Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 3 de 3
Filter
1.
Urologe A ; 59(8): 963-972, 2020 Aug.
Article in German | MEDLINE | ID: mdl-32691107

ABSTRACT

Idiopathic overactive bladder (OAB) is defined as a symptom complex characterized by urinary urgency with or without urinary incontinence, nycturia and increased frequency of micturition without the presence of an infection or other pathological conditions, especially a neurological disease. It is a diagnosis by exclusion. If conservative treatment with behavioral therapy and pelvic floor muscle training alone is not successful, pharmaceutical treatment is recommended according to the OAB staged treatment. For treatment refractory OAB, intravesical injection of onabotulinum toxin A is recommended according to the current guidelines (recommendation level A). The approved dose is 100 U botulinum toxin and is transurethrally injected into the detrusor muscle. The treatment effect lasts on average for 6-9 months and injections can be repeated without limitations. Due to the low rate of complications, the good success rate and the low invasiveness, botulinum toxin offers a good treatment option for treatment refractory OAB.


Subject(s)
Botulinum Toxins, Type A/therapeutic use , Neuromuscular Agents/therapeutic use , Urinary Bladder, Overactive/drug therapy , Urinary Incontinence/drug therapy , Urination Disorders/drug therapy , Administration, Intravesical , Botulinum Toxins, Type A/administration & dosage , Humans , Injections , Neuromuscular Agents/administration & dosage , Treatment Outcome , Urinary Bladder, Overactive/diagnosis , Urinary Incontinence/diagnosis , Urination Disorders/diagnosis
2.
Urologe A ; 57(3): 274-279, 2018 Mar.
Article in German | MEDLINE | ID: mdl-29460170

ABSTRACT

BACKGROUND: The incidence of small renal masses has been rising over the last few decades. At the same time, mortality of renal cell carcinoma (RCC) is decreasing. These trends can be explained by the availability of improved therapeutic measures and the good prognosis of small renal masses (SRM) turning out to be histopathologically benign or of low malignancy in many cases. OBJECTIVES: The aim of this article is to present epidemiology and diagnostic assessment of SRM. MATERIALS AND METHODS: Statistics, basic research, guidelines. RESULTS: The incidence of SRM is rising due to the widespread use of imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and contrast-enhanced ultrasound (CEUS). Sensitivity is excellent for CEUS and for CECT in the characterization of SRM, while good specificity values can be reached by MRI. For characterization of complex cystic renal masses, CEUS has good diagnostic accuracy. CONCLUSIONS: Due to improved diagnostic possibilities, SRMs can be diagnosed in early asymptomatic stages. As SRM have a good prognosis and often are of low malignancy therapy, options should be carefully considered; especially in older patients, active surveillance should considered.


Subject(s)
Carcinoma, Renal Cell/diagnostic imaging , Carcinoma, Renal Cell/epidemiology , Kidney Neoplasms/diagnostic imaging , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Ultrasonography , Aged , Contrast Media , Humans , Incidence , Kidney Neoplasms/epidemiology
3.
Urol Int ; 98(2): 156-161, 2017.
Article in English | MEDLINE | ID: mdl-27750248

ABSTRACT

OBJECTIVES: To evaluate the usage of different guidelines and to estimate the impact of changed recommendation in routine management, therapy and follow-up of patients with renal cell cancer (RCC). METHODS: An anonymous questionnaire was sent to 600 urologists in Germany. Twenty-seven percent of them were included in the analysis. The questions were about the practice setting, surgical and medical treatment of RCC, follow-up modalities, knowledge and usage of RCC guidelines. Results were correlated with the recommendations of the EAU-guideline. RESULTS: Sixty-eight percent of the urologists were office based. Sixty percent were located in bigger cities. Ninety-eight percent of the colleagues reported to be knowledgeable about the EAU-guidelines, 62% reported to know the American Urological Association, 59% DGU/AWMF, 19% National Comprehensive Cancer Network, 19% European Society for Medical Oncology, 13% Onkopedia, and 3% British Association of Urological Surgeons-guidelines. Eighty-seven percent reported that partial nephrectomy (Nx) was performed in tumours with diameter <4 cm. Forty-one percent performed a radical Nx for tumours that were 4-7 cm. Follow-up of RCC was done in 99%. Fifty-nine percent underwent an abdominal CT scan after 6 months. Thirty-nine percent got a chest X-ray done. Among those with metastatic RCC, only 84% were offered systemic therapy. First-line therapy was predominantly advocated using sunitinib. CONCLUSION: Almost all urologists know and use the EAU-guidelines. Other guidelines are rarely used. Follow-up is performed in discordance with the EAU-recommendations. Interestingly, only 84% with metastatic disease are introduced to systemic therapy.


Subject(s)
Carcinoma, Renal Cell/therapy , Kidney Neoplasms/therapy , Urology/standards , Follow-Up Studies , Germany , Guideline Adherence , Humans , Neoplasm Metastasis , Nephrectomy/methods , Practice Guidelines as Topic , Radiography, Thoracic , Surveys and Questionnaires , Treatment Outcome
SELECTION OF CITATIONS
SEARCH DETAIL
...