Abstract:
:Pharmacological treatment of BPS is often considered the first therapeutic approach for patients who experience progression in lower urinary tract symptoms (LUTS).α1-adrenoceptor antagonists are often chosen as the first line pharmacological treatment, due to their rapid onset of action, as well as their significant impact on LUTS and Qmax and post-void residual. Adverse effects appear to be low.With larger prostate volume and LUTS, long term treatment with 5α-reductase inhibitors (5ARIs) significantly improves LUTS and post-void residual. In addition, 5ARIs have a significant impact on the reduction in disease progression.Patients with LUTS who mainly suffer from bladder storage symptoms appear to respond to treatment with muscarinic receptor antagonists and beta-3 agonists. Both of these drug classes significantly improve LUTS, but beta-3 agonists seem to be superior with respect to adverse effects.Treatment with phosphodiesterase-5 inhibitors, which are well established in the treatment of erectile dysfunction (ED) gives significant improvement in LUTS and post-void residual and can therefore be recommended for patients with LUTS and ED.Phytotherapies have low rates of adverse effects, which has made them increasingly popular, but effects on LUTS, Qmax and post-void residual remain to be proven.New substances and therapeutic approaches are continuously expanding the options for pharmacological treatment of BPS. As regards adverse effects, therapeutic schemes can increasingly be customised to a patient profile. :Die medikamentöse Therapie des BPS ist oftmals das erstes Therapieregime bei symptomatischen BPS-Patienten, die unter zuwartendem Verhalten signifikant beschwerdeprogredient werden. Ziel der medikamentösen Therapie ist eine schnelle Verbesserung der „lower urinary tract symptoms“ (LUTS), die Verbesserung des Harnstrahls sowie die Verminderung der Restharnmenge. Unerwünschte Nebenwirkungen sollten möglichst niedrig sein. Die häufig primär eingesetzten α1-Adrenorezeptorblocker überzeugen bei guter Verträglichkeit durch schnelle Wirksamkeit und signifikante Verbesserung von LUTS, Qmax und Restharnmengen. Bei LUTS auf Grund von größeren Prostatavolumina zeigen 5α-Reduktase-Hemmer nach längerer Einnahme signifikante Verbesserung hinsichtlich Qmax, LUTS und Restharn. Zudem wirken sie als einziges Medikament relevant der Krankheitsprogression entgegen.Bei ausgeprägten irritativen Beschwerden zeigen umfangreiche Studien gute Ergebnisse unter Therapie mit Muskarinrezeptorantagonisten und den seit kurzem zur BPS-Therapie erneut in Deutschland erhältlichen Beta-3-Agonisten. Beide bewirken Verbesserung der LUTS, ein günstigeres Nebenwirkungsprofil zeigt sich unter Therapie mit Beta-3-Agonisten.Vorrangig als Therapie erektiler Dysfunktion (ED) genutzte PDE-5-Hemmer zeigen ebenfalls eine signifikante Verbesserung von LUTS und Restharnmengen und eignen sich gut für Patienten mit LUTS in Kombination mit ED.Die zunehmend äußerst beliebten Phytopharmaka bestechen durch geringe Nebenwirkungen, werden jedoch auf Grund fraglicher Wirksamkeit durch keine akute Leitlinie empfohlen.Neue Substanzgruppen, aber auch neue Therapieansätze mit bewährten Substanzen ergänzen laufend das wachsende Spektrum der medikamentösen Therapie des BPS. So ermöglichen neue Therapie-Algorithmen die individuelle Anpassung der Therapie an das Risikoprofil des Patienten unter Berücksichtigung unerwünschter Nebenwirkungen.
journal_name
Aktuelle Uroljournal_title
Aktuelle Urologieauthors
Westhofen T,Magistro G,Stief C,Gratzke Cdoi
10.1055/a-0649-0702subject
Has Abstractpub_date
2018-08-01 00:00:00pages
328-333issue
4eissn
0001-7868issn
1438-8820journal_volume
49pub_type
杂志文章,评审abstract::Prostate cancer (PCa) with distant metastasis at diagnosis (M1) is associated with an unfavourable prognosis. Therefore, according to current treatment guidelines, local treatment (radical prostatectomy or irradiation of the prostate gland) is not recommended in men with M1 disease. However, M1 patients inevitably dev...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-113547
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Partial nephrectomy is the treatment of choice for clinical stage 1 renal tumours. Open partial nephrectomy is the standard operative technique. The use of minimally-invasive strategies such as laparoscopic, robot-assisted partial nephrectomy or laparoendoscopic single site (LESS) partial nephrectomy has inc...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0041-106151
更新日期:2015-11-01 00:00:00
abstract:PURPOSE:In order to assess the efficacy and toxicity of oral estramustine phosphate (EMP) administration, low-dose EMP monotherapy (study 1) and very low-dose EMP therapy with luteinizing hormone-releasing hormone (LH-RH) agonist (study 2) were conducted in previously untreated prostate cancer and long-term outcomes we...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0029-1224657
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:We evaluated children with pelvic kidney and their follow-up according to initial renal function and the appearance of concomitant urological pathologies. PATIENTS AND METHODS:In a retrospective analysis of our case notes, we studied 17 children (8 female, 9 male) who had been referred to our department for...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2005-915621
更新日期:2006-07-01 00:00:00
abstract:PURPOSE:Gap junctions are intercellular contacts important for the synchronization of muscle cell activity through electrical coupling. Since the role of gap junctions for the function of smooth bladder muscle is still a matter of debate, we investigated the occurrence of gap junctions and the gap junctional protein co...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2003-42001
更新日期:2003-09-01 00:00:00
abstract::With a share of 22.4%, nosocomial urinary tract infections (nUTIs) are among the most frequent infections acquired in hospitals, along with surgical site infections (24.7%), pneumonia (21.5%), clostridium difficile infections (6.6%) and primary sepsis (6%) 1. 80% of all nUTIs are associated with indwelling urinary cat...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-101845
更新日期:2016-05-01 00:00:00
abstract::The scrotal leiomyoma is a rare benign tumour, deriving from the smooth muscle. This tumour entity constitutes a differential diagnosis to malignant testicular tumours. Up to now, only 8 cases have been reported in the literature. We report on a 63-year-old European patient, presenting in our clinic for further treatm...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1385898
更新日期:2014-07-01 00:00:00
abstract::The online marketing of physicians must be measured against the same advertising regulations as conventional marketing. In this context, the Medical Professional Code of Conduct, the Medical Products Advertising Act ("Heilmittelwerbegesetz") and the Law against Unfair Competition are particularly relevant. In addition...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/a-0893-6315
更新日期:2019-08-01 00:00:00
abstract::In recent years, PSMA-targeting PET tracers such as 68Ga-PSMA-11 have shown promising results, thus contributing to a better management of prostate cancer patients. At the present time, 68Ga-PSMA-11 is most frequently used for diagnostic evaluation in the setting of biochemical recurrence of prostate cancer. In this c...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-0043-100269
更新日期:2017-04-01 00:00:00
abstract::In this narrative review, we give an overview of contemporary conservative treatment concepts for urinary incontinence in female patients. Hereby, we focus on pure stress urinary incontinence, urge incontinence and mixed urinary incontinence. We emphasise the value of rationally used diagnostic methods to be able to d...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-0043-121483
更新日期:2018-02-01 00:00:00
abstract::Numerous substances are available for the treatment of metastatic renal cell carcinoma (mRCC). Therefore, medical treatment of patients with mRCC has become a very complex subject. This review summarises clinical studies and typical side-effects of currently available agents that have been approved in Germany. The aut...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/a-0972-0788
更新日期:2019-12-01 00:00:00
abstract:AIM:The aim of the present study was to evaluate the initiated consecutive diagnostic course after measurement of an elevated PSA value by the general practitioner. PATIENTS AND METHODS:406 patients who underwent ultrasound-guided transrectal biopsy of the prostate were assessed retrospectively. Using a standardised q...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0028-1098883
更新日期:2009-05-01 00:00:00
abstract::In 2002, the International Continence Society defined the term overactive bladder (OAB) as a symptom syndrome that is accompanied by urgency with or without urge incontinence, frequency and nocturia. A proven urinary tract infection or other obvious pathologies must be excluded.The pathophysiology of OAB has not been ...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-108871
更新日期:2016-12-01 00:00:00
abstract::Between 15 and 20 % of patients diagnosed with renal cell carcinoma suffer from metastatic disease by the time of diagnosis. In addition to systemic therapy, there are various surgical strategies to treat the primary tumour, e. g. cytoreductive nephrectomy (CN) or palliative nephrectomy (PN). In the immunotherapy era,...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/a-0658-0832
更新日期:2018-09-01 00:00:00
abstract::Abiraterone acetate (in combination with prednisone/prednisolone (abiraterone/P)), enzalutamide or docetaxel may all be used for the first-line treatment of asymptomatic or mildly symptomatic mCRPC. As treatment with docetaxel can result in the emergence of considerable adverse events, the less toxic substances abirat...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/a-1036-1568
更新日期:2020-12-01 00:00:00
abstract:PURPOSE:The aim of this study was to prove the efficacy of antegrade sclerotherapy for varicocele testis in patients with azoospermia and in patients with cryptozoospermia (less than 0.1 million spermatozoons/mL ejaculate). We have investigated the induction of spermatogenesis in patients with non-obstructive azoosperm...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2005-915619
更新日期:2006-03-01 00:00:00
abstract::Leiomyomas are benign neoplasms arising from smooth muscle cells. We describe the case of a 17-year-old boy admitted with progressive severe obstructive voiding symptoms. Retrograde urethrography showed a bulbous urethral stricture which was resected with primary urethral anastomosis. Histopathological examination con...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2007-993038
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The aim of this study was to integrate and validate an additional post-treatment module including improvement and satisfaction scales to the validated German pelvic floor questionnaire. METHODS:The questionnaire contained the domains bladder, bowel prolapse, and sexual symptoms. It was completed by 55 patie...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0031-1271544
更新日期:2011-09-01 00:00:00
abstract:MATERIAL AND METHODS:100 consecutive cases after radical prostatectomy with a bacterial count of 10(4) CFU/ml in midstream urine were followed during urological inpatient rehabilitation without antibiotic treatment. Before discharge, a follow-up examination with a urine dipstick and a second urine culture were performe...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0042-103198
更新日期:2016-05-01 00:00:00
abstract::The outpatient forensic aftercare department of the Charité Berlin treated 32 paraphilic sex offenders with GnRH analogues within the past 5 years. Out of those patients, three men suffered from urolithiasis and were in need of treatment. All 3 patients had previously developed osteopenia/osteoporosis while on antiand...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0042-112999
更新日期:2016-12-01 00:00:00
abstract:PURPOSE:Germ cell differentiation, DNA synthesis, and apoptosis can be evaluated quantitatively. On the other hand, an interstitial lesion is difficult to examine. We have focused on the quantitative analysis of testicular interstitial fibrosis after vasectomy. MATERIALS AND METHODS:Forty testicular biopsy specimens f...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2003-41612
更新日期:2003-07-01 00:00:00
abstract::Unenhanced computed tomography (CT) has a sensitivity of 97.7 to 100 % for the detection of urolithiasis. Using a modified examination protocol, the radiation exposure of a CT examination can be reduced to the level of a single conventional radiographic view of the abdomen (ultra-low-dose CT), assuming the examination...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-2004-830031
更新日期:2004-08-01 00:00:00
abstract:PURPOSE:Throughout the past years, several studies have shown that fluorescence cystoscopy with ALA (5-aminolevulinic acid) improves the detection rate of superficial bladder tumors by approximately 20 % compared to standard white light cystoscopy. These results suggest a reduced rate of residual/recurrent tumors with ...
journal_title:Aktuelle Urologie
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1055/s-2004-818544
更新日期:2004-11-01 00:00:00
abstract::Faced with the dilemma of choosing between the extremes of standard whole gland therapy and active surveillance, those affected by prostate cancer have recently been on the lookout for less invasive alternatives. Particularly the question of whether it would be possible in low risk cancer to treat only the tumour itse...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1396803
更新日期:2015-01-01 00:00:00
abstract::Although ureteroarterial fistulas are rare, they result in a high mortality because of the massive urogenital haemorrhage. The diagnosis is often difficult even when invasive measures are applied. Including the ureteroarterial fistula in the diagnostic process in cases of macrohaematuria with a positive medical histor...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0034-1376953
更新日期:2014-05-01 00:00:00
abstract:INTRODUCTION:Nephron-sparing surgery (NSS) is mandatory for patients with renal tumors in both kidneys or in a solitary kidney in order to preserve renal function (imperative indication). NSS has also become the gold standard (elective indication) for small unilateral renal tumors (< 4 cm) with a normal contralateral k...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0029-1224649
更新日期:2010-01-01 00:00:00
abstract::Urolithiasis is an urologist's daily business. This article provides an overview of the developments in the management of urinary stone disease since the 1970s. While conventional KUB X-rays and intravenous pyelography were standard imaging procedures in the past, computed tomography is the first choice today. Conserv...
journal_title:Aktuelle Urologie
pub_type: 杂志文章,评审
doi:10.1055/a-0828-9936
更新日期:2019-04-01 00:00:00
abstract::Treatment of a biochemical prostate cancer relapse represents a difficult clinical dilemma, which has remained without a definitive solution so far. Based on clinical studies, we combine radical prostatectomy with extended pelvic lymph node dissection in intermediate and high risk patients as a routine procedure at ou...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-0032-1333239
更新日期:2013-01-01 00:00:00
abstract:INTRODUCTION:Ovarian metastases of renal cell cancer (RCC) are extremely rare with less than 20 cases reported to date. These metastases occur in the majority of cases metachronous (i. e. prior to or after identification of the primary tumour) or--such as in our case--synchronous. CASE REPORT:A 42-year-old women was d...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/s-2006-932159
更新日期:2007-01-01 00:00:00
abstract::The treatment of a varicocele in childhood and adolescence is considered very controversial. In the past varicocele was often diagnosed during the medical examination for military purposes, but today varicocele is common in the J1 exam and is found rather frequently. However, we are still lacking evidence-based recomm...
journal_title:Aktuelle Urologie
pub_type: 杂志文章
doi:10.1055/a-1075-1665
更新日期:2020-04-01 00:00:00