Der Urologe. Ausg. A
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Der Urologe. Ausg. A · Sep 2018
Review[Robots in urology-an analysis of current and future devices].
The monopoly of robotic surgical devices of the last 15 years will end in 2019 when key patents of Intuitive Surgical expire. Thus, we can expect an interesting competitive situation in the coming years. Based on personal experience with robot-assisted surgery since 2001, we conducted a search of the current literature together with a search of relevant patents in this field. ⋯ For this purpose, we propose to classify the main features of the different devices, such as type of console (closed/open), arrangement of robotic arms (single/multiple carts/attached to operating room table), type of three-dimensional videosystem (by mirror/ocular/using polarizing glasses) or degrees of freedom (DOF) of end effectors (5 vs. 7 DOF). In the meantime, there are also robotic systems used in endourology: Avicenna Roboflex® and the AquaBeam® system for robot-assisted aquablation therapy of the prostate. While Roboflex® improves the ergonomics of flexible ureteroscopy-similar to the Da Vinci robot, AquaBeam® may for the first time eliminate the surgeon, who might only be needed to manage severe postoperative bleeding.
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Der Urologe. Ausg. A · Oct 2017
[What is the perception of the 10-point plan of the German Federal Ministry of Health against multidrug-resistant pathogens and measures of antibiotic stewardship? : An interdisciplinary analysis among German clinicians and development of a decision tool for urologists].
Due to increasing antibiotic resistances, relevant treatment problems are currently emerging in clinical practice. In March 2015, the German Federal Ministry of Health (BMG) published a 10-point plan designed to combat this development. Furthermore, the first German guideline on antibiotic stewardship (ABS) was implemented in 2013 and instructs physicians of different specialties about several treatment considerations. Evidence is scarce on how such concepts (10-point plan/BMG, ABS) are perceived among clinicians. ⋯ The 10-point plan/BMG and ABS programs should be implemented into clinical practice, but awareness and knowledge of both is insufficient. Thus, it stands to reason that the actual realization of such measures is inadequate and continuous training towards rational prescription of antibiotics is necessary, regardless of medical specialty.
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Der Urologe. Ausg. A · Aug 2017
[Chronic pelvic pain syndrome : Treatment options using osteopathy].
Urogenital problems are dramatically increasing; especially chronic pelvic pain syndrome (CPPS) poses a major challenge for physicians and therapists. Few forms of therapy have been able to promise relief because the cause of CPPS remains unclear. Functional complaints are increasingly discussed as triggers. ⋯ In this article, the approach and osteopathic point of view of functional complaints are presented. In addition, possible causes for the development of CPPS and important anatomical structures that are directly involved in it are explained. Further interdisciplinary research of functional relationships would be desirable in the future.
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Der Urologe. Ausg. A · Jul 2017
Comparative Study[Cost effectiveness of GnRH antagonists in patients with prostate cancer and cardiovascular risk : Comparative analysis against Leuprorelin by the Number Needed to Treat].
Recent studies suggest that androgen deprivation therapy (ADT) is associated with increased cardiovascular (CV) risk for patients with hormone-sensitive prostate cancer (PCa) and pre-existing CV disease. This risk seems to be different for the gonadotropin-releasing hormone (GnRH) agonists leuprolide and goserelin and GnRH antagonists, whereas the slightly more expensive GnRH antagonist shows a beneficial risk profile. The present study assesses the cost effectiveness of degarelix compared to leuprolide for PCa patients with increased CV risk. ⋯ Compared to leuprolide, degarelix is cost effective for patients with increased CV risk.
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Der Urologe. Ausg. A · Jun 2017
Randomized Controlled Trial[Nivolumab combined with ipilimumab versus sunitinib monotherapy-SUNNIFORECAST AN 41/16 of the AUO : A phase 2, randomized, open-label study in subjects with previously untreated and advanced (unresectable or metastatic) non-clear cell renal cell carcinoma].