1
|
Saner Y, Tschirdewahn S. [The value of the penumbra in targeted prostate biopsy]. Urologie 2023; 62:75-76. [PMID: 36319707 DOI: 10.1007/s00120-022-01962-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 01/21/2023]
Affiliation(s)
- Y Saner
- Klinik und Poliklinik für Urologie, Kinderurologie und Uroonkologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland.
| | - S Tschirdewahn
- Klinik und Poliklinik für Urologie, Kinderurologie und Uroonkologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland
| |
Collapse
|
2
|
Saner Y, Wiesenfarth M, Tschirdewahn S, Püllen L, Bonekamp D, Krafft U, Kesch C, Darr C, Forsting M, Umutlu L, Hadaschik B, Radtke J. Detection of significant prostate cancer using target saturation in transperineal magnetic resonance imaging/transrectal ultrasonography–fusion biopsy: A prospective, randomized comparison to conventional target biopsy. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01281-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
3
|
Szarvas T, Csizmarik A, Váradi M, Fazekas T, Hüttl A, Nyirády P, Hadaschik B, Grünwald V, Tschirdewahn S, Shariat SF, Sevcenco S, Maj-Hes A, Kramer G. The prognostic value of serum MMP-7 levels in prostate cancer patients who received docetaxel, abiraterone, or enzalutamide therapy. Urol Oncol 2020; 39:296.e11-296.e19. [PMID: 33046366 DOI: 10.1016/j.urolonc.2020.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/06/2020] [Accepted: 09/12/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The rapidly changing treatment landscape in metastatic castration-resistant prostate cancer (mCRPC) calls for biomarkers to guide treatment decisions. We recently identified MMP-7 as a potential serum marker for the prediction of response and survival in mCRPC patients who received docetaxel (DOC) chemotherapy. Here, we aimed to test this finding in an independent patient cohort and in addition to explore the prognostic potential of serum MMP-7 in abiraterone (ABI) or enzalutamide (ENZA) treated patients. METHODS AND MATERIALS MMP-7 levels were measured in 836 serum samples from 320 mCRPC patients collected before and during DOC (n = 95), ABI (n = 140), or ENZA (n = 85) treatment by using the ELISA method. Results were correlated with clinical and follow-up data. RESULTS MMP-7 baseline levels were similar between the 3 treatment groups. In the ABI and ENZA cohorts, baseline MMP-7 levels were lower in patients with prior radical prostatectomy (P = 0.058 and P = 0.041, respectively). Baseline MMP-7 levels above the median were associated with shorter overall survival for the DOC (P = 0.001) and ENZA (P = 0.006) cohorts. Multivariable analyses in the DOC and ENZA cohorts revealed that high pretreatment MMP-7 level is an independent risk factor for patients' survival. In addition, in DOC-treated patients with high baseline MMP-7 level, marker decrease at the third DOC cycle was associated with improved survival. Patients with high baseline MMP-7 levels had better survival when treated with ABI compared to DOC or ENZA. CONCLUSIONS We confirmed the prognostic value of pretreatment MMP-7 serum level and its changes as independent predictors of survival in DOC-treated mCRPC patients. In addition, high MMP-7 was a negative predictor in ENZA-treated but not in ABI-treated patients. These results warrant further research to confirm the predictive value of serum MMP-7 and to explore the potential mechanistic involvement of MMP-7 in DOC and ENZA resistance of mCRPC patients.
Collapse
Affiliation(s)
- T Szarvas
- Department of Urology, Semmelweis University, Budapest, Hungary; Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
| | - A Csizmarik
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - M Váradi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - T Fazekas
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - A Hüttl
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - P Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - B Hadaschik
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - V Grünwald
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - S Tschirdewahn
- Department of Urology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - S F Shariat
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern, Dallas, TX; Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - S Sevcenco
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| | - A Maj-Hes
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| | - G Kramer
- Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
4
|
Tschirdewahn S, Wiesenfarth M, Bonekamp D, Püllen L, Reis H, Panic A, Kesch C, Darr C, Giganti F, Forsting M, Wetter A, Hadaschik B, Radtke J. Detection of significant prostate cancer using target saturation in transperineal MRI/ TRUS-fusion biopsy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33758-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
5
|
Darr C, Krafft U, Fendler WP, Costa PF, Barbato F, Praus C, Reis H, Hager T, Tschirdewahn S, Radtke JP, Herrmann K, Hadaschik BA. First-in-man intraoperative Cerenkov luminescence imaging for oligometastatic prostate cancer using 68Ga-PSMA-11. Eur J Nucl Med Mol Imaging 2020; 47:3194-3195. [PMID: 32356006 DOI: 10.1007/s00259-020-04778-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 03/18/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Christopher Darr
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - U Krafft
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - W P Fendler
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - P Fragoso Costa
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - F Barbato
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - C Praus
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - H Reis
- Institute of Pathology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - T Hager
- Institute of Pathology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - S Tschirdewahn
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - J P Radtke
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - K Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - B A Hadaschik
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| |
Collapse
|
6
|
Darr C, Krafft U, Panic A, Tschirdewahn S, Hadaschik BA, Rehme C. Renal duplication with ureter duplex not following Meyer-Weigert-Rule with development of a megaureter of the lower ureteral segment due to distal stenosis - A case report. Urol Case Rep 2019; 28:101038. [PMID: 31763165 PMCID: PMC6864332 DOI: 10.1016/j.eucr.2019.101038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/04/2019] [Accepted: 10/08/2019] [Indexed: 02/08/2023] Open
Abstract
Meyer-Weigert-Rule predicts the draining pattern of duplex ureters in bipolar renal duplications. The upper pole is normally seen as ectopic and therefore dysplastic due to obstruction, whereas the lower pole is related to vesicoureteral reflux. In our case, this rule is violated with uncrossed ureter duplex and a dysplastic lower pole in connection with obstruction.
Collapse
Affiliation(s)
- C Darr
- Department of Urology, University Hospital Essen, Essen, Germany
| | - U Krafft
- Department of Urology, University Hospital Essen, Essen, Germany
| | - A Panic
- Department of Urology, University Hospital Essen, Essen, Germany
| | - S Tschirdewahn
- Department of Urology, University Hospital Essen, Essen, Germany
| | - B A Hadaschik
- Department of Urology, University Hospital Essen, Essen, Germany
| | - C Rehme
- Department of Urology, University Hospital Essen, Essen, Germany
| |
Collapse
|
7
|
Tschirdewahn S, Harke NN, Hirner L, Stagge E, Hadaschik B, Eisenhardt A. Narrow-band imaging assisted cystoscopy in the follow-up of patients with transitional cell carcinoma of the bladder: a randomized study in comparison with white light cystoscopy. World J Urol 2019; 38:1509-1515. [PMID: 31471739 DOI: 10.1007/s00345-019-02926-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/20/2019] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To evaluate the diagnostic accuracy of a second look narrow-band imaging (NBI) cystoscopy in the follow-up of patients with NMIBC as compared to a second white light cystoscopy (WLI). PATIENTS AND METHODS From August 2013 to October 2014, 600 patients with history of non-muscle invasive bladder cancer (NMIBC), who presented for follow-up cystoscopy at an academic outpatient clinic, were randomized to flexible WLI-cystoscopy plus second look NBI-cystoscopy (n = 300) or flexible WLI-cystoscopy plus second look WLI-cystoscopy (n = 300) in the same session. We analysed the detection rate of bladder tumours in second look cystoscopy as primary endpoint. In addition, we evaluated recurrence rates before study enrolment and after transurethral resection (TUR-BT) in each group. RESULTS In 600 patients with a history of NMIBC, 78 out of 300 patients (26%) with WLI-NBI-cystoscopy and 70 out of 300 patients (23%) with WLI-WLI-cystoscopy were diagnosed with cancer recurrence (p = 0.507). Overall, WLI-NBI detected 404 and WLI-WLI 234 lesions, respectively. The second look cystoscopy detected 57 additional cancer lesions: 45 tumours in 18 patients with WLI-NBI and 12 tumours in 9 patients with WLI-WLI (p = 0.035). After initial examination without tumour detection an improvement was determined by the second cystoscopy in 3 patients (75 vs. 78 pat.) with WLI-NBI and in only one patient (69 vs. 70 pat.) with WLI-WLI (p = 0.137). Second look cystoscopy did not influence the detection of carcinoma in situ in both groups (p = 0.120). After TUR-BT the median recurrence-free survival was 4 months in 57 recurring patients (73%) in the group with WLI-NBI- and 6 months in 56 patients (80%) with WLI-WLI-cystoscopy (p = 0.373), respectively. CONCLUSION Our study showed no differences in per-patient tumour detection between WLI and NBI. Although NBI has significant benefits for detecting individual lesions overlooked by WLI-cystoscopy, this did not positively affect recurrence-free survival after transurethral resection.
Collapse
Affiliation(s)
- S Tschirdewahn
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| | - N N Harke
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| | - L Hirner
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| | - E Stagge
- Outpatient Clinic Praxisklinik für Urologie Rhein/Ruhr, Schulstr. 11, 45468, Mülheim an der Ruhr, Germany
| | - B Hadaschik
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| | - Andreas Eisenhardt
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany. .,Outpatient Clinic Praxisklinik für Urologie Rhein/Ruhr, Schulstr. 11, 45468, Mülheim an der Ruhr, Germany.
| |
Collapse
|
8
|
Krafft U, Tschirdewahn S, Hess J, Harke NN, Hadaschik BA, Nyirády P, Szendröi A, Szücs M, Módos O, Olah C, Székely E, Reis H, Szarvas T. STIP1 Tissue Expression Is Associated with Survival in Chemotherapy-Treated Bladder Cancer Patients. Pathol Oncol Res 2019; 26:1243-1249. [PMID: 31250373 DOI: 10.1007/s12253-019-00689-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/16/2019] [Indexed: 12/23/2022]
Abstract
To optimize treatment decisions in advanced bladder cancer (BC), we aimed to assess the therapy predictive value of STIP1 with regard to cisplatin therapy. Cisplatin-based chemotherapy represents the standard first-line systemic treatment of advanced bladder cancer. Since novel immunooncologic agents are already available for cisplatin-resistant or ineligible patients, biological markers are needed for the prediction of cisplatin resistance. STIP1 expression was analyzed in paraffin-embedded bladder cancer tissue samples of 98 patients who underwent adjuvant or salvage cisplatin-based chemotherapy by using immunohistochemistry. Furthermore, pre-chemotherapy serum STIP1 concentrations were determined in 48 BC patients by ELISA. Results were correlated with the clinicopathological and follow-up data. Stronger STIP1 nuclear staining was associated with worse OS in both the whole patient group (p = 0.034) and the subgroup of patients who received at least 2 cycles of chemotherapy (p = 0.043). These correlations remained significant also in the multivariable analyses (p = 0.035 and p = 0.040). Stronger STIP1 cytoplasmatic immunostaining correlated with shorter PFS both in the whole cohort (p = 0.045) and in the subgroup of patients who received at least 2 cycles of chemotherapy (p = 0.026). Elevated STIP1 serum levels were associated with older patient's age, but we found no correlation between STIP1 serum levels and patients' outcome. Our results suggest that tissue STIP1 analysis might be used for the prediction of cisplatin-resistance in BC. In contrast, pretreatment STIP1 serum levels showed no predictive value for chemotherapy response and survival.
Collapse
Affiliation(s)
- U Krafft
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - S Tschirdewahn
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - J Hess
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - N N Harke
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - B A Hadaschik
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - P Nyirády
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - A Szendröi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - M Szücs
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - O Módos
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - C Olah
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - E Székely
- 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - H Reis
- Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Tibor Szarvas
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany. .,Department of Urology, Semmelweis University, Budapest, Hungary.
| |
Collapse
|
9
|
Schenck M, Michels-Oswald W, Tschirdewahn S, Rübben H, vom Dorp F, Rose A, Panic A, Niedworok C, Rossi R. Erratum zu: Wie sollen Urologen venöse subkutane Portsysteme implantieren? Erfahrungen an einem Zentrum bei 347 Patienten. Urologe A 2018; 57:968. [DOI: 10.1007/s00120-018-0720-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Hess J, Breidenstein A, Henkel A, Tschirdewahn S, Rehme C, Teufel M, Tagay S, Hadaschik B. Satisfaction, quality of life and psychosocial resources of male to female transgender after gender reassignment surgery. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/s1569-9056(18)32062-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
11
|
Abstract
Cystoscopy and transurethral resection in combination with urinary cytology are integral parts of the diagnosis and therapy of urothelial cell carcinoma of the bladder. Given the fact that low grade bladder cancer has high recurrence and extremely low progression rates, the benefit for additional diagnostics needs to be further evaluated. In high grade tumors, early and accurate diagnosis is of high importance. Fluorescence cystoscopy and narrow band imaging are procedures to increase the detection rate. This article provides an overview of the current value of these two procedures.
Collapse
Affiliation(s)
- S Tschirdewahn
- Klinik und Poliklinik für Urologie, Universitätsklinikum Essen, Essen, Deutschland
| | | |
Collapse
|
12
|
Vom Dorp F, Tschirdewahn S, Szarvas T, Rübben H, Kraemer R, Rehme C. [Transitional cell carcinoma of the bladder: bladder-sparing therapy]. Urologe A 2014; 53:1322-8. [PMID: 25148911 DOI: 10.1007/s00120-014-3554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Transitional cell carcinoma of the bladder can - in the majority of cases - be safely treated by transurethral resection and bladder preservation. In case of more aggressive and genetically instable tumors, the effect of radical cystectomy depends on tumor volume. If complete resection of invasive tumors is also possible, the additional effect of radical cystectomy seems to be marginal. In patients with favorable tumor location and acceptable prostate parameters, prostate-sparing surgery seems to be oncologically safe with good quality of life.
Collapse
Affiliation(s)
- F Vom Dorp
- Urologische Klinik, Helios Klinikum Duisburg, Duisburg, Deutschland
| | | | | | | | | | | |
Collapse
|
13
|
Schenck M, Eder R, Rübben H, Niedworok C, Tschirdewahn S. [Organ and kidney function preservation in renal cell carcinoma]. Urologe A 2014; 53:1329-43. [PMID: 25142788 DOI: 10.1007/s00120-014-3558-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The organ-preserving partial nephrectomy has increasingly established itself in small unilateral renal tumours (<4 cm) with contralateral healthy kidney and counter gained in recent years in importance. There was found a significantly increased cardiovascular mortality rate and deteriorated quality of life, the more intact kidney tissue has been removed. OBJECTIVES In the present study, the influence of pre- and perioperative factors on direct postoperative course was examined, including 5-year survival rate and relapse behaviour after open organ-preserving partial nephrectomy in our own collective. MATERIALS AND METHODS In this retrospective study of 1657 patients were collected, who underwent surgery between 2007 and 2013 in the Department of Urology at the University Hospital Essen because of a renal tumour. 38 % of these operations (n = 636) were performed organ-preserving. In this trial there are factors identified that have an impact on need of blood transfusion and length of hospitalization in organ-preserving operation method. RESULTS No independent parameter can be determined for the need of blood transfusion. Tumour size and thus time of resection procedure does not affect the need of erythrocytes administration. In addition, the tumour size influences neither the postoperative serum-haemoglobin nor serum-creatinine. Increased patient age and female gender are identified as non-modifiable factors, which cause a longer hospitalisation. Postoperative pain therapy can be considered as a variable size, which does not affect the length of hospital stay. Modifiable factors that increase the overall length of stay, however, are the type of direct postoperative monitoring (ICU vs. anaesthetic recovery room) and the administration of blood transfusions. CONCLUSIONS There are constant factors, which can be associated with a longer residence time in the framework of an organ-preserving partial nephrectomy. Further there is shown evidence of the independence of the tumour size - in addition to proven good oncological results - of an extension of indication of organ-preserving nephrectomy of tumours > 4 cm.
Collapse
Affiliation(s)
- M Schenck
- Urologische Universitätsklinik Essen, Hufelandstraße 55, 45122, Essen, Deutschland,
| | | | | | | | | |
Collapse
|
14
|
Tschirdewahn S, Rübben H, Schenck M. [Urological surgery with analogosedation and local anesthesia. What makes sense?]. Urologe A 2013; 52:1302-11. [PMID: 23959458 DOI: 10.1007/s00120-013-3316-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Analogosedation and local anesthesia, including regional nerve blocks are used for endoscopic diagnostic or radiological and ultrasound-guided procedures in which the patient should not move or has to be free of pain. We retrospectively analyzed patient satisfaction, complications and the risk of urological interventions with analgosedation and/or local anesthesia between 2008 and 2012. MATERIAL AND METHODS In total 21,690 urological patients underwent surgical treatment at the Department of Urology of the University Hospital of Essen between 2008 and 2012 and 3,327 of these cases were performed by urologists with the patient under analogosedation (n=1484) and local anesthesia (n=1843). In total 13 surgical and endoscopic procedures were separately analyzed and evaluated for safety and practicability. RESULTS In five cases (0.15%) the procedures with analgosedation or local anesthesia were interrupted because of agitation (n=3) and in one case the transurethal resection was stopped due to a large bladder tumor. One patient suffered anaphylactic shock after preoperative intravenous application of cefuroxim 1.5 g. After cardiopulmonary resuscitation and a short stay on the intensive care unit the patient was discharged after 2 days.Conclusions. Local anesthesia and analgosedation should be performed by urologists for minor surgery, endoscopic procedures and radiological or ultrasound-guided treatment. For safety reasons there should always be a second medical doctor present for assistance. Analgesia with deep sedation or loss of defensive reflexes should be administered by anesthesiologists.
Collapse
|
15
|
Jäger T, Tschirdewahn S, vom Dorp F, Piechotta G, Rübben H, Szarvas T. MMP-7-Bestimmung im Urin basierend auf Siliziumchiptechnologie. Urologe A 2013; 52:853-8. [DOI: 10.1007/s00120-012-3110-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
16
|
Hess J, Tschirdewahn S, Szarvas T, Rossi R, Rübben H, Vom Dorp F. [Urothelial carcinoma of the bladder: evaluation by combined endoscopy and urine cytology: is incontrovertible assessment possible?]. Urologe A 2011; 50:702-5. [PMID: 21465088 DOI: 10.1007/s00120-010-2502-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Transurethral resection of transitional cell carcinoma of the bladder provides a definitive surgical treatment and supplies tissue for histological evaluation. Superficial low-grade carcinomas with a small risk of progression are treated properly with fulguration alone. To justify fulguration as a definitive treatment of papillary bladder tumours, one must be able to safely distinguish low-grade, noninvasive tumours from those that are high grade and potentially invasive. MATERIAL AND METHODS A total of 160 patients with a transitional cell carcinoma at cystoscopy underwent transurethral resection of the tumour. The macroscopic appearance of the tumour, the aspect with bimanual palpation and the perioperative urine cytology were compared with the histological report. RESULTS In our study we were able to safely distinguish low-grade tumours from high-grade tumours. All noninvasive tumours could be identified visually as such. CONCLUSION Urologists skilled in the evaluation of urine cytology can distinguish low-grade noninvasive tumours of the bladder from high-grade and potentially invasive tumours by means of appearance at cystoscopy and perioperative urine cytology.
Collapse
Affiliation(s)
- J Hess
- Klinik für Urologie, Kinderurologie und Urologische Onkologie, Universitätsklinikum Essen, Hufelandstraße 55, 45122 Essen, Deutschland
| | | | | | | | | | | |
Collapse
|
17
|
Vom Dorp F, Tschirdewahn S, Olbricht T, Szarvas T, Rübben H. [Photodynamic diagnostics of bladder carcinoma]. Urologe A 2011; 50:1068-71. [PMID: 21845422 DOI: 10.1007/s00120-011-2696-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The question whether conventional cystoscopy should always be performed together with fluorescent diagnostic procedures remains to be answered. The current article presents the current literature dealing with this topic. Particularly for relevant carcinoma in situ lesions of the bladder there is no obvious advantage for photodynamic diagnostics compared to conventional cystoscopy with consistent use of urine cytology.
Collapse
Affiliation(s)
- F Vom Dorp
- Pelvines Exzellenzzentrum, Klinik und Poliklinik für Urologie, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen, Deutschland.
| | | | | | | | | |
Collapse
|
18
|
vom Dorp F, Pal P, Tschirdewahn S, Rossi R, Börgermann C, Schenck M, Becker M, Szarvas T, Hakenberg OW, Rübben H. Correlation of Pathological and Cytological-Cytometric Grading of Transitional Cell Carcinoma of the Urinary Tract. Urol Int 2011; 86:36-40. [DOI: 10.1159/000321017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Accepted: 09/04/2010] [Indexed: 11/19/2022]
|
19
|
Abstract
Great progress has been seen in the treatment of urethral strictures since the first endoscopic urethrotomy was performed in 1893 by Felix Martin Oberländer in Dresden, Germany. With the introduction of endoscopic laser therapy and the variety of urethral reconstruction methods other ways to treat this important urologic entity became available. Despite this progress, urethrotomy still represents the preferred treatment concept for primary, short and bulbar urethral strictures. In this study we performed a 2-year retrospective analysis of 20 patients undergoing primary endoscopic urethrotomy by single bulbar or penile narrowing. A high incidence of recurrence was seen in 70% of the patients. Nevertheless, direct vision urethrotomy represented a safe and effective transitory method to treat these patients. Moreover, 80% of the patients preferred, in cases of recurrence, a repeated urethrotomy as the treatment of choice. Although the long-term results evidence high relapse rates after the first and second procedures, there have been no sufficient data in the literature which support the use of other methods. Furthermore, primary endoscopic management of urethral strictures remains a simple, safe, and cost-effective procedure that should be indicated before more invasive approaches are taken to provide relief to these patients from this limiting problem.
Collapse
Affiliation(s)
- R Rossi Neto
- Klinik und Poliklinik für Urologie, Kinderurologie und urologische Onkologie, Universitätsklinikum Essen, Hufelandstrasse 55, 45122, Essen, Germany.
| | | | | | | | | |
Collapse
|