Publications by authors named "Paulo Pfitzinger"

Higher intraoperative opioid doses may be associated with worse long-term oncological outcomes after radical prostatectomy (RP) for prostate cancer. We aimed to evaluate the impact of higher doses of intraoperative opioids and type of anesthesia on biochemical recurrence (BCR) and mortality after RP in a high-volume tertiary center. All patients underwent RP at our center between 2015 and 2021.

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Mast cells are commonly found in pancreatic ductal adenocarcinoma (PDAC), yet their role in the disease remains uncertain. Although mast cells have been associated with depression in several diseases, their connection to PDAC in this context remains unclear. This study explored the correlation between mast cells and psychosocial stress in patients with PDAC.

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Background: An increased intraoperative opioid dose seems to lead to worse outcomes in several types of cancer. We assessed the effect of intraoperatively administered opioids as well as the type of anesthesia on survival, recurrence rates and major perioperative outcomes in patients who underwent radical cystectomy (RC) for urothelial carcinoma of the urinary bladder.

Methods: We included patients who underwent open RC at our center between 2015 and 2022.

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The prostate biopsy is an essential tool for diagnosing prostate cancer (PCa). While transrectal biopsy (TR-Bx) continues to be considered the gold standard in Germany, the European Association of Urology (EAU) guidelines increasingly recommend transperineal biopsy (TP-Bx) due to lower infection rates and higher tumor detection rates. This article provides an overview of the history and development of the perineal biopsy, compares TR-Bx and TP-Bx and discusses the need for antibiotic prophylaxis before TP-Bx.

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Article Synopsis
  • The study analyzed in-hospital outcomes and trends for patients with low-flow and high-flow priapism using data from Germany's nationwide inpatient records between 2008-2021.
  • It included a total of 6,588 low-flow and 729 high-flow priapism cases, revealing an increase in low-flow cases requiring hospitalization and a decline in high-flow cases over recent years.
  • The findings indicated that 22.4% of low-flow patients required shunt surgery, especially among those with sickle cell disease, while high-flow cases were primarily managed conservatively, showing no significant differences in hospital stay or complications related to treatment.
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  • The study aimed to evaluate the benefits of adding ultrasonography-guided biopsies (SBx) to multiparametric MRI-targeted biopsies for detecting clinically significant prostate cancer (csPCa) and to assess the risk of overdiagnosing clinically insignificant prostate cancer (ciPCa).
  • A total of 1552 men with positive MRI underwent both types of biopsies, revealing that SBx contributed to the detection of csPCa in 15% of cases where mpMRI-targeted biopsy either returned negative results or detected ciPCa.
  • The analysis indicated a 22% overdiagnosis rate from SBx, and factors like the presence of high-grade lesions (PI-RADS 4 and 5) and
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We aimed to assess the recommended annual hospital volume for inflatable penile prosthesis implantation (PPI) and to provide evidence on perioperative outcomes of semi-rigid and inflatable PPI in Germany. We used the GeRmAn Nationwide inpatient Data (GRAND) from 2005 to 2021 and report the largest study to date with 7,222 patients. 6,818 (94.

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Objectives: To explore whether Christmas might be a risk factor for penile fractures due to the Christmas spirit related to the intimacy and euphoria of these holly jolly days.

Patients And Methods: We evaluated the incidence of penile fractures during Christmas and New Year's Eve through the GeRmAn Nationwide inpatient Data (GRAND) from the Research Data Center of the Federal Bureau of Statistics (Wiesbaden, Germany). Furthermore, we assessed the impact of COVID-19 on penile fractures and their seasonality.

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Objective: Multiparametric magnetic resonance imaging (mpMRI) -Ultrasound- fusion guided biopsy of the prostate (FBx) is the new gold standard for the detection of prostate cancer. Hallmark studies showing superior detection rates of FBx over randomized biopsies routinely excluded patients≥75 years and information on outcome of FBx on this patient cohort is sparse. As a large referral center, we have performed FBx on a substantial number of patients this age.

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Multiparametric magnetic resonance imaging (mpMRI) has emerged as a new cornerstone in the diagnostic pathway of prostate cancer. However, mpMRI is not devoid of factors influencing its detection rate of clinically significant prostate cancer (csPCa). Amongst others, prostate volume has been demonstrated to influence the detection rates of csPCa.

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Objectives: As structured reporting is increasingly used in the evaluation of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) for prostate cancer, there is a need to assess the reliability of these frameworks. This study aimed to evaluate the intra- and interreader agreement among readers with varying levels of experience using PSMA-RADS 1.0 for interpreting PSMA-PET/CT scans, even when blinded to clinical data, and therefore to determine the feasibility of implementing this reporting system in clinical practice.

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Article Synopsis
  • The study investigates how factors related to patients, surgery, and tumors affect the presence of detrusor muscle (DM) in bladder cancer surgeries and its influence on patient outcomes.
  • Out of 3,237 TUR-BTs analyzed, DM was found in 67.6% of cases, with surgery duration, tumor type, and location being significant predictors for DM absence.
  • The absence of DM, particularly in high-grade bladder cancer, is linked to a lower chance of recurrence-free survival, highlighting the need for thorough and skilled surgical techniques.
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Background: Transrectal (TR) prostate biopsy is the gold standard in diagnosis of prostate cancer (PC). It requires a precise and safe technique for sample acquisition.

Objective: Several approaches will be discussed to avoid overdiagnosis, false-negative results, and complications of the procedure.

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The clinical and histological diagnosis of prostate cancer is a crucial aspect of the routine work of a urologist. The high prevalence of multiresistant microorganisms leads to an increased incidence of sepsis after transrectal prostate biopsy. It requires a switch from the still gold-standard method to the transperineal fusion biopsy procedure after multiparametric prostate magnetic resonance imaging (MRI).

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Objective: Over the last decade, active surveillance (AS) of low-risk prostate cancer has been increasing. The mpMRI fusion-guided biopsy of the prostate (FBx) is considered to be the gold standard in preoperative risk stratification. However, the role of FBx remains unclear in terms of risk stratification of low-risk prostate cancer outside high-volume centers.

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The diagnostics and treatment of pediatric urology patients in the clinical routine can be extremely challenging. In contrast to adult patients, the main concerns in the diagnostics of congenital diseases are time consuming examinations and limited options in addition to the expectations of the parents. The exact knowledge of the diagnostic possibilities in association with the correct interpretation of the indications is essential.

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The diagnostics and treatment of pediatric urology patients in the clinical routine can be extremely challenging. In comparison to adult patients, congenital diseases, more time consuming examinations and limited options in addition to the parents' expectations must be taken into account in the diagnostic work up. In this first of two parts we will delve into ultrasound diagnostics as the cornerstone in the diagnostic pathway of children with hydronephrosis ans take a closer look on contrast enhanced ultrasound (CEUS).

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Objective: To determine the impact of asymptomatic bacteriospermia on semen quality in subfertile men.

Methods: We conducted a retrospective, single-centre cohort study in 1300 subfertile men. In those diagnosed with asymptomatic bacteriospermia we performed univariate and multivariate logistic regression models to evaluate the strain-specific association with semen parameters.

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Introduction: Radical cystectomy (RC) and urinary diversion by ileal conduit (IC) or ileal orthotopic neobladder (ONB) is the standard-of-care for surgical treatment of muscle-invasive bladder cancer. Yet, it is unclear how urinary diversion affects the patient's health-related quality of life (HRQOL) in the longer-term.

Methods: HRQOL was assessed preoperatively, 3mo postoperatively and then annually until a maximum follow-up of 48 months using the validated EORTC QLQ-C30- as well as the bladder cancer-specific FACT-BL- and QLQ-BLM30-questionnaires.

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Introduction: Biomarkers are known predictors for survival after radical cystectomy (RC) and can improve patient stratification. Yet, it remains unclear how age influences their prognostic value. The current study aimed to assess the impact of age on standard prognostic biomarkers in different age-groups.

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Background: In high-grade urothelial carcinoma (UC) of the bladder, bacillus Calmette-Guerin (BCG) therapy is a therapeutic mainstay, and urinary cytology is recommended to detect recurrences. However, intravesical BCG instillations can induce morphologic changes in urothelial cells. The authors investigated the impact of BCG therapy on the efficacy of urinary cytology.

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Purpose: Contrast-enhanced CT scan is the standard staging modality for patients with bladder cancer undergoing radical cystectomy (RC). Involvement of lymph nodes (LN) determines prognosis of patients with bladder cancer. The detection of LN metastasis by CT scan is still insufficient.

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