Revue medicale suisse最新文献

The treatment of upper urinary tract stones is one of the main urological activities. Endoscopic surgical techniques, namely semirigid or flexible ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL), represent a major therapeutic modality, alternatively to chemolysis, extracorporeal shock wave lithotripsy and open, laparoscopic or robotic-assisted surgery. In this article, the specificities of these endoscopic techniques, their clinical performances, as well as their development following recent technological advances are discussed.

Penile cancer is a rare but serious disease, with major consequences for patients' quality of life. Although it accounts for less than 1 % of male cancers in the Western world, its incidence is higher in certain regions of the world. His staging, particularly the evaluation of lymph nodes according to the TNM system, is crucial in determining prognosis and guiding treatment. Regular follow-up is essential to detect early recurrence and monitor the side effects of treatment. In this article, we explore penile cancer, from diagnosis to treatment options, with an emphasis on clinical presentation to ensure early detection and referral to a specialist.

Small renal masses (SRMs), which are tumors less than 4 cm in diameter, are increasingly discovered incidentally due to the rise in diagnostic imaging. Although many of these masses are benign, managing SRMs remains challenging. Active surveillance (AS) offers a viable alternative to surgery, particularly for patients with high surgical risks or limited life expectancy. AS, validated by various studies, involves close monitoring with regular imaging, enabling delayed surgical intervention if the tumor shows signs of progression. However, the adoption of AS is hindered by the absence of standardized protocols and the growing availability of minimally invasive surgical options.

Even though people with spinal cord injury are usually followed by a spinal cord injury specialist, studies show that they continue to be monitored by their general practitioner. In Switzerland, over a one-year period, 88 % of spinal cord injury patients consult their general practitioner. The five most common health problems reported by people with spinal cord injury are pain, spasticity, neurogenic disorders of bladder and bowel function, and urinary tract infections. Even if these are common problems in primary care medicine, it is important for general practitioner to be aware of the specificities of spinal cord injury patients, to ensure optimal management. This article provides some useful information on the management of spinal cord injured patients in outpatient care.

Peripheral arterial disease (PAD) is a major public health issue, with a growing prevalence due to the aging population and the rise in risk factors such as diabetes, hypertension, and dyslipidemia. Managing PAD involves a multidisciplinary approach, with the primary care physician playing a crucial role in early screening. This article compiles the latest data from 2024 and current practices for the management of this disease. In simplified terms, all symptomatic patients should receive single antiplatelet therapy, and all post-revascularization patients should be on at least DAPT (Dual Antiplatelet Therapy) orDPI (Dual Pathway Inhibition), as recommended by the European Society for Vascular Surgery 2024 guidelines.

Urological cancers are substantial burden for public health worldwide, due to their considerable incidence, morbidity and mortality. The cornerstone of an effective disease management is an appropriate diagnostic strategy and early detection. Based on the data from the population-based Geneva cancer registry, this article aimed to report epidemiological trends in urological cancers in Geneva from the last 26 years. Furthermore, it underlines the central role of all practitioners in identifying patients at risk and addressing them to the appropriate diagnostic pathway. This article enables us to take a step back from our current clinical practice in order to highlight their challenges and opportunities and find areas of improvement.