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Marianne Leitsmann

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Citation Analysis

Scheipner L, Jankovic D, Jasarevic S, Seidl M, Altziebler JV, Pemberger K, Pohl KC, Primus G, Tian Z, Leitsmann M, Ahyai S. Patient reported outcomes of intermittent self-dilatation after direct vision internal urethrotomy. Neurourol Urodyn 2024;43:664-671. [PMID: 38221870 DOI: 10.1002/nau.25390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/25/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024]

Abstract

PURPOSE

Long-term results on quality of life (QoL) as well as clinical outcomes of intermittent self-dilatation (ISD) of the urethra after direct visual internal urethrotomy (DVIU) are scarce. The aim of this study was to prospectively evaluate patient reported outcomes (PROs) on voiding symptoms and QoL in a large cohort of urethral stricture patients performing ISD.

METHODS

We identified a total of 121 patients who performed ISD following DVIU between 2008 and 2013. Baseline assessment was conducted for each patient before ISD was started. Follow-up visits were scheduled in 6-month intervals. Each assessment included the following questionnaires: International prostate symptom score (IPSS), IPSS quality of life index (IPSS-QoL), patient global impression of severity (PGI-S), and patient global impression of improvement (PGI-I). Additional parameters were maximum urinary flow rate (Qmax ), postvoid residual urine, rate of complications, and stricture recurrence. Linear mixed models were used to examine the change over the course of the follow-up visits to the baseline.

RESULTS

The median age of the patients was 58 years (interquartile range [IQR]: 43-70). The median follow-up was 17 months (IQR: 7-30). Mean change from baseline IPSS was -6.1, -5.9, -4.2, and -4.8 points at 6, 24, 36, and 48 months. Mean change from baseline IPSS-QoL was -1.3, -1.4, -1.6, and -1.8 points, respectively. Mean PGI-I was 1.7 points at 6, 1.9 points at 24, 1.9 points at 36, and 2.2 points at 48 months after ISD initiation. Mean change of Qmax ranged from 1.7 at 6 to 2.2 mL/s at 48 months. The median complication rate was 3.3% per 6-month ISD interval. Overall, 11 patients developed stricture recurrence (9%).

CONCLUSION

ISD after DVIU had no negative impact on patients' QoL (IPSS-QoL, PGI-I, PGI-S). Urodynamic parameters remained stable for up to 48 months with low complications and an acceptable stricture recurrence rate.

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Uhlig A, Bergmann L, Bögemann M, Fischer T, Goebell PJ, Leitsmann M, Reichert M, Rink M, Schlack K, Trojan L, Uhlig J, Woike M, Strauß A. Sunitinib for metastatic renal cell carcinoma: Real world data from the STAR-TOR registry and detailed literature review. Urol Int 2024:000536563. [PMID: 38310863 DOI: 10.1159/000536563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/15/2024] [Indexed: 02/06/2024]

Leitsmann C, Kahlmeier L, Lampe PO, Groeben C, Baunacke M, Huber J, Trojan L, Uhlig J, Leitsmann M, Uhlig A. [Comparison of hospital rating websites among each other and with data from hospital quality reports and quality assurance based on routine data]. Urologie 2024:10.1007/s00120-023-02263-6. [PMID: 38265488 DOI: 10.1007/s00120-023-02263-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 01/25/2024]

Aksoy C, Reimold P, Schumann A, Schneidewind L, Karschuck P, Flegar L, Leitsmann M, Heers H, Huber J, Zacharis A, Ihrig A. Enhancing Human Papillomavirus Vaccination Rates through Better Knowledge? Insights from a Survey among German Medical Students. Urol Int 2024;108:153-158. [PMID: 38246131 PMCID: PMC10994630 DOI: 10.1159/000536257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024]

Scheipner L, Zurl H, Altziebler JV, Pichler GP, Schöpfer-Schwab S, Jasarevic S, Gaisl M, Pohl KC, Pemberger K, Andlar S, Hutterer GC, Bele U, Leitsmann C, Leitsmann M, Augustin H, Zigeuner R, Ahyai S, Mischinger J. Charlson-Deyo Comorbidity Index as a Novel Predictor for Recurrence in Non-Muscle-Invasive Bladder Cancer. Cancers (Basel) 2023;15:5770. [PMID: 38136315 PMCID: PMC10742244 DOI: 10.3390/cancers15245770] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 11/04/2023] [Revised: 11/19/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open

Affiliation(s)

Lukas Scheipner Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Hanna Zurl Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Julia V. Altziebler Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Georg P. Pichler Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Stephanie Schöpfer-Schwab Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Samra Jasarevic Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Michael Gaisl Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Klara C. Pohl Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Karl Pemberger Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Stefan Andlar Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Georg C. Hutterer Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Uros Bele Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Conrad Leitsmann Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Marianne Leitsmann Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.) Institute for Applied Quality Improvement and Research in Health Care, 37073 Goettingen, Germany
Herbert Augustin Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Richard Zigeuner Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Sascha Ahyai Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)
Johannes Mischinger Department of Urology, Medical University of Graz, 8010 Graz, Austria; (H.Z.); (J.V.A.); (G.P.P.); (S.S.-S.); (S.J.); (M.G.); (K.C.P.); (K.P.); (S.A.); (G.C.H.); (U.B.); (C.L.); (M.L.); (H.A.); (R.Z.); (S.A.); (J.M.)

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Scheipner L, Leitsmann M. Editorial Comment on Internet research of utilization of social media in patients with urological disease and their families in Japan. Int J Urol 2023;30:1146. [PMID: 37749846 DOI: 10.1111/iju.15303] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]

Siegel FP, Kuru TH, Boehm K, Leitsmann M, Probst KA, Struck JP, Huber J, Borgmann H, Salem J. Radical Prostatectomy on YouTube: Education or Disinformation? ARCH ESP UROL 2023;76:764-771. [PMID: 38186069 DOI: 10.56434/j.arch.esp.urol.20237610.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]

Leitsmann C, Uhlig A, Bremmer F, Mohr MN, Trojan L, Leitsmann M, Reichert M. Impact of multiparametric magnetic resonance imaging targeted biopsy on functional outcomes in patients following robot-assisted laparoscopic radical prostatectomy. Front Surg 2023;10:1305365. [PMID: 38053718 PMCID: PMC10694190 DOI: 10.3389/fsurg.2023.1305365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open

Abstract

Introduction

Multiparametric magnetic resonance imaging guided prostate biopsy (mpMRI PBx) leads to a higher rate of successful nerve-sparing in robot-assisted laparoscopic prostatectomy (ns-RALP) for prostate cancer (PCa). This study aimed to evaluate the impact of mpMRI PBx compared to standard ultrasound-guided PBx on functional outcomes focusing on erectile function in patients following ns-RALP.

Material and methods

All RALPs performed between 01/2016 and 06/2021 were retrospectively stratified according to (attempted) ns vs. non ns RALPs and were then categorized based on the PBx technique (mpMRI PBx vs. standard PBx). We compared RALP outcomes such as pathological tumor stage, rates of secondary nerve resection (SNR) and positive surgical margin status (PSM). Furthermore, we explored the association between PBx-technique and patient-reported outcomes assessed 12 months after RALP using the prospectively collected 26-item Expanded Prostate Cancer Index Composite (EPIC-26) questionnaire. Chi-square tests and logistic regression analysis were conducted.

Results

A total of 849 RALPs included 517 (61%) procedures with (attempted) ns. Among these, 37.5% were diagnosed via preoperative mpMRI PBx. Patients with a preoperative standard PBx had a 57% higher association of PSM (p = 0.030) compared to patients with mpMRI PBx and a 24% higher risk of erectile dysfunction (ED) 12 months post RALP (p = 0.025). When ns was attempted, we observed a significantly higher rate of SNR in patients who underwent a standard PBx compared to those who received a mpMRI PBx (50.8% vs. 26.7%, p < 0.001) prior RALP. In comparison, upgrading occurred more often in the standard PBx group (50% vs. 40% mpMRI PBx, p = 0.008).

Conclusion

The combination of mpMRI PBx for PCa diagnosis followed by ns-RALP resulted in significantly fewer cases of SNR, better oncological outcomes and reduced incidence of ED 1 year after surgery. This included fewer PSM and a lower rate of postoperative tumor upgrading.

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Baierl MA, Strauß A, Uhlig A, Hahn O, Reichert M, Schneider TR, Lüdecke J, Mohr MN, Voß JW, von Knobloch HC, Trojan L, Leitsmann C, Leitsmann M. Erratum zu: Einsatz einer stützenden Herrenunterhose bei elektiven skrotalen Eingriffen. Urologie 2023;62:1221-1222. [PMID: 36592170 DOI: 10.1007/s00120-022-02002-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]

Affiliation(s)

Maxi Ann Baierl Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
Arne Strauß Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
Annemarie Uhlig Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
Oliver Hahn Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
Mathias Reichert Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
Till Rasmus Schneider Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
Jan Lüdecke Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
Mirjam Naomi Mohr Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
Joost Wilhelm Voß Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
Hans-Christoph von Knobloch Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
Lutz Trojan Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
Conrad Leitsmann Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
Marianne Leitsmann Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland. Klinik für Urologie, Medizinische Universität Graz, Auenbruggerplatz 29, 8036, Graz, Österreich.

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Scheipner L, Cano Garcia C, Barletta F, Incesu RB, Morra S, Baudo A, Assad A, Tian Z, Saad F, Shariat SF, Chun FKH, Briganti A, Tilki D, Longo N, Carmignani L, Leitsmann M, Ahyai S, Karakiewicz PI. Regional differences in penile cancer patient characteristics and treatment rates across the United States. Cancer Epidemiol 2023;86:102424. [PMID: 37506474 DOI: 10.1016/j.canep.2023.102424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/30/2023] [Accepted: 07/09/2023] [Indexed: 07/30/2023]

Abstract

INTRODUCTION

We tested for regional-specific differences in patient, tumor and treatment characteristics as well as cancer-specific mortality (CSM) of squamous cell carcinoma of the penis (SCCP) patients, across the Surveillance, Epidemiology, and End Results (SEER) registries.

METHODS

The SEER database (2000-2018) was used to tabulate patient (age at diagnosis, race/ethnicity), tumor (stage, grade, N-stage) and treatment characteristics (proportions of primary tumor surgery, local lymph node surgery, systemic therapy), according to 12 SEER registries. Multinomial regression models, as well as multivariable Cox regression models tested for CSM differences, adjusting for patient, tumor and treatment characteristics.

RESULTS

In 5395 SCCP patients, registry-specific patient counts ranged from 2060 (38 %) to 64 (1 %). Differences across registries existed for race/ethnicity, stage, grade and N-stage. Additionally, in stage I-II SCCP patients, proportions of local tumor destruction (LTD) ranged from 19 % to 39 % and from 33 % to 61 % for partial penectomy. In stage III-IV SCCP patients, proportions of partial penectomy ranged from 40 % to 59 % and from 17 % to 50 % for radical penectomy. Local lymph node surgery ranged from 8 % to 24 % and proportions of systemic therapy ranged from 3 % to 14 %. Significant inter-registry differences remained, after adjustment for treatment proportions. Unadjusted five-year CSM ranged from 19 % to 32 %. In multivariable analyses, one registry exhibited significantly higher CSM (SEER registry 10, Hazard Ratio [HR] 1.48), relative to the largest reference registry (SEER registry 1, n = 2060).

CONCLUSION

Important regional differences including patient, tumor and treatment characteristics exist for SCCP patients across SEER registries. After multivariable adjustment, no differences in CSM were recorded, with the exception of one registry.

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Affiliation(s)

Lukas Scheipner Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, Medical University of Graz, Graz, Austria.
Cristina Cano Garcia Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
Francesco Barletta Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Unit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
Reha-Baris Incesu Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
Simone Morra Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
Andrea Baudo Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IRCCS Policlinico San Donato, Milan, Italy
Anis Assad Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
Zhe Tian Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
Fred Saad Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
Shahrokh F Shariat Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
Felix K H Chun Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
Alberto Briganti Unit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
Derya Tilki Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, Turkey
Nicola Longo Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
Luca Carmignani Department of Urology, IRCCS Policlinico San Donato, Milan, Italy; Department of Urology, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy
Marianne Leitsmann Department of Urology, Medical University of Graz, Graz, Austria
Sascha Ahyai Department of Urology, Medical University of Graz, Graz, Austria
Pierre I Karakiewicz Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada

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Baierl MA, Strauß A, Uhlig A, Hahn O, Reichert M, Schneider TR, Lüdecke J, Mohr MN, Voß JW, von Knobloch HC, Trojan L, Leitsmann C, Leitsmann M. [Use of men's support underwear after elective scrotal surgery-a prospective, randomized assessment of postoperative complication rates and health-related quality of life : A prospective, randomized assessment of postoperative complication rates and health-related quality of life]. Urologie 2023;62:56-65. [PMID: 36418539 PMCID: PMC9684802 DOI: 10.1007/s00120-022-01975-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 11/27/2022]

Abstract

BACKGROUND

Elective scrotal surgery is associated with a high rate of postoperative complications. There is no specific recommendation for postoperative care.

AIM

We investigated whether support underwear has an impact on postoperative complications and quality of life.

MATERIALS AND METHODS

From July 2020 to November 2021, patients with prior elective scrotal surgery were randomized into the intervention group "support underwear" or the control group. In addition to patient characteristics, intraoperative and postoperative findings were documented. The primary endpoint comprised postoperative complications. Secondary endpoints were prolonged length of hospital stay, emergency visits, unplanned readmissions, increased use of analgesics, and quality of life, which was recorded using the EQ5D (European Quality of Life 5 Dimensions) questionnaire preoperatively, on day 1 and 4 weeks postoperatively.

RESULTS

Data from 50 patients were analyzed. The mean age was 46.7 years (standard deviation [SD] 18.6). Inguinal surgery with/without orchiectomy (52%), hydrocele resection (22%), or ligation of varicocele (14%) were performed most frequently. The mean operating time was 62.8 min (SD 35.2); length hospital stay was 2.6 days (SD 1.2). In all, 20% of the patients suffered a postoperative complication. Type of surgery was significantly associated with postoperative complications (p = 0.01) and unplanned readmission (p = 0.04). Regarding biometric and perioperative data, there were no significant differences between the interventional group (n = 27) and control group (n = 23).

CONCLUSION

A nonnegligible number of complications occurs after elective scrotal surgery. Complications affects quality of life up to 4 weeks after the surgery. Postoperative care with support underwear does not appear to affect the postoperative complication rate, but it positively influences the quality of life in patients with scrotal access.

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Aksoy C, Reimold P, Borgmann H, Kölker M, Cebulla A, Struck JP, Zehe V, Nestler T, von Landenberg N, Uhlig A, Boehm K, Leitsmann M. [Impact of the COVID-19 pandemic on urology residency training programs in Germany]. Aktuelle Urol 2022;53:317-324. [PMID: 35580617 DOI: 10.1055/a-1824-4288] [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: 10/18/2022]

Abstract

BACKGROUND

Several international medical societies reported a negative impact on urology residency training programs due to the COVID-19 pandemic.

OBJECTIVES

The aim of this study was to investigate the impact of the pandemic on urological residency in Germany.

MATERIALS AND METHODS

From the 20^th of May 2020 until the 20^th of June 2020, a Germany-wide online survey on the continuing residency training was distributed via the members of the working group, social media (Facebook, Twitter, Instagram) and the German Society of Residents in Urology (GeSRU e.V.) newsletter. The survey covered 3 topics: 1) basic characteristics of the participants, 2) general and 3) subjective influence of the COVID-19 pandemic on clinics and further residency training.

RESULTS

A total of 50 residents took part in the survey; 54% were women. The median age was 31 years. Most of the participants were in their 2nd (22%) and 5th (26%) year of training and worked in a university hospital (44%) or in a clinic of maximum care (30%). 38% of the respondents stated that they only served urological emergencies during the COVID-19 pandemic. For 28% this meant a very large delay (80-100%) in the specialisation, while 28% stated only a minor impact. 66% documented training impairments caused by fewer operations, low patient numbers in the outpatient department (50%), congress (50%) and workshop (44%) cancellations. 46% of residents reported direct contact with COVID-19 patients while 10% were deployed on interdisciplinary IMC units. Numerous physical distancing and hygiene measures have been implemented by the clinics.

CONCLUSION

On average, around 50% of the urology residents indicated significant restrictions in training due to the COVID-19 pandemic in Germany. The delay in training cannot currently be measured in units of time, but it can be assumed that training for residents during the pandemic is likely to be of a lower quality compared to previous generations.

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Leitsmann C, Uhlig A, Bremmer F, Mut TT, Ahyai S, Reichert M, Leitsmann M, Trojan L, Popeneciu IV. Impact of mpMRI targeted biopsy on intraoperative nerve-sparing (NeuroSAFE) during robot-assisted laparoscopic radical prostatectomy. Prostate 2022;82:493-501. [PMID: 34970758 DOI: 10.1002/pros.24295] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/05/2021] [Accepted: 12/14/2021] [Indexed: 11/06/2022]

Uhlig A, Baunacke M, Groeben C, Borkowetz A, Volkmer B, Ahyai SA, Trojan L, Eisenmenger N, Schneider A, Thomas C, Huber J, Leitsmann M. [Contemporary surgical management of benign prostatic obstruction in Germany : A population-wide study based on German hospital quality report data from 2006 to 2019]. Urologe A 2022;61:508-517. [PMID: 35174398 PMCID: PMC9072522 DOI: 10.1007/s00120-022-01777-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 12/26/2022]

Abstract

Hintergrund

Die operative Therapie des benignen Prostatatsyndroms (BPS) hat in den letzten Jahren an Diversität gewonnen.

Ziel der Arbeit

Ziel dieser Studie ist die Darstellung aktueller Therapietrends sowie der Versorgungssituation in Deutschland.

Material und Methoden

Auf Basis der Qualitätsberichte der Krankenhäuser wurden mithilfe der Onlineplattform reimbursement.INFO Diagnose- wie Eingriffszahlen erhoben. Für die benigne Prostatahyperplasie (BPH) wurden die ICD-Codes N40 und D29.1 ausgewertet. Die Prozeduren wurden mittels der OPS-Codes 5‑600.0, 5‑601, 5‑603, 5‑609.4 und 5‑609.8 inklusive Subcodierungen extrahiert. Es erfolgten eine deskriptive Darstellung, Trend- und Korrelationsanalysen.

Ergebnisse

Insgesamt wurden 2019 83.687 BPS-Operationen in 473 urologischen Fachabteilungen durchgeführt. Am häufigsten wurde die transurethrale Prostataresektion (TURP; 71,7 %) angewendet. Die Holmiumlaserenukleation (HoLEP; 9,5 %) bzw. die chirurgische Adenomektomie (5,6 %) waren das zweit- bzw. dritthäufigste Verfahren. Seltener wurden Thuliumlaserenukleation (ThuLEP; 3,1 %), Laservaporisation (2,9 %) und elektrische Vaporisation (2,8 %) durchgeführt. Alle weiteren Verfahren machten jeweils < 1 % aus. HoLEP, ThuLEP und elektrische Vaporisation erlebten seit 2006 eine stetige Zunahme der Eingriffszahlen (HoLEP: +42,42 %/Jahr; p < 0,001, ThuLEP: +20,6 %/Jahr, p = 0,99; elektrische Vaporisation: +43,42 %/Jahr, p < 0,001), während die chirurgische Adenomektomie abnahm (−1,66 %/Jahr, p < 0,001). Die Krankenhausverweildauer lag 2019 bei mittleren 5,1 ± 0,1 Tagen.

Schlussfolgerung

Die TURP bleibt das am häufigsten durchgeführte Operationsverfahren. Während, insbesondere in Zentren, die Lasertherapien zunehmen, geht die chirurgische Adenomektomie zurück.

Zusatzmaterial online

Die Online Version dieses Artikels (10.1007/s00120-022-01777-9) enthält weitere Tabellen und Abbildungen zur Entwicklung der Eingriffszahlen für die chirurgische Adenomresektion, Urologische Fachabteilungen mit den höchsten Eingriffszahlen, Entwicklung der Eingriffe TURP, chirurgische Adenomektomie, HoLEP und ThuLEP in den 5 Häusern mit den meisten BPS-Eingriffen und zur Deutschlandweiten Verteilung der BPH-Diagnosen.

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Borkowetz A, Leitsmann M, Baunacke M, Borgmann H, Boehm K, Groeben C, Roigas J, Schneider AW, Speck T, Schroeder-Printzen I, Zillich S, Volkmer B, Witzsch U, Huber J. [Acceptance and status of digitalization in clinics and practices : Current assessment in German urology]. Urologie 2022;61:1365-1372. [PMID: 35925111 PMCID: PMC9729156 DOI: 10.1007/s00120-022-01889-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 12/14/2022]

Affiliation(s)

Angelika Borkowetz grid.4488.00000 0001 2111 7257Klinik und Poliklinik für Urologie, Universitätsklinikum Dresden, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Deutschland
Marianne Leitsmann grid.11598.340000 0000 8988 2476Klinik für Urologie, Medizinische Universität Graz, Graz, Österreich
Martin Baunacke grid.4488.00000 0001 2111 7257Klinik und Poliklinik für Urologie, Universitätsklinikum Dresden, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Deutschland
Hendrik Borgmann grid.410607.4Klinik für Urologie, Universitätsmedizin Mainz, Mainz, Deutschland
Katharina Boehm grid.4488.00000 0001 2111 7257Klinik und Poliklinik für Urologie, Universitätsklinikum Dresden, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Deutschland
Christer Groeben grid.10253.350000 0004 1936 9756Klinik für Urologie, Philipps-Universität Marburg, Marburg, Deutschland
Jan Roigas grid.415085.dKlinik für Urologie, Vivantes Klinikum Friedrichshain, Berlin, Deutschland
Andreas W. Schneider Kooperative Belegarztpraxis für Urologie, Winsen/Luhe, Deutschland
Thomas Speck Praxis Urologie, Berlin, Deutschland
Immo Schroeder-Printzen grid.411067.50000 0000 8584 9230Universitätsklinikum Gießen, Gießen, Deutschland
Susanne Zillich grid.411668.c0000 0000 9935 6525Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Erlangen, Deutschland
Björn Volkmer grid.419824.20000 0004 0625 3279Klinik für Urologie, Klinikum Kassel, Kassel, Deutschland
Ulrich Witzsch grid.468184.70000 0004 0490 7056Klinik für Urologie und Kinderurologie, Krankenhaus Nordwest, Frankfurt am Main, Deutschland
Johannes Huber grid.10253.350000 0004 1936 9756Klinik für Urologie, Philipps-Universität Marburg, Marburg, Deutschland
Arbeitskreis Versorgungsforschung, Qualität und Ökonomie der Deutschen Gesellschaft für Urologie e. V.
Arbeitskreis Informationstechnologie und Dokumentation der Deutschen Gesellschaft für Urologie e. V.

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Leitsmann M, Stammann C, Zielke R, Weißbach L. Ambulante spezialfachärztliche Versorgung. Uro-News 2021. [PMCID: PMC8586827 DOI: 10.1007/s00092-021-4714-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]

Leitsmann M, Uhlig A, Aksoy C, Boehm K. Auswirkung der COVID-19-Pandemie auf die Urologie. Uro-News 2021. [PMCID: PMC8489974 DOI: 10.1007/s00092-021-4693-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]

Wenzel M, Kleimaker A, Uhlig A, Würnschimmel C, Becker A, Yu H, Meyer CP, Fisch M, Chun FKH, Leitsmann M. Impact of comorbidities on acute kidney injury and renal function impairment after partial and radical tumor nephrectomy. Scand J Urol 2021;55:377-382. [PMID: 34427540 DOI: 10.1080/21681805.2021.1948916] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]

Wenzel M, Yu H, Uhlig A, Würnschimmel C, Wallbach M, Becker A, Fisch M, Chun FKH, Meyer CP, Leitsmann M. Cystatin C predicts renal function impairment after partial or radical tumor nephrectomy. Int Urol Nephrol 2021;53:2041-2049. [PMID: 34269968 PMCID: PMC8463386 DOI: 10.1007/s11255-021-02957-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/03/2021] [Accepted: 07/09/2021] [Indexed: 11/28/2022]

Baunacke M, Groeben C, Borkowetz A, Uhlig A, Leitsmann M, Volkmer B, Thomas C, Huber J. [Health care reality of urological endoprosthetics in Germany from 2006 to 2016]. Urologe A 2021;60:351-360. [PMID: 33481064 PMCID: PMC7979589 DOI: 10.1007/s00120-021-01444-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Accepted: 01/04/2021] [Indexed: 12/17/2022]

Abstract

Hintergrund

Die Behandlung von Harninkontinenz und erektiler Dysfunktion verbessert die Lebensqualität vieler Patienten. Insbesondere die Endoprothetik mit Sphinkter- und Penisprothesen erzielt hierbei sehr gute Ergebnisse, wenn konservative Therapieoptionen ausgeschöpft sind. Ziel dieser Studie ist eine Darstellung der Entwicklung und aktuellen Versorgungslage der Sphinkter- und Penisprothesenimplantation in Deutschland.

Material und Methoden

Wir führten eine Analyse der Diagnosis-Related-Groups-Abrechnungsdaten in Deutschland im Zeitraum von 2006 bis 2016 durch. Die Versorgungslage im Jahr 2016 beschrieben wir auf Basis der Qualitätsberichtsdaten der deutschen Krankenhäuser.

Ergebnisse

Von 2006 bis 2012 stieg die Zahl der implantierten Sphinkterprothesen in Deutschland von 739 auf 1112 (p < 0,001) und die Zahl der implantierenden Kliniken von 129 auf 206 (p < 0,001). Von 2012 bis 2016 fielen die Fallzahlen auf 980 und die Zahl der Kliniken auf 198. Im Jahr 2016 implantierten 168 (88 %) urologische Kliniken 1–9 Sphinkterprothesen und 23 (12 %) Kliniken ≥ 10 Sphinkterprothesen. Die 10 Top-Kliniken (≥20 Sphinkter) implantierten 34 % (283/839) aller Sphinkter. Von 2006 bis 2013 stieg die Zahl der implantierten Penisprothesen kontinuierlich von 263 auf 503 (p < 0,001) sowie die Zahl der implantierenden Kliniken von 71 auf 107 (p < 0,001). Von 2013 bis 2016 stagnierte die Fallzahl (p = 0,9) und die Zahl der implantierenden Kliniken (p = 0,5). Der Anteil implantierter Penisprothesen im Rahmen von Geschlechtsumwandlungen stieg von 17 % im Jahr 2006 auf 25 % im Jahr 2016 (p = 0,03). Im Jahr 2016 implantierten 83 (85 %) urologische Kliniken 1–6 Penisprothesen und 14 (15 %) Kliniken ≥ 7 Prothesen. Die 7 Top-Kliniken (≥20 Prothesen/Jahr) implantierten 232/448 (52 %) der Prothesen.

Diskussion

Der Versorgungsstand der urologischen Endoprothetik in Deutschland zeigt eine deutliche Zentrenbildung, aber auch eine große Zahl von Kliniken mit geringer Fallzahl. Seit 2012/2013 zeigt sich eine Stagnation der Fallzahlen von Penis- und Sphinkterprothesenimplantationen, die in Zusammenschau mit den Prostatektomiefallzahlen eine Unterversorgung vermuten lässt.

Zusatzmaterial online

Die Online-Version dieses Artikels (10.1007/s00120-021-01444-5) enthält weitere Tabellen zu Fallzahlen von Sphinkterprothesen und Penisprothesenimplantationen. Beitrag und Zusatzmaterial stehen Ihnen auf www.springermedizin.de zur Verfügung. Bitte geben Sie dort den Beitragstitel in die Suche ein, das Zusatzmaterial finden Sie beim Beitrag unter „Ergänzende Inhalte“.

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Uhlig A, Uhlig J, Trojan L, Woike M, Leitsmann M, Strauß A. Toxicities of axitinib, sunitinib and temsirolimus: implications for progression-free and overall survival in metastatic renal cell cancer. Future Oncol 2020;17:45-56. [PMID: 33275038 DOI: 10.2217/fon-2020-0900] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 12/24/2022] Open