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  • 1
    Online Resource
    Online Resource
    Evaluating the Use of Prostate-Specific Antigen as an Instrument for Early Detection of Prostate Cancer beyond Urologists: Results of a Representative Cross-Sectional Questionnaire Study of General Practitioners and Internal Specialists
    S. Karger AG ; 2014
    In:  Urologia Internationalis Vol. 93, No. 2 ( 2014), p. 160-169
    Details
    In: Urologia Internationalis, S. Karger AG, Vol. 93, No. 2 ( 2014), p. 160-169
    Abstract: 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 The aim of this cross-sectional study was to evaluate the value of prostate-specific antigen (PSA) testing as a tool for early detection of prostate cancer (PCa) applied by general practitioners (GPs) and internal specialists (ISs) as well as to assess criteria leading to the application of PSA-based early PCa detection. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Between May and December 2012, a questionnaire containing 16 items was sent to 600 GPs and ISs in the federal state Brandenburg and in Berlin (Germany). The independent influence of several criteria on the decision of GPs and ISs to apply PSA-based early PCa detection was assessed by multivariate logistic regression analysis (MLRA). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 392 evaluable questionnaires were collected (return rate 65%). 81% of the physicians declared that they apply PSA testing for early PCa detection; of these, 58 and 15% would screen patients until the age of 80 and 90 years, respectively. In case of a pathological PSA level, 77% would immediately refer the patient to a urologist, while 13% would re-assess elevated PSA levels after 3-12 months. Based on MLRA, the following criteria were independently associated with a positive attitude towards PSA-based early PCa detection: specialisation (application of early detection more frequent for GPs and hospital-based ISs) (OR 3.12; p 〈 0.001), physicians who use exclusively GP or IS education (OR 3.95; p = 0.002), and physicians who recommend yearly PSA assessment after the age of 50 (OR 6.85; p 〈 0.001). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 GPs and ISs frequently apply PSA-based early PCa detection. In doing so, 13% would initiate specific referral to a urologist in case of pathological PSA values too late. Improvement of this situation could possibly result from specific educational activities for non-urological physicians active in fields of urological core capabilities, which should be guided by joint boards of the national associations of urology and general medicine.
    Type of Medium: Online Resource
    ISSN: 0042-1138 , 1423-0399
    URL: Article
    DOI: 10.1159/000356367
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1464417-4
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  • 2
    Online Resource
    Online Resource
    Patient-Reported Side Effects of Intradetrusor Botulinum Toxin Type A for Idiopathic Overactive Bladder Syndrome
    S. Karger AG ; 2011
    In:  Urologia Internationalis Vol. 86, No. 1 ( 2011), p. 68-72
    Details
    In: Urologia Internationalis, S. Karger AG, Vol. 86, No. 1 ( 2011), p. 68-72
    Abstract: 〈 i 〉 Objective: 〈 /i 〉 The aim of the study was a prospective assessment of patient-reported side effects in an open-label study after intradetrusor botulinum toxin injections for idiopathic overactive bladder (OAB). 〈 i 〉 Patients and Methods: 〈 /i 〉 Botulinum toxin A injection was performed in 56 patients with idiopathic OAB. Patients were followed up for 6 months concerning side effects and patients’ satisfaction. 〈 i 〉 Results: 〈 /i 〉 Different types of side effects were assessed such as dry mouth (19.6%), arm weakness (8.9%), eyelid weakness (8.9%), leg weakness (7.1%), torso weakness (5.4%), impaired vision (5.4%) and dysphagia (5.4%). In all cases, symptoms were mild and transient. Urological complications such as gross hematuria (17.9%), acute urinary retention (8.9%) and acute urinary tract infection (7.1%) were noticed. In all cases, acute urinary retention was transient and treated with temporary intermittent self-catheterization. There was no statistically significant correlation between dosage and observed side effects. Patients’ satisfaction rate was high (71.4%). 〈 i 〉 Conclusion: 〈 /i 〉 Intradetrusor injection of botulinum toxin was associated with a high rate of neurourological side effects. In general, side effects were transient, mild and did not require special treatment.
    Type of Medium: Online Resource
    ISSN: 0042-1138 , 1423-0399
    URL: Article
    DOI: 10.1159/000316080
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1464417-4
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  • 3
    Online Resource
    Online Resource
    Coupling of α〈sub〉1〈/sub〉-Adrenoceptors to ERK1/2 in the Human Prostate
    S. Karger AG ; 2011
    In:  Urologia Internationalis Vol. 86, No. 4 ( 2011), p. 427-433
    Details
    In: Urologia Internationalis, S. Karger AG, Vol. 86, No. 4 ( 2011), p. 427-433
    Abstract: 〈 i 〉 Introduction: 〈 /i 〉 α 〈 sub 〉 1 〈 /sub 〉 -Adrenoceptors are considered critical for the regulation of prostatic smooth muscle tone. However, previous studies suggested further α 〈 sub 〉 1 〈 /sub 〉 -adrenoceptor functions besides contraction. Here, we investigated whether α 〈 sub 〉 1 〈 /sub 〉 -adrenoceptors in the human prostate may activate extracellular signal-regulated kinases (ERK1/2). 〈 i 〉 Methods: 〈 /i 〉 Prostate tissues from patients undergoing radical prostatectomy were stimulated in vitro. Activation of ERK1/2 was assessed by Western blot analysis. Expression of ERK1/2 was studied by immunohistochemistry. The effect of ERK1/2 inhibition by U0126 on phenylephrine-induced contraction was studied in organ-bath experiments. 〈 i 〉 Results: 〈 /i 〉 Stimulation of human prostate tissue with noradrenaline (30 µ 〈 i 〉 M 〈 /i 〉 ) or phenylephrine (10 µ 〈 i 〉 M 〈 /i 〉 ) resulted in ERK activation. This was reflected by increased levels of phosphorylated ERK1/2. Expression of ERK1/2 in the prostate was observed in smooth muscle cells. Incubation of prostate tissue with U0126 (30 µ 〈 i 〉 M 〈 /i 〉 ) resulted in ERK1/2 inhibition. Dose-dependent phenylephrine-induced contraction of prostate tissue was not modulated by U0126. 〈 i 〉 Conclusions: 〈 /i 〉 α 〈 sub 〉 1 〈 /sub 〉 -Adrenoceptors in the human prostate are coupled to ERK1/2. This may partially explain previous observations suggesting a role of α 〈 sub 〉 1 〈 /sub 〉 -adrenoceptors in the regulation of prostate growth.
    Type of Medium: Online Resource
    ISSN: 0042-1138 , 1423-0399
    URL: Article
    DOI: 10.1159/000322639
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1464417-4
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  • 4
    Online Resource
    Online Resource
    Impact of the ‘Repositioning Test' on Postoperative Outcome of Retroluminar Transobturator Male Sling Implantation
    S. Karger AG ; 2013
    In:  Urologia Internationalis Vol. 90, No. 3 ( 2013), p. 334-338
    Details
    In: Urologia Internationalis, S. Karger AG, Vol. 90, No. 3 ( 2013), p. 334-338
    Abstract: 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To evaluate prospectively the value of the ‘repositioning test' (RT) in preoperative patient selection for the efficacy of male stress urinary incontinence (SUI) treatment using a retroluminar transobturator male sling (AdVance sling). 〈 b 〉 〈 i 〉 Patients and Methods: 〈 /i 〉 〈 /b 〉 65 consecutive patients with SUI after radical prostatectomy were included in this single-center prospective study. Preoperatively, patients were classified into those with ‘positive' and ‘negative' RT. Postoperative results were analyzed and the association between the result of the RT and postoperative outcome was evaluated. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 53 patients (81.5%) showed preoperatively a positive RT and 12 patients (18.5%) a negative RT. After a follow-up of 12 months, patients with positive RT showed a cure rate (0 pads/day) of 83% and patients with a negative RT showed only a cure rate of 25%. A positive RT significantly correlated with cure in outcome (p 〈 0.001). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Patients with positive RT have a significantly better chance for successful AdVance sling implantation. The RT is minimally invasive, easy to learn and easy to perform. Therefore, the RT is a very useful tool for preoperative patient selection.
    Type of Medium: Online Resource
    ISSN: 0042-1138 , 1423-0399
    URL: Article
    DOI: 10.1159/000347123
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
    detail.hit.zdb_id: 1464417-4
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  • 5
    Online Resource
    Online Resource
    Plasma N-Terminal Pro-Brain Natriuretic Peptide as Prognostic Marker in Fatal Cardial Decompensation with Sunitinib Malate Therapy
    S. Karger AG ; 2010
    In:  Urologia Internationalis Vol. 84, No. 1 ( 2010), p. 119-121
    Details
    In: Urologia Internationalis, S. Karger AG, Vol. 84, No. 1 ( 2010), p. 119-121
    Abstract: A 74-year-old man with metastatic renal cell carcinoma and a history of cardiac failure was treated with sunitinib malate. MUGA echocardiography could not detect a relevant change in the ejection fraction although the clinical situation of the patient worsened dramatically. The only parameter to hint at the deteriorated cardiac function was plasma N-terminal pro-brain natriuretic peptide (BNP). Finally, the patient died after only one cycle of sunitinib treatment. We propose to prospectively include BNP for the early detection of cardiovascular decompensation in high-risk patients. Future studies concerning the relevance of BNP in drug-related cardiotoxicity are urgently needed.
    Type of Medium: Online Resource
    ISSN: 0042-1138 , 1423-0399
    URL: Article
    DOI: 10.1159/000273480
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2010
    detail.hit.zdb_id: 1464417-4
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  • 6
    Online Resource
    Online Resource
    Real-Time MRI of Continent and Stress Incontinent Male Patients after Orthotopic Ileal Neobladder
    S. Karger AG ; 2011
    In:  Urologia Internationalis Vol. 87, No. 3 ( 2011), p. 325-329
    Details
    In: Urologia Internationalis, S. Karger AG, Vol. 87, No. 3 ( 2011), p. 325-329
    Abstract: 〈 i 〉 Introduction: 〈 /i 〉 The aim of this study was to correlate anatomic differences with continence status in male patients after cystoprostatectomy and ileal neobladder using real-time magnetic resonance imaging. 〈 i 〉 Patients and Methods: 〈 /i 〉 Anatomic differences of 14 male patients (7 daytime continent and 7 stress incontinent) with ileal neobladder were determined by measuring the orthogonal distance of the bladder neck to the pubococcygeal line (PCL) to correlate anatomic differences with continence status. 〈 i 〉 Results: 〈 /i 〉 The median distance of the bladder neck to PCL was +5.4 mm in continent patients before voiding whereas in incontinent patients it was +2 mm (p = 0.012). During the Valsalva maneuver, the median distance in continent patients was +4 and in incontinent patients –3 mm (p = 0.003). At the end of micturition, the median distance was +2.3 mm in continent patients and –12 mm in incontinent patients (p = 0.002). 〈 i 〉 Conclusions: 〈 /i 〉 The bladder neck in incontinent patients showed more pronounced mobility in relation to the PCL during micturition and the Valsalva maneuver as compared to continent patients. In addition, the ileal neobladder was positioned significantly lower in the pelvis of incontinent patients. These preliminary results suggest that a stable bladder neck may be an important factor to reach full continence in patients with ileal neobladder.
    Type of Medium: Online Resource
    ISSN: 0042-1138 , 1423-0399
    URL: Article
    DOI: 10.1159/000330938
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1464417-4
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  • 7
    Online Resource
    Online Resource
    Patients' Perception of Surgical Outcomes and Quality of Life after Retroperitoneoscopic and Open Pyeloplasty
    S. Karger AG ; 2014
    In:  Urologia Internationalis Vol. 92, No. 1 ( 2014), p. 74-82
    Details
    In: Urologia Internationalis, S. Karger AG, Vol. 92, No. 1 ( 2014), p. 74-82
    Abstract: 〈 b 〉 〈 i 〉 Purpose: 〈 /i 〉 〈 /b 〉 To report postoperative health-related quality of life (HRQoL) and patients' subjective evaluations of open pyeloplasty (OP) and retroperitoneoscopic pyeloplasty (RP) and influences on preoperative counselling. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 107 patients (age 16-80 years, mean 31.5) with symptomatic primary ureteropelvic junction obstruction who underwent OP (32) or RP (75) were evaluated prospectively. HRQoL was evaluated using Short Form 36 (SF-36) questionnaires with 1 year follow-up. Operative outcomes were evaluated using a self-designed questionnaire regarding cosmetic outcomes, objective postoperative/current pain, convalescence and return to work. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The mean operative time was 174.4 vs. 161.4 min for RP versus OP, respectively, without intraoperative complications/conversions. There was an advantage for RP - except for two domains - without significance in any of the eight SF-36 domain scores. An advantage favouring RP in all aspects of the second questionnaire with significance in four aspects (cosmetic results, scar length, pain and convalescence) was found. Five weeks postoperatively, 58.7% (RP) vs. 25.8% (OP) were fully convalescent compared to 87.0% (RP) vs. 71.0% (OP) at 8 weeks. Similarly, 58.7 vs. 45.1% returned work 5 weeks postoperatively while 93.5 vs. 74.2% did so after 8 weeks, respectively. The small sample size, more questions on satisfaction/regret and mixed design are the main study limitations. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 RP provides the same functional results beside earlier convalescence, better HRQoL and patients' convenience with surgery, which favours its inclusion in preoperative counselling providing patients with realistic postoperative expectations.
    Type of Medium: Online Resource
    ISSN: 0042-1138 , 1423-0399
    URL: Article
    DOI: 10.1159/000352055
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1464417-4
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