Der Urologe. Ausg. A
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The political debate concerning organ donations reached increased public awareness from 2012, despite the multiple scandals around organ allocation. The process of organ donation has been restructured since financing improved by the GZSO (Gesetz für bessere Zusammenarbeit und bessere Strukturen bei der Organspende). ⋯ Hence, it is time to introduce an "opt-out" solution, a system already standard in other European countries. Finally, to increase in the much-needed organ donations within Germany a multistructured concept should be established: improving hospital pathways, staff recognition, public awareness and political support.
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Der Urologe. Ausg. A · Dec 2019
Review[The role of the vesical imaging-reporting and data system (VI-RADS) for bladder cancer diagnostics-status quo].
Initial clinical and pathological diagnostic workup of urinary bladder cancer is based on cystoscopy, transurethral resection of suspicious lesions, and computed tomography when indicated. Accurate staging is necessary for further therapeutic decision-making. This review summarizes the current status of multiparametric magnetic resonance imaging (mpMRI) and the vesical imaging-reporting and data system (VI-RADS) classification. ⋯ Preliminary data suggest low interobserver variability. However, prospective multicenter studies are necessary to validate the VI-RADS classification. Progress in functional, molecular, and hybrid imaging may further improve the accuracy of clinical tumor and nodal staging for bladder cancer.
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Der Urologe. Ausg. A · Jun 2019
Review[Sacral neuromodulation in under- and overactive detrusor-quo vadis? : Principles and developments].
Sacral neuromodulation (SNM) has been used in the treatment of refractory overactive bladder syndrome, nonobstructive urinary retention and faecal incontinence for almost 40 years now. It is not to be confused with the sacral anterior root stimulation which is exclusively used for bladder dysfunction due to spinal paraplegia. ⋯ The indications for SNM in the German health care system can be expected to be expanded upon the chronic pelvic pain syndrome, erectile dysfunction and additional gastrointestinal conditions. Technical progress will continue to improve the risk-benefit ratio of SNM.
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Der Urologe. Ausg. A · Feb 2019
Review[Urology training in Germany: international comparison of educational concepts and satisfaction].
The training of residents in urology is challenged by global trends in surgical education, increasing technological developments, subspecialization of the field and working hour regulations for physicians. Currently, there is no standardized curriculum in Europe and significant international differences exist in the education of residents. ⋯ Structured and validated competence assessments and not "minimum numbers of operations" may help improve surgical training. An objective nationwide examination at the end of residency may be useful for international benchmarking.
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Der Urologe. Ausg. A · Jan 2019
Review[Cochrane Rapid Review: the immune checkpoint inhibitor pembrolizumab versus chemotherapy for the treatment of advanced urothelial carcinoma].
Abstract