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European Urological Association

A Spek, B Szabados, B Ziegelmüller, C Stief, M D'Anastasi, M Staehler
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...
October 18, 2016: Urologia Internationalis
Kim E M van Kessel, Willemien Beukers, Irene Lurkin, Angelique Ziel-van der Made, Kirstin A van der Keur, Joost L Boormans, Lars Dyrskjøt, Mirari Márquez, Torben F Ørntoft, Francisco X Real, Ulrika Segersten, Núria Malats, Per-Uno Malmström, Wim Van Criekinge, Ellen C Zwarthoff
PURPOSE: Only 3-28% of patients referred to the urology clinic for hematuria are diagnosed with bladder cancer (BC). Cystoscopies lead to high diagnostic costs and patient burden. Therefore, to improve selection of patients for cystoscopy, reduce costs and over-testing we aimed to validate a recently developed diagnostic urine assay MATERIALS AND METHODS: We included 200 patients from three European countries undergoing cystoscopy for hematuria (n=97 BC, n=103 non-malignant). Voided urine samples were collected prior to cystoscopy...
October 13, 2016: Journal of Urology
Akhil Muthigi, Abhinav Sidana, Arvin K George, Michael Kongnyuy, Mahir Maruf, Subin Valayil, Bradford J Wood, Peter A Pinto
INTRODUCTION AND OBJECTIVE: Multiparametric magnetic resonance imaging (MRI) and magnetic resonance (MR) -targeted biopsy have a growing role in the screening and evaluation of prostate cancer. We aim to evaluate the current knowledge, attitude, and practice patterns of urologists regarding this new technique. METHODS: An anonymous online questionnaire was designed to collect information on urologists' beliefs and use of prostate multiparametric MRI and MR-targeted biopsy...
October 12, 2016: Urologic Oncology
Jan Oldenburg, Klaus-Peter Dieckmann
INTRODUCTION: In 1979, the Copenhagen group around Dr. Skakkebaek introduced contralateral biopsy in patients with testicular germ cell tumour (GCT) as a means of early diagnosing a contralateral testicular tumour (Berthelsen et al. in Br Med J 2(6186):363-364, 1). Although the rationale of contralateral biopsies is based on much of scientific evidence, no issue regarding the management of GCTs has been more controversial than the issue of contralateral biopsies (Heidenreich in BJU Int 104(9 Pt B):1346-1350, 2; Grigor and Rorth in Eur Urol 23(1):129-135, 3)...
October 13, 2016: World Journal of Urology
O R Brouwer, H G van der Poel, R F Bevers, E J van Gennep, S Horenblas
This review aims to discuss the current state-of-the-art of sentinel node (SN) mapping in urological malignancies. The principles and methodological aspects of lymphatic mapping and SN biopsy in urological malignancies are reviewed. Literature search was restricted to English language. The references of the retrieved articles were examined to identify additional articles. The review also includes meta-analyses published in the past 5 years. SN biopsy for penile cancer is recommended by the European Association of Urology as the preferred staging tool for clinically node-negative patients with at least T1G2 tumours (level of evidence 2a, Grade B)...
2016: Clinical and Translational Imaging: Reviews in Nuclear Medicine and Molecular Imaging
Oktay Üçer, Ali Can Albaz, Elif Atag, Aziz Karaoglu, Talha Muezzinoglu
PURPOSE: To investigate the proportion of neoadjuvant chemotherapy (NAC) use in patients with muscle invasive bladder cancer before radical cystectomy and the approach of urologists to this subject. MATERIALS AND METHODS: We invited 242 urologists during the 12th International Urooncology Congress in Turkey to answer a self-administered questionnaire. The questionnaire included questions related to radical cystectomy, lymph node dissection and neoadjuvant chemotherapy that had been performed in patients with muscle invasive bladder cancer by the urologist...
October 10, 2016: Urology Journal
Sacha L Moore, Ewa Bres-Niewada, Paul Cook, Hannah Wells, Bhaskar K Somani
INTRODUCTION: Kidney stone disease is increasing worldwide with its most common location being in the lower pole. A clear strategy for effective management of these stones is essential in the light of ever increasing choice, effectiveness, and complications of different treatment options. MATERIAL AND METHODS: This review identifies the latest and clinically relevant publications focused on optimal management of lower pole stones. RESULTS: We present an up-to-date European Association of Urology and American Urological Association algorithm for lower pole stones, risks and benefits of different treatments, and changing landscape with the miniaturization of percutaneous stone treatments...
2016: Central European Journal of Urology
Arjun K Nambiar, Gary E Lemack, Christopher R Chapple, Fiona C Burkhard
This article summarises the European Association Urology guidelines position on the role of urodynamic studies in investigating the problem of urinary incontinence. The guidelines recommend that urodynamics should not be necessary to help decide the best treatment for uncomplicated urinary incontinence, but may help if there is any uncertainty over the choice of invasive treatments. The guidelines also stress the importance of conducting urodynamic tests to the highest possible quality standards for the results to be useful in the decision-making process...
October 7, 2016: European Urology
Pascal Rischmann, Albert Gelet, Benjamin Riche, Arnauld Villers, Gilles Pasticier, Pierre Bondil, Jean-Luc Jung, Hubert Bugel, Jacques Petit, Harry Toledano, Stéphane Mallick, Olivier Rouvière, Muriel Rabilloud, Hélène Tonoli-Catez, Sebastien Crouzet
BACKGROUND: Up to a third of patients with localized prostate cancer have unilateral disease that may be suitable for partial treatment with hemiablation. OBJECTIVE: To evaluate the ability of high intensity focused ultrasound (HIFU) to achieve local control of the tumor in patients with unilateral localized prostate cancer. DESIGN, SETTING, AND PARTICIPANTS: The French Urological Association initiated a prospective IDEAL multi-institutional study (2009-2015), to evaluate HIFU-hemiablation as a primary treatment...
October 6, 2016: European Urology
Vincenzo Serretta, Cristina Scalici Gesolfo, Vincenza Alonge, Fabrizio Di Maida, Giovanni Caruana
Mitomycin C (MMC) intravesical therapy for "superficial" papillary bladder tumors was firstly introduced in the early seventies with promising results. In the following years, several pharmacokinetic studies investigated its mechanism of action to optimize the intravesical administration. Numerous studies confirmed thereafter both the ablative and the prophylactic efficacy and the low toxicity of MMC when intravesically given. In 1984, a complete response rate of 42% in 60 patients not responsive to thiotepa was reported with intravesical MMC at the dose of 40 mg diluted in 40 ml for 8 weeks...
October 4, 2016: Urologia
Stefano Paolo Zanetti, Luca Boeri, Michele Catellani, Andrea Gallioli, Alberto Trinchieri, Kemal Sarica, Emanuele Montanari
OBJECTIVE: A wide selection of both anterograde and retrograde mini-invasive procedures exist for stones' treatment. The 2016 European Association of Urology (EAU) guidelines still don't univocally define a best option. Our purpose is to give an overview on some European Stone Centers' customs and to compare real life clinical practice with statements of opinion leaders and Guidelines. MATERIALS AND METHODS: In 2015 we performed a survey in 3 step about the spread of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) techniques among EAU Section of Urolithiasis (EULIS) members...
October 5, 2016: Archivio Italiano di Urologia, Andrologia
Ariana Singh, Kamran Ahmed, Abdullatif Aydin, Muhammad Shamim Khan, Prokar Dasgupta
INTRODUCTION AND HYPOTHESIS: Fournier's gangrene is a rare, necrotising fasciitis of the external genitalia, perineal or perianal regions. The disease has a higher incidence in males and risk factors for development include diabetes, HIV, alcoholism and other immune-compromised states. The aggressive disease process is associated with a high mortality rate of 20-30%. In addition, the increasing age and prevalence of diabetes in the population, begs the need for increased clinical awareness of Fournier's gangrene with emphasis on early diagnosis and management...
October 5, 2016: Archivio Italiano di Urologia, Andrologia
Fabrizio Presicce, Cosimo De Nunzio, Mauro Gacci, Enrico Finazzi Agrò, Andrea Tubaro
BACKGROUND: To evaluate the role of the ultrasound assessments of the bladder/detrusor wall thickness (BWT/DWT) and the ultrasound estimated bladder weight (UEBW) in lower urinary tract symptoms diagnosis and treatment. EVIDENCE ACQUISITION: A systematic literature search from January 1995 until February 2016 was performed on PubMed using the following terms: Bladder Weight, Bladder Wall Thickness, Detrusor Wall Thickness, LUTS, Bladder Outlet Obstruction (BOO), Benign Prostatic Obstruction...
October 5, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Sachin Malde, Arjun K Nambiar, Roland Umbach, Thomas B Lam, Thorsten Bach, Alexander Bachmann, Marcus J Drake, Mauro Gacci, Christian Gratzke, Stephan Madersbacher, Charalampos Mamoulakis, Kari A O Tikkinen, Stavros Gravas
CONTEXT: Several noninvasive tests have been developed for diagnosing bladder outlet obstruction (BOO) in men to avoid the burden and morbidity associated with invasive urodynamics. The diagnostic accuracy of these tests, however, remains uncertain. OBJECTIVE: To systematically review available evidence regarding the diagnostic accuracy of noninvasive tests in diagnosing BOO in men with lower urinary tract symptoms (LUTS) using a pressure-flow study as the reference standard...
September 26, 2016: European Urology
Christian Radmayr, Hasan S Dogan, Piet Hoebeke, Radim Kocvara, Rien Nijman, Raimund Stein, Shabnam Undre, Serdar Tekgul
CONTEXT: Undescended testis is the most common endocrinological disease in the male newborn period. Incidence varies between 1.0% and 4.6% in full-term neonates, with rates as high as 45% in preterm neonates. Failure or delay of treatment can result in reduced fertility and/or increased testicular cancer risk in adulthood. OBJECTIVE: To provide recommendations for the diagnosis and treatment of boys with undescended testes which reduce the risk of impaired fertility and testicular cancer in adulthood...
September 15, 2016: Journal of Pediatric Urology
F Nejatbakhsh, L Shirbeigi, R Rahimi, H Abolhassani
The male reproductive function can be influenced by many different factors, including genetic, environmental and socioeconomic parameters leading to a progressive decline. However, the cause of infertility cannot be found in a significant proportion of couples, and even with the presence of the sign of testicular dysfunction or obstructive azoospermia, the main aetiology is not identified. In the absence of knowledge about predisposing factor, targeted therapeutic modalities for male infertility may not be possible, and a wide variety of empiric drug approaches, even with low scientific evidence, have been utilised in current conventional medicine...
October 2016: Andrologia
Mauro Ragonese, Marco Racioppi, Pier Francesco Bassi, Luca Di Gianfrancesco, Niccolò Lenci, Alessio Filianoti, Salvatore M Recupero
Mitomycin C (MMC) as an intravesical chemotherapeutic agent is a well-known option for treatment of nonmuscle invasive bladder cancer (NMIBC) recurrence; it is probably the most commonly used agent given its low rate of side effects and its efficacy.Both the American Urologic Association (AUA) and European Association of Urology (EAU) consider MMC as a standard treatment for immediate single-dose postoperative treatment and for adjuvant therapy in low and intermediate-risk NMIBC.Despite the popularity of this agent in the treatment of NMIBCs, many questions regarding the optimal approach to MMC therapy remain unanswered and the schedule widely used is empirical...
October 4, 2016: Urologia
R Mano, J Eastham, O Yossepowitch
BACKGROUND: Treatment of high-risk prostate cancer has evolved considerably over the past two decades, yet patients with very-high-risk features may still experience poor outcome despite aggressive therapy. We review the contemporary literature focusing on current definitions, role of modern imaging and treatment alternatives in very-high-risk prostate cancer. METHODS: We searched the MEDLINE database for all clinical trials or practice guidelines published in English between 2000 and 2016, with the following search terms: 'prostatic neoplasms' (MeSH Terms) AND ('high risk' (keyword) OR 'locally advanced' (keyword) OR 'node positive' (keyword))...
September 13, 2016: Prostate Cancer and Prostatic Diseases
Alexandra Grahn, Miden Melle-Hannah, Camilla Malm, Fredrik Jäderling, Eva Radecka, Mats Beckman, Marianne Brehmer
OBJECTIVE: To investigate diagnostic accuracy of multiphase computed tomography urography (MCTU) and visual assessment at ureterorenoscopy (URS) for detection of upper tract urothelial carcinoma (UTUC). PATIENTS AND METHODS: Consecutive patients referred to our tertiary care centre were included in a prospective study covering the period 2005 to 2012. The patients underwent initial imaging and URS with focal samples taken. Cytopathological results served as reference standard...
September 9, 2016: BJU International
C Türk
The first German guidelines on urolithiasis were published in four sections in "Der Urologe A" in 1997 and were listed at The Association of the Scientific Medical Societies in Germany (AWMF) in 1999. The European Association of Urology (EAU) published the first guidelines on urolithiasis in 2000. All guidelines must be updated on a regular basis. Guidelines should represent the highest level of evidence for the best diagnostic and therapeutic procedures, independent of economic pressure. Guidelines should safeguard optimal patient care and also serve as a basis for education and training of healthcare professionals...
October 2016: Der Urologe. Ausg. A
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