverse health-related quality of life after permanent iodine-125 brachytherapy for localized prostate cancer.

Objectives: To characterize the influence of neoadjuvant hormonal therapy (NHT) on health-related quality of life after permanent iodine-125 brachytherapy (BT) for prostate cancer.

Methods: A cross-sectional survey using the Expanded Prostate Cancer Index Composite health-related quality-of-life instrument was administered to 134 consecutive patients a median of 29 months after BT. A separate group of 111 patients with comparable demographic characteristics without any prior treatment for prostate cancer rendered the baseline information (control group).

Erectile function after non-nerve-sparing radical prostatectomy: fact or fiction?

Objective: To evaluate the potency in patients after radical perineal prostatectomy with wide excision of both neurovascular bundles.

Material And Methods: In this prospective study, a quality-of-life questionnaire was completed by 128 patients at the preoperative stage, and 6 and 12 months postoperatively. Ten questions concerning the patient's sexuality were included on the pre- and both postoperative questionnaires.

Dose-volume impact in high-dose-rate Iridium-192 brachytherapy as a boost to external beam radiotherapy for localized prostate cancer--a phase II study.

Background And Purpose: Evaluation of dose-volume-time-related factors in 64 patients treated with high-dose-rate brachytherapy (HDR-BT) as a boost to external beam radiotherapy (EBRT) for localized prostate cancer.

Patients And Methods: Clinical parameters were correlated with morbidity scores of the EPIC (Expanded Prostate Cancer Index) questionnaire. Median time after radiotherapy (HDR-BT up to 18 Gy in two fractions and EBRT up to a median dose of 50.

Fecal incontinence after radical perineal prostatectomy: a prospective study.

Objectives: To assess, in a prospective study, the incidence of fecal incontinence after radical perineal prostatectomy.

Methods: Bowel symptoms were evaluated with questionnaires mailed to 132 patients preoperatively and 6 months postoperatively, and annually thereafter. All patients had undergone extrafascial perineal prostatectomy for Stage cT1-cT3N0M0 prostate cancer.

Permanent 125I-seed brachytherapy or radical prostatectomy: a prospective comparison considering oncological and quality of life results.

Objective: To assess the quality of life in patients with prostate cancer after permanent brachytherapy (BT) or radical perineal prostatectomy (RP).

Patients And Methods: The American Brachytherapy Society recommends the permanent implantation of radioactive seeds as a monotherapy for patients with T1-T2aN0M0 prostate cancer and a prostate-specific antigen (PSA) level of < or = 10 ng/mL, a Gleason score of <7 and a prostate volume of <60 mL. Using these criteria, 132 patients with low-risk prostate cancer were selected; 52 had BT with 125I-seed implantation, 38 had RP with unilateral nerve-sparing (RP + NS) and 42 extended RP (RP group).

Numeric definition of the clinical performance of the nested reverse transcription-PCR for detection of hematogenous epithelial cells and correction for specific mRNA of non-target cell origin as evaluated for prostate cancer cells.

Background: Inappropriate quality management of reverse transcription-PCR (RT-PCR) assays for the detection of blood-borne prostate cancer (PCa) cells hampers clinical conclusions. Improvement of the RT-PCR methodology for prostate-specific antigen (PSA) mRNA should focus on an appropriate numeric definition of the performance of the assay and correction for PSA mRNA that is not associated with PCa cells.

Methods And Results: Repeated (RT-)PCR tests for PSA mRNA in single blood specimens from PCa patients and PCa-free controls, performed by four international institutions, showed a large percentage (approximately equal to 50%) of divergent test results.

Inverse automated treatment planning with and without individual optimization in interstitial permanent prostate brachytherapy with high- and low-activity 125I.

Purpose: To determine whether dose distribution achieved with treatment plans using high- and low-activity (125)I implants differs.

Patients And Methods: Based on intraoperative transrectal ultrasound scans of 71 patients, inverse automated treatment plans (IATP) were performed with 15.5-kBq (0.