Urologie最新文献

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.

Even today, not all wounds can be healed. Treatment, which often takes many years, is a burden for patients and is very cost-intensive. Therefore, additional procedures such as cold plasma are becoming increasingly popular. Active components of cold plasma include electromagnetic radiation and free radicals. The active principle is based on, among other things, damage to bacterial cells and positive interaction with epithelial and endothelial cells. Angiogenesis and cellular oxygen metabolism are stimulated. The evidence base is still limited and heterogeneous, as some results are contradictory and comparability is difficult. However, new, well-designed studies have confirmed previous findings. In order to create a solid database, further studies are needed.

Urothelial carcinoma is one of the most common malignancies both in Germany and worldwide. Due to the frequent occurrence of late-onset or nonspecific symptoms, carcinomas are often diagnosed at advanced stages. Structured early detection programs have the potential to detect urothelial carcinoma in earlier stages and to improve survival rates. Various risk factors are associated with urothelial carcinoma, most notably tobacco abuse and occupational exposure, as well as genetic disorders such as Lynch syndrome in upper urinary tract carcinoma. In clinical practice, diagnostic tools include general examinations and ultrasound imaging of the urinary tract, with microhematuria and urine cytology playing key roles. For screening purposes noninvasive urine markers have demonstrated limited evidence. Despite the lack of optimal diagnostic markers for systematic early detection in high-risk populations, it is essential to ensure that every patient presenting with hematuria undergoes appropriate and risk-adapted diagnostics.