Urologie最新文献

The aim of this article is to raise awareness among healthcare providers about the adverse events (AEs) associated with the combined treatment with enfortumab vedotin and pembrolizumab. The differential diagnostic allocation of these AEs to the respective agents is discussed, overlaps between the side effect profiles of the two drugs are identified and strategies for an effective management of these AEs are presented. The recommendations are based on the currently valid prescription information for both drugs, the results of pivotal approval studies and the guidelines of recognized specialist organizations as well as the clinical experience of the authors.

Background: Radical prostatectomy (RP) is one of the most common therapeutic strategies for treating localized prostate cancer (PCa). Currently, the significance of postoperative functional limitations for affected patients in the long-term course, especially in comparison to age-related comorbidities, is unclear.

Objective: The aim of this study was to quantify the prevalence of subjective health restrictions alongside functional deficits in long-term PCa survivors after RP and their relevance for subjective impairments in everyday life.

Materials and methods: Using the German version of the Self-Administered Comorbidity Questionnaire (SCQ-D), 3173 long-term survivors after RP reported their comorbidities in 13 predefined categories and in 3 free-text fields along the dimensions "problem," "treatment," and "impairment".

Results: The mean age at survey was 79.5 years (standard deviation, SD ± 6.4), with a mean time since RP of 17.4 years (SD ± 3.7). The three most frequently identified comorbidities/percentage of patients who felt impaired were: hypertension (62.2%/8.5%), back pain (44.1%/54.5%), and osteoarthritis (36.1%/54.1%). The most frequently mentioned additional health problems can be subsumed under the umbrella term "urological problems" (6.1%/72.7%): incontinence (4.8%/74.3%), bladder problems (1.1%/61.8%), and erectile dysfunction (0.5%/47.1%).

Conclusion: In summary, non-cancer-related comorbidities in the long-term course after RP are often perceived as "problems" but rarely lead to subjective impairment. In contrast, treatment-related urological problems are rarely reported as "problems", but they very often lead to subjective impairment in everyday life.

Background and objectives: The human papillomavirus (HPV) is one of the most common viruses transmitted through intimate contact, causing many benign and malignant diseases. Vaccination protects against these diseases. Despite the HPV vaccination being recommended by the Standing Committee on Vaccination (STIKO), knowledge and vaccination rates in Germany are very low. Therefore, the aim of the study was to assess the HPV knowledge among German students.

Materials and methods: Between 06/2019 and 01/2024, a nationwide online survey on HPV knowledge among students in Germany was distributed via the respective student councils. The survey included two aspects: 1) basic characteristics of the participants and 2) knowledge questions about HPV (e.g., transmission routes, effectiveness, and side effects of vaccination, knowledge about the HPV subtypes). Data collection was anonymous.

Results: A total of 459 students took part in the study. Of these, 335 (72.98%) were female, 122 (26.57%) were male, and 2 (0.45%) did not specify their gender. The average age of the students was 24.02 years, and most of the participants were in their 6th (23.31%/107) semester. In all, 75.82% (348) of the participants were medical students followed by law students with 19.61% (90) participants. The most represented study location was Aachen, with 270 (58.82%) participants. Only about half (48.80%/223) of the students knew that approximately 8000 new cancer cases in Germany are HPV-associated annually. Regarding the HPV vaccination, more than a third (35.82%/163) of participants did not know that it also protects against genital warts, while 21.93% (100) did not know that boys can also benefit from the HPV vaccination and that it does not only improve HPV protection of girls against cervical cancer.

Conclusion: Despite several years of HPV vaccination recommendation by the Standing Committee on Vaccination (STIKO), knowledge about HPV among college students still remains very low. Further prevention and educational efforts are needed to address HPV knowledge gaps, with the additional goal of improving HPV vaccination rates.

Background: Testicular tumors and penile cancer are rare but potentially life-threatening diseases. Testicular tumors primarily affect younger men, while penile cancer is more common in older men. Early detection can significantly improve survival rates.

Objectives: This article investigates the indications for early detection screenings for testicular tumors and penile cancer.

Methods: A comprehensive literature review was conducted to analyze current studies and guidelines.

Results: No general screening programs are recommended for either type of cancer. For testicular tumors, self-examination of the testes is recommended, while for penile carcinomas, education on risk factors such as human papillomavirus (HPV) infections or phimosis is emphasized. In both cases, medical examination is crucial.

Conclusion: Education and awareness, especially among at-risk groups, are essential. Physicians play a key role in conducting and recommending early detection measures.

Background: Population-based screening for prostate cancer (PC) is still controversially discussed. Furthermore, an organized, risk-adapted screening program is already being called for across Europe. Although large randomized controlled trials have shown that prostate-specific antigen (PSA)-based screening can significantly reduce PC-specific mortality, all known screening strategies still frequently lead to overdiagnosis and consecutively to overtreatment of clinically insignificant PC.

Objective: This review article presents the current evidence regarding PC screening.

Results: The current German early detection program, which is based on the annually recommended digital rectal examination (DRE), lacks specificity and sensitivity. In Germany, an opportunistic PSA screening is currently being carried out, which is no longer recommended due to an unfavorable benefit-risk ratio. Since 2022, the European Commission has been calling for the development of organized, risk-adapted screening strategies that combine the PSA test with magnetic resonance imaging (MRI). The integration of MRI improves the detection of clinically relevant PC and reduces the overdiagnosis of low-risk cancers. In the future, an algorithm for early detection of PC needs to be developed, which, in an organized and personalized screening, combines the PSA test with MRI and possibly genetic markers.

Conclusion: The early detection of prostate cancer should be organized at the population level and integrated into personalized, evidence-based screening strategies.