[Inadmissible cooperation contract between hospital and physician. New court decision confirms criticism of the previous practice]. / Unzulässiger Kooperationsvertrag zwischen Krankenhaus und Arzt. Neues Urteil bestätigt Kritik an Zuweisermodell.

The decision of the Higher Regional Court of Düsseldorf from 01.09.2009 (20 U 121/08), given below in parts, confirms the decision of the Regional Court Duisburg from 01.04.2008 (4 O 300/07) published in Der Urologe issue 10.2008 (1355 ff). The hope expressed in the literature (e.g. Wienke/Janke, OM 4-2009, 461) that the decision of the Regional Court Duisburg would not be upheld on appeal, proved to be unwarranted.

[Improper cooperation contract between a hospital and a physician]. / Unzulässiger Kooperationsvertrag zwischen Krankenhaus und Arzt.

The term interdisciplinary care is frequently used to indicate the often criticized division between inpatient and outpatient treatment. Interdisciplinary care in the actual sense in the form of integrated care necessarily requires the involvement of health insurance providers as the contractual partner.

[Gas gangrene in urologic diseases. An example based on 3 case reports]. / Gasbrandinfektion bei urologischen Erkrankungen. Ein Beispiel an drei Fallbeschreibungen.

Gas gangrene is a rare infection of grave consequences. It is caused by obligatory anaerobic bacteria. Its appearance in urology is extremely rare. The infection can be acquired either from the outside or from enteral invasion of saprophytes, which are common in body cavities. Very often resistance-weak patients are attacked. In acute cases with typical signs of sepsis in addition to local signs of infection, a fatal outcome cannot be prevented in all cases despite adequate early therapy. Search for bacteria is mostly in vain. The 3 cases demonstrate that absolute asepsis and hygienic rules in simple manipulations (e.g. catheterizing as well as in major urologic operations are absolutely necessary. Traumatic lesions must be reduced to a minimum. Therapy must be started immediately.

[Pyrogen-free sterile water for operative endoscopy (author's transl)]. / Pyrogenfreies Sterilwasser für die Transurethrale operative Endoskopie.

In transurethral endoscopic operations we have maximal demands for the water conditions where, as in urology, for the diagnostic endoscopy one mostly uses sterile filtered but on principle hydrant water containing pyrogen. First the determinations of the order for drinking water and its possible consequences for irrigator systems are laid down. Water for injections like the irrigator water in operative endoscopy must conform to the demands in pharmacopoeia of the different countries. With the new combination of reverse osmosis system with an irrigator, hydrant water can be purified to pyrogen-free sterile water in the place of treatment.