Publications by authors named "Thomas Herrmann"

Introduction: Water Jet Ablation Therapy (WJAT) and Holmium Laser Enucleation of the Prostate (HoLEP) represent two common surgical treatments for Benign Prostatic Hyperplasia (BPH). Despite their increasing use, there is no study between these two methods. We aim to evaluate their efficacy and safety through a network meta-analysis (NMA), providing critical insights for clinical decision-making in the management of moderate to severe lower urinary tract symptoms (LUTS) due to BPH.

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Objective: To assess urologists' perceptions and current practices of using suction-based techniques and technologies in percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for kidney stones.

Materials And Methods: A customized web-based 28-item questionnaire was created. All participation was voluntary.

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Purpose: To investigate the effect of pre-biopsy rectal swab and urine screening combined with a risk-adapted antibiotic treatment strategy on reducing post-biopsy infections (PBIs) following multiparametric magnetic resonance imaging (mpMRI)/ transrectal ultrasound (TRUS) fusion-targeted transrectal prostate biopsy (TRPBx).

Methods: 1119 Patients undergoing mpMRI-TRUS fusion TRPBx between June 2017 and February 2024 were included. Patients were screened for rectal extended-spectrum beta-lactamase (ESBL)/multi-resistant gram-negative (MRGN) and urinary pathogens.

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Purpose: The goal of this systematic review is to assess the temporal changes in outcomes and complications of transurethral resection of the prostate (TURP) from 2000 to 2022.

Methods: We conducted a systematic review and meta-analysis of 103 randomized clinical trials from PubMed on TURP, involving 8521 patients. Studies were grouped by years: 2000-2004, 2005-2009, 2010-2014, and 2015-2022.

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Article Synopsis
  • Open simple prostatectomy (OSP) is still an important treatment for benign prostatic hyperplasia (BPH) in patients with large prostate volumes (>80 ml), especially when compared to newer methods like minimally invasive simple prostatectomy (MISP) and laser enucleation.
  • A meta-analysis of 10 randomized controlled trials showed that while OSP significantly improves voiding symptoms, it has a higher risk of postoperative complications such as bleeding and transfusions.
  • Although OSP remains a viable treatment option, its higher morbidity rates necessitate careful patient selection and ongoing research to enhance surgical techniques and overall outcomes.
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Purpose: Urinary sepsis is the leading cause of mortality in the setting of endourological procedures for stone treatment such as URS and PCNL; renal stones themselves may be a source of infection. Aim of this study is to determine the diagnostic accuracy of stone cultures (SC) collected during URS and PCNL in predicting post-operative septic complications, compared to preoperative bladder urine culture (BUC).

Methods: We performed a systematic review (SR) of literature according to the PRISMA guidelines; Literature quality was evaluated according to The Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) assessment tool.

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Background: To explore how urologists manage prostate cancer (PCa) screening and treatment in patients undergoing endoscopic enucleation of the prostate (EEP).

Methods: A team of experts in EEP collaboratively formulated the survey questions through an interactive process. The survey opened in January 2024 and closed in February 2024.

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Article Synopsis
  • The study looks at how the size of the prostate affects patients’ recovery and symptoms after a surgery called RASP, which helps treat an enlarged prostate (BPH).
  • They reviewed 25 articles and found that patients with smaller prostates had worse symptoms before surgery but improved more after, while those with larger prostates still had some moderate symptoms.
  • The researchers concluded that RASP is a safe and effective surgery for treating BPH, but more studies are needed to understand how prostate size influences the results.
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Background And Objective: The widespread adoption and rapid integration of new technologies and techniques in endoscopic and laser bladder interventions, particularly endoscopic enucleation, have led to new types of bladder injuries. This underscores the need for an intraoperative injury classification system. This study aims to develop and validate the Bladder Injury Classification System for Endoscopic Procedures (BICEP), which standardizes the classification of complications and intervention requirements.

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Purpose: Optimal follow-up strategies following trimodal treatment for muscle invasive bladder cancer play a crucial role in detecting and managing relapse and side-effects. This article provides a comprehensive summary of the patterns and risk factors of relapse, functional outcomes, and follow-up protocols.

Methods: A systematic literature search on PubMed and review of current guidelines and institutional follow-up protocols after trimodal therapy were conducted.

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Vγ9Vδ2 T cells comprise 1-10% of human peripheral blood T cells. As multifunctional T cells with a strong antimicrobial and antitumor potential, they are of strong interest for immunotherapeutic development. Their hallmark is the eponymous Vγ9Vδ2 T-cell antigen receptor (TCR), which mediates activation by so-called "phosphoantigens" (PAg).

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Background: We aimed to determine if preoperative prostate volume-enucleated weight concordance predicts short-term anatomical endoscopic enucleation of the prostate (AEEP) outcomes using the REAP international database.

Methods: 649 patients with data on both preoperative ultrasound-derived prostate volume and enucleated specimen weight were analyzed. Linear regression was used to investigate the effect of volume-weight concordance on postoperative outcomes.

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Background: En bloc resection of bladder tumor (ERBT) is an established surgical treatment method for patients with non-muscle invasive bladder cancer (NMIBC) in tumors less than 3 cm. Data regarding the efficacy and safety of ERBT on larger than 3 cm tumors are sparse and its efficacy compared to conventional transurethral resection (TURBT) remains unclear. The aim of this study was to prospectively compare the feasibility, safety and oncological outcomes of laser (Tm-fiber) ERBT and TURBT in patients with primary bladder lesions ≥3 cm.

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Objectives: We aim to compare efficacy and safety of water vapour therapy (Rezūm), transurethral needle ablation (TUNA) and transurethral microwave therapy (TUMT) for treating men with moderate to severe benign prostatic hyperplasia (BPH) symptoms.

Materials: PubMed/MEDLINE, EMBASE and Cochrane Library were searched from inception to 30 July 2023, followed by reference searching and dual-independent study selection. We analysed only randomized clinical trials.

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Fatty acid transport protein (FATP)4 was thought to mediate intestinal lipid absorption, which was disputed by a study using keratinocyte-Fatp4-rescued Fatp4 mice. These knockouts when fed with a Western diet showed elevated intestinal triglyceride (TG) and fatty acid levels. To investigate a possible role of FATP4 on intestinal lipid processing, (KO) mice were generated by -specific inactivation of the gene.

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Background And Objective: Thulium fiber laser (TFL) emerged as a competitor of holmium:yttrium-aluminum-garnet (Ho:YAG) laser for anatomic enucleation of the prostate (AEEP) in men with lower urinary tract symptoms (LUTS) related to benign prostatic obstruction (BPO). The aim was to compare the surgical outcomes of Ho:YAG and TFL for AEEP.

Methods: A literature search was conducted to identify reports published from inception until January 2024.

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Surgical approaches for benign prostatic hyperplasia have evolved and diversified over the past decades. While numerous studies document the efficacy of surgical procedures for moderate prostate sizes, there remains insufficient data for large prostate volumes >200 ml, leaving important questions unanswered regarding their effectiveness and safety. Consequently, selecting and adapting suitable therapeutic options for this specific patient group often poses a significant challenge.

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Purpose: The primary aim of the study was to evaluate if en-bloc vs. non en-bloc made a difference to intra-, peri- and post-operative surgical outcomes of anatomical endoscopic enucleation (AEEP) in large (> 80 cc) and very large prostates (> 200 cc). The secondary aim was to determine the influence of energy and instruments used.

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In En-Bloc Resection of Bladder Tumours (ERBT), tumours are not removed in fragments, but are dissected in one layer and, if possible, extracted in one piece. This method represents a significant shift in the surgical management of non-muscle-invasive bladder tumours, providing multiple benefits over the traditional transurethral resection of the bladder (TUR-B). The histological analysis of ERBT specimens is more accurate, enhancing diagnostic precision.

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Background And Objective: The European Association of Urology (EAU) Guidelines Panel on non-neurogenic male lower urinary tract symptoms (LUTS) aimed to develop a new subchapter on underactive bladder (UAB) in non-neurogenic men to inform health care providers of current best evidence and practice. Here, we present a summary of the UAB subchapter that is incorporated into the 2024 version of the EAU guidelines on non-neurogenic male LUTS.

Methods: A systematic literature search was conducted from 2002 to 2022, and articles with the highest certainty evidence were selected.

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Background: The surgical landscape for Lower Urinary Tract Symptoms (LUTS) and Benign Prostatic Hyperplasia (BPH) has evolved with the introduction of Minimally Invasive Surgical Therapies (MISTs), recognizing the impact of sexual function on patients' well-being, and prioritizing ejaculation-sparing approaches.

Methods: This systematic review explored ejaculation sparing after classic endoscopic procedures and MISTs (iTind, Rezūm, Urolift, Aquablation, and TPLA) and a literature search yielded 41 studies.

Results: While all procedures demonstrated efficacy in improving LUTS/BPH symptoms (IPSS, QoL, Qmax), a subset of studies evaluated ejaculatory function.

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Purpose Of Review: Surgical treatment of benign prostatic hyperplasia (BPH) carries a significant risk of ejaculation dysfunction. Preservation of antegrade ejaculation while providing effective, well tolerated, and durable treatment of BPH is a paramount component of physical and sexual well being for significant number of men. We reviewed available literature with an aim of providing status on antegrade ejaculation preserving BPH surgical therapies.

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Article Synopsis
  • The study investigates complications and urinary incontinence rates after using the thulium fiber laser (ThuFLEP) for prostate enucleation in patients with varying prostate volumes (PV), specifically ≤80 ml and >80 ml.
  • Out of 2,732 reviewed patients, findings showed that while blood transfusion rates were higher in larger prostates, overall complications and incontinence rates were similar between both groups, with a notable correlation between preoperative urine residual and increased incontinence risk.
  • The study is limited by its retrospective design, but it concludes that ThuFLEP shows comparable outcomes in terms of complications and urinary incontinence, regardless of prostate size.
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