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To prove that holmium laser prostatectomy (HoLEP) is safe and effective in the treatment of benign prostatic hyperplasia (BPH), and is superior to transurethral prostatectomy (TURP) for elderly patients.We retrospectively studied 565 HoLEP patients and 76 TURP elderly patients. HoLEP patients were first divided into three groups according to their age(Under 65 years old group, 65-79 years old group and over 80 years old group), and their preoperative, intraoperative, and postoperative characteristics were then compared. Secondly, the same characteristics of HoLEP and TURP patients over 80 years were compared. Chi-square test, one-way ANOVA and Fisher's exact test were used in this study.Firstly, we compared HoLEP patients in different age groups and found that there was statistically significant difference in diabetes, CCVD and bladder stones, among the three groups (P<0.05).Secondlye, we compared HoLEP and TURP treatments in elderly patients (≥80 years old). The patients with HoLEP had a higher share of diabetes, CCVD and anticoagulation (P<0.05). Moreover, compared with TURP patients, HoLEP patients had shorter enucleation duration, more enucleate prostate weight, fewer hemoglobin diminutions, shorter bladder irrigation time, shorter catheter-indwelling period, and shorter hospital period (P<0.05). Although there was no difference in IPSS, Qmax and QOL between the two groups before operation (P>0.05), the difference was statistically significant, 6 months after the operation (P<0.05).HoLEP is safe and effective for BPH patients, and is superior to transurethral TURP for elderly patients.

This study investigates and compares the clinical safety and efficiency of Holmium Laser Enucleation of the Prostate (HoLEP) and robot-assisted transvesical enucleation of the prostate (RASP) for the treatment of benign prostatic hyperplasia (BPH) with large prostate volumes in a tertiary care centre. Perioperative data were collected from 39 patients who underwent RASP at our centre between 2015 and 2021. Propensity score matching was performed based on prostate volume, patient age, and body mass index (BMI), comparing these patients with 721 individuals treated with HoLEP at our clinic. An analysis was performed of preoperative parameters, including prostate volume, age, BMI, PSA level, IPSS score, and IIEF score, as well as intra- and postoperative parameters, including operative time, resected tissue weight, postoperative catheterization duration, length of hospital stay, haemoglobin decrease, transfusion rate, postoperative urinary retention, Clavien-Dindo classification (CDC), and the Comprehensive Complication Index (CCI). A statistically significant advantage was observed in favour of HoLEP regarding operative time (114.5 vs. 153.5 minutes; p<0.001), catheterization duration (2.6 vs. 7.4 days; p<0.001), and length of hospital stay (2.9 vs. 8.8 days; p<0.001). No statistically significant difference was found in terms of haemoglobin decrease or transfusion rate. The overall complication rate was lower in the HoLEP group, but the difference did not reach statistical significance (p=0.051). However, regarding the severity of complications, a statistically significant disadvantage for RASP was observed based on the CDC (p=0.027), while the CCI did not show a statistically significant difference between the cohorts (p=0.098). Both HoLEP and RASP proved to be effective and safe for the treatment of BPH with large prostate volumes. Compared to RASP, HoLEP demonstrated advantages in terms of catheterization duration and length of hospital stay. No statistically significant differences were observed regarding the overall complication rate.

Counselling regarding a planned provision of medical aids is currently neither reimbursed nor regulated in Germany. It is offered by a range of providers with employees with varying levels of qualification and may be provided in a personal conversation, by phone, or remotely. In many cases, counselling is omitted entirely between the prescription and trial use or delivery of the product. The quality of medical aids counselling, which plays a key role in temporary, supportive or palliative care for urinary incontinence, is therefore considered problematic.In 2019, the working group "Geriatric Urology" of the German Society for Urology published the first guideline on the counselling process related to the provision of medical aids. An updated version is currently available and has been listed by the Association of the Scientific Medical Societies. The underlying idea was to define quality standard in Germany for the individual components of the counselling process - from identifying the type of incontinence and its severity to product trial use, the counselling setting, the counselling itself, the qualification of the counselling personnel, and the communication between prescribing physicians, service providers, and patients.This article presents the published guideline sections regarding the counselling process, its scope, and the assessment of urinary incontinence, including information relevant to patients.As medical aids counselling is expected to be financed from the low reimbursement rates provided by statutory health insurers for what is defined as an "appropriate and sufficient" supply - typically amounting to less than EUR 15 a month - more and more providers are withdrawing entirely from the sector of medical aids provision. Others continue to supply medical aids but offer no counselling at all or only to a very limited extent. The guideline "Medical Aids Counselling for Urinary Incontinence" developed by the working group "Geriatric Urology" of the German Society for Urology is meant to define quality standards, also with a view to a political discussion on reimbursement rates.