Urologie最新文献

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. Current studies have shown that TP-Bx can be performed without antibiotic prophylaxis and new techniques such as robotic-assisted and vector biopsy show very precise results. The establishment of TP-Bx is being promoted by extrabudgetary funding and technological advancements, with the choice of biopsy method remaining an individual decision jointly made in dialogue with the patient.

This article examines the development of urology as an independent medical discipline in Germany, with a particular focus on professionalization and specialization in the 19th and 20th centuries. Based on historical sources, the text illuminates the importance of the German medical profession's further training regulations as an instrument of medical self-administration and the classification of urology as a medical specialty in the Bremen guidelines of 1924, which established board certification in diseases of the urinary organs (urology).

Objective: Large language models (LLMs) are gaining popularity due to their ability to communicate in a human-like manner. Their potential for science, including urology, is increasingly recognized. However, unresolved concerns regarding transparency, accountability, and the accuracy of LLM results still exist.

Research question: This review examines the ethical, technical, and practical challenges as well as the potential applications of LLMs in urology and science.

Materials and methods: A selective literature review was conducted to analyze current findings and developments in the field of LLMs. The review considered studies on technical aspects, ethical considerations, and practical applications in research and practice.

Results: LLMs, such as GPT from OpenAI and Gemini from Google, show great potential for processing and analyzing text data. Applications in urology include creating patient information and supporting administrative tasks. However, for purely clinical and scientific questions, the methods do not yet seem mature. Currently, concerns about ethical issues and the accuracy of results persist.

Conclusion: LLMs have the potential to support research and practice through efficient data processing and information provision. Despite their advantages, ethical concerns and technical challenges must be addressed to ensure responsible and trustworthy use. Increased implementation could reduce the workload of urologists and improve communication with patients.

The number of patients living with or after cancer is constantly increasing due to improved diagnostics and care as well as the ageing society. This is particularly true for the group of older cancer survivors with complex health and supportive care needs. For many of those affected and their relatives, the disease and its treatment are accompanied by high levels of emotional stress, an impaired quality of life, and a variety of psychosocial challenges. Psychosocial distress, such as depression and anxiety, sometimes persists for years after treatment has ended. The most common unmet supportive care needs of patients include psychological and emotional needs as well as information needs. Therefore, it is essential to implement effective psychosocial screening and low-threshold needs-based referral to evidence-based psycho-oncological support services. Around a third of all cancer patients express a desire for professional psycho-oncological support. Although there is compelling evidence that psycho-oncological interventions can reduce psychosocial distress and improve quality of life, there is a need for further research into the design and effectiveness of intervention services for specific subgroups, such as prostate cancer patients.