[Urinary diversion in old patients (80+ years)].

With increasing life expectancy there is also an increased need for the management of older (≥ 80 years) patients with the diagnosis of muscle-invasive bladder cancer. Radical cystectomy with urinary diversion is the state of the art treatment (with neoadjuvant chemotherapy, as long as the patient is fit enough). Choosing the best urinary diversion with respect to morbidity compared to functionality and quality of life remains a challenge in these patients.

[The 1-cm lower calyx calculus: SWT, URS or Mini-PCNL? Guidelines vs. reality.].

Urinary stones of the upper urinary tract can be considered a widespread public health concern due to their high incidence and prevalence and their health policy-related and financial implications. A significant proportion of newly diagnosed kidney stones are lower-pole stones, i.e.

[Safety and efficacy of en bloc vs. conventional transurethral resection of bladder tumors: a meta-analysis and systematic review].

Background: En bloc tumor resection of bladder tumors (ERBT) is a novel alternative procedure to conventional resection of bladder tumor (cTURBT), which might help to address common problems of the standard method, such as inadequate detrusor muscle in specimens, high re-resection rates and high recurrence rates.

Objective: To analyze current data on ERBT in efficacy and safety compared to cTURBT.

Data Sources: PubMed.

Frequency of microsatellite instability (MSI) in upper tract urothelial carcinoma: comparison of the Bethesda panel and the Idylla MSI assay in a consecutively collected, multi-institutional cohort.

Aims: Upper tract urothelial carcinoma (UTUC) is a rare malignancy with a poor prognosis which occurs sporadically or in few cases results from a genetic disorder called Lynch syndrome. Recently, examination of microsatellite instability (MSI) has gained importance as a biomarker: MSI tumours are associated with a better response to immunomodulative therapies. Limited data are known about the prevalence of MSI in UTUC.

[Lasers in urology : Relevant principles].

A fundamental understanding of the physical properties is necessary for the application of lasers in medicine in order to be able to understand and appreciate the biological effect. The most important parameters are emission mode, wavelength of the laser and power output measured in watts. Pulsed lasers can be used for the treatment of stones and soft tissues, whereby in urology this essentially applies to the prostate gland and to a lesser extent also for the ureter, urethra, bladder and kidneys.

[CpG-ODN instillation boosts ICAM-1 expression in an orthotopic murine UCC model: immunohistochemical evaluation of the local response to immunostimulatory DNA].

Background: Immunostimulatory CpG oligodeoxynucleotides (CpG-ODN) have been verified as an effective antineoplastic agent for intravesical application in a murine orthotopic C57-BL6 /MB-49 urothelial cell carcinoma (UCC). To date, many details in the mode of action have remained unclear. Preceding studies pointed towards a Th1-weighted response.

[Management of geriatric patients with benign prostatic hyperplasia].

Multimorbid older men are increasingly more common in daily practice and present a challenge because they are often affected by lower urinary tract symptoms (LUTS) and age-associated benign prostatic hyperplasia (BPH). In order to identify possible risks in diagnostics, therapy and counselling at an early stage, screening for functional deficits or risk factors with standardized procedures is helpful. An initial screening with subsequent assessment of everyday skills using the Barthel Index, Timed up & Go Test, and a cognitive test are recommended.

[Urological infections and antibiotic management in geriatric patients].

Both the demographic shift and progress in medicine are resulting in an increasingly longer life expectancy. It is presumed that a mean age of 90 years will be achieved within the next decade in many countries. Thus, geriatric medicine, which is committed to the specific needs of older, often frail and frequently comorbid patients, is becoming increasingly more important.

[Endoscopic enucleation of the prostate].

The spectrum of surgical procedures for the minimally invasive treatment of benign prostatic hyperplasia (BPH) has significantly increased over the last two decades. The simple suprapubic prostatectomy (subtotal prostatectomy, SP) has largely lost relevance in current practice. On the other hand, transurethral resection of the prostate (TURP) has been further standardized and potentially made safer by the introduction of the bipolar technique and low-pressure systems.

[Follow-up of bladder cancer : The right examinations at the right time].

Schedules for the follow-up (FU) of bladder cancer patients are predominantly based on studies with low level of evidence and the resulting guidelines' recommendations that are often founded on expert consensus. FU of non-muscle invasive bladder cancer (NMIBC) includes cystoscopy and cytology as standard, and imaging modalities to a lower extent. FU of muscle-invasive bladder cancer (MIBC) depends primarily on the therapeutic modality chosen and on the stage of disease.

[Extracorporeal shock wave lithotripsy].

Interventional treatment of stones essentially consists of three treatment modalities. Extracorporeal shockwave lithotripsy (ESWL), in addition to uterorenoscopy (URS) and percutaneous nephrolitholapaxy (PCNL) is an essential treatment pillar and is the only noninvasive therapy option for the treatment of urinary stones. After a long period of ESWL being the leading choice in stone treatment, the number of SWL interventions diminished in recent years in favor of the other two treatment modalities (URS and PCNL).

[Surgical positioning techniques in urology : Tips and tricks].

Correct positioning of patients during preoperative preparations is essential for success of the intervention to avoid any positioning trauma and to provide the best access to the targeted structures. The appropriate positioning (and optimal performance) means that complications are avoided and also makes an essential contribution to the smooth course of the surgical intervention. A correct position is essential particularly in urology because the organs assigned to the discipline of urology are anatomically mostly difficult to reach.

Immunohistochemiocal subtyping using CK20 and CK5 can identify urothelial carcinomas of the upper urinary tract with a poor prognosis.

Purpose: Genome-wide analyses revealed basal and luminal subtypes of urothelial carcinomas of the bladder. It is unknown if this subtyping can also be applied to upper tract urothelial carcinomas.

Materials And Methods: Tumor samples from 222 patients with upper tract urothelial carcinomas who were treated with radical nephroureterectomy were analyzed for the expression of seven basal/luminal immunohistochemical markers (CK5, EGFR, CD44, CK20, p63, GATA3, FOXA1).

[Ureterorenoscopy].

Ureterorenoscopy (URS) is a minimally invasive treatment option for removal of kidney stones, which has gained importance in this field over the past two decades. This technique has replaced extracorporeal shock wave lithotripsy (ESWL) stone surgery for many indications. It is also particularly important in the diagnostics and treatment for tumors of the upper urinary tract.

The Influence of Body Mass Index on Outcomes in Ureteroscopy: Results from the Clinical Research Office of Endourological Society URS Global Study.

Introduction: Although ureteroscopy (URS) has been established as a viable treatment for stones in obese patients, its safety and success has not been fully elucidated. The current study describes the worldwide prevalence of obesity in patients with urolithiasis and examines trends in URS outcomes, safety, and efficacy.

Methods: This study utilized the Clinical Research Office of the Endourological Society (CROES) URS Global Study, which was a prospective, multicenter study including 11,885 patients treated with URS for urinary stones at 1 of 114 urology departments across 32 countries.

[Operative technique for percutaneous nephrolithotomy].

Percutaneous nephrolithotomy (PCNL) is a well-established minimally invasive treatment option for removal of kidney stones. This technique has now replaced open stone surgery for virtually all indications. This article describes the indications, the surgical technique and the complication management of PCNL.

Assessing blood platelets as RNA biomarker source for prostate cancer.

Context: Blood platelets may offer as RNA biomarker source for cancer as recently described for an oncogenic transcript in glioma patients and for PCA3 in prostate cancer (PCa) patients.

Objective: Here, we elaborated on this aspect for PCa.

Materials And Methods: PCA3 and other PCa-associated RNA markers were measured in platelets of PCa patients (cases) and healthy subjects (controls) in comparison to PCa cell lines by relative quantitative RT-PCR.

Female Gender Is an Age-dependent Negative Prognostic Factor for Patients with Upper Tract Urothelial Carcinoma.

Aim: To analyze female gender as a possible age-dependent prognostic factor for overall (OS) and cancer-specific survival (CSS) in patients with upper urinary tract urothelial carcinoma (UUTUC) after radical nephroureterectomy (RNU).

Patients And Methods: A total of 167 men and 101 women with UUTUC treated with RNU with bladder cuff resection at our clinic were retrospectively analyzed. Female patients were divided into pre- and post-menopausal groups and compared against male patients of the same age.

Lymphoceles Post-Radical Retropubic Prostatectomy: A Retrospective Evaluation of Epidemiology, Risk Factors and Outcome.

Introduction: We aimed at evaluating the incidence of lymphoceles, a common complication after radical retropubic prostatectomy (RRP), at a high volume centre, define risk factors and assess the clinical outcome.

Materials And Methods: 454 patients receiving RRP and pelvic lymph node dissection were assessed for postoperative lymphoceles using the ultrasound method. Findings were correlated to clinical parameters from a database (age, BMI, initial PSA, number of lymph nodes removed, prostate weight, duration of surgery, hospital stay, duration of catheterisation) and possible unconventional risk factors using meteorological data.

[Therapy of low-grade nonmuscle-invasive bladder cancer].

Nonmuscle-invasive bladder cancer (NMIBC) comprises a very heterogeneous group of malignancies; the biological behavior of these tumors depends primarily on their grading. Low-grade NMIBC are characterized by a high propensity for recurrence but a very low risk for progression to muscle invasion or metastatic disease. Thus, the first line goal of diagnostic procedures and therapy is reliable visualization and complete resection of all foci.

[Metastasized renal cell carcinoma. Measurement of plasma levels of the tyrosine kinase inhibitors sunitinib, sorafenib and pazopanib].

Background: Several tyrosine kinase inhibitors (TKI) are used in the treatment of metastasized renal cell carcinoma (mRCC). This article presents a feasibility study for the measurement of plasma levels of sunitinib, sorafenib and pazopanib using liquid chromatography tandem mass spectrometry (LC-MS/MS).

Methods: A total of 23 patients suffering from mRCC under treatment with sunitinib (n=16), sorafenib (n=3) and pazopanib (n=4) were included.

[Indications for nephron-sparing surgery. Analysis over a 13-year period in the context of changing guidelines].

Background: The indications for nephron-sparing surgery have been considerably extended by guideline recommendations in recent years. It remains unclear whether clinical practice still reflects these new guidelines.

Objective: In this retrospective, monocentric analysis at a tertiary referral center the indications for partial nephrectomy over a 13-year period were evaluated.