Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Urology Reports
Erschienen in: Current Urology Reports 10/2014

01.10.2014 | Urosurgery (A Stenzl, Section Editor)

How to Minimize Lymphoceles and Treat Clinically Symptomatic Lymphoceles After Radical Prostatectomy

verfasst von: Hak J. Lee, Christopher J. Kane

Erschienen in: Current Urology Reports | Ausgabe 10/2014

Einloggen, um Zugang zu erhalten

Abstract

The development of a lymphocele after pelvic surgery is a well-documented complication, especially where pelvic lymph node dissection (PLND) is part of the operation. However, not all lymphoceles are symptomatic and require treatment. Most lymphoceles spontaneously resolve, and even lymphoceles that become symptomatic may resolve without any intervention. Robotic assisted radical prostatectomy (RARP) is a common operation in urology where PLND is likely to be performed in intermediate and high-risk prostate cancer patients. The rationale for performing a PLND in prostate cancer is for accurate staging and potential therapeutic benefits. However, due to potential intraoperative and postoperative complications there is still a debate regarding the value of PLND in prostate cancer. In this review, we will discuss the potential risk factors to be aware of in pelvic surgery in order to minimize the formation of a lymphocele, along with the management for clinically significant lymphoceles.
Literatur
1.
Novara G, Ficarra V, Rosen RC, et al. Systematic review and meta-analysis of perioperative outcomes and complications after robot-assisted radical prostatectomy. Eur Urol. 2012;62(3):431–52.PubMedCrossRef
2.•
Yuh B, Artibani W, Heidenreich A, et al. The Role of Robot-assisted Radical Prostatectomy and Pelvic Lymph Node Dissection in the Management of High-risk Prostate Cancer: A Systematic Review. Eur Urol. May 18 2013. A systemic expert review of peri-operative outcomes of men with high risk prostate cancer after robotic assisted prostatectomy. There is significant variability in the template of the lymph node dissection, but overall extended lymph node dissection improved the staging and has a higher pelvic lymph node yield with minial post-operative lymphoceles.
3.••
Ploussard G, Briganti A, de la Taille A, et al. Pelvic lymph node dissection during robot-assisted radical prostatectomy: efficacy, limitations, and complications - a systematic review of the literature. Eur Urol. 2014;65(1):7–16. A literature review of the efficacy, limitations and complications of pelvic node dissection during roboticradical prostatectomy. Pelvic lymph node dissection only related complications are rare, but the most commoncomplication after lymph node dissection is lymphoceles that are subclinical. The overall types and rates ofrobotic complications are similar to open and laparoscopic prostatectomies.
4.
Liss MA, Skarecky D, Morales B, Osann K, Eichel L, Ahlering TE. Preventing perioperative complications of robotic-assisted radical prostatectomy. Urology. 2013;81(2):319–23.PubMedPubMedCentralCrossRef
5.••
Orvieto MA, Coelho RF, Chauhan S, Palmer KJ, Rocco B, Patel VR. Incidence of lymphoceles after robot-assisted pelvic lymph node dissection. BJU Int. 2011;108(7):1185–90.Only study to prospectively follow patients with computed tomography 6-12 wks after the robotic assisted radical prostatectomy to determine the true post-operative lymphocele rates. PubMedCrossRef
6.
Naselli A, Andreatta R, Introini C, Fontana V, Puppo P. Predictors of symptomatic lymphocele after lymph node excision and radical prostatectomy. Urology. 2010;75(3):630–5.PubMedCrossRef
7.
Capitanio U, Pellucchi F, Gallina A, et al. How can we predict lymphorrhoea and clinically significant lymphocoeles after radical prostatectomy and pelvic lymphadenectomy? Clinical implications. BJU Int. 2011;107(7):1095–101.PubMedCrossRef
8.
Patel VR, Sivaraman A. Current status of robot-assisted radical prostatectomy: progress is inevitable. Oncology (Williston Park, NY). 2012;26(7):616–9. 622.
9.
Ayanian JZ, Van der Wees PJ. Tackling rising health care costs in Massachusetts. N Engl J Med. 2012;367(9):790–3.PubMedCrossRef
10.
Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63(1):11–30.PubMedCrossRef
11.
Abbou CC, Hoznek A, Salomon L, et al. Laparoscopic radical prostatectomy with a remote controlled robot. J Urol. 2001;165(6 Pt 1):1964–6.PubMedCrossRef
12.
Rassweiler J, Frede T, Seemann O, Stock C, Sentker L. Telesurgical laparoscopic radical prostatectomy. Initial experience. Eur Urol. 2001;40(1):75–83.PubMedCrossRef
13.
Pasticier G, Rietbergen JB, Guillonneau B, Fromont G, Menon M, Vallancien G. Robotically assisted laparoscopic radical prostatectomy: feasibility study in men. Eur Urol. 2001;40(1):70–4.PubMedCrossRef
14.
H. Lavery DS, and A. Levinson Not a zero-sum game: the adoption of robotics has increased overall prostatectomy utilization in the united states. Proc Am Urol Assoc Annu Meet, Poster Session. 2011.
15.
Stitzenberg KB, Wong YN, Nielsen ME, Egleston BL, Uzzo RG. Trends in radical prostatectomy: centralization, robotics, and access to urologic cancer care. Cancer. 2012;118(1):54–62.PubMedPubMedCentralCrossRef
16.
Musch M, Klevecka V, Roggenbuck U, Kroepfl D. Complications of pelvic lymphadenectomy in 1,380 patients undergoing radical retropubic prostatectomy between 1993 and 2006. J Urol. 2008;179(3):923–8. discussion 928–929.PubMedCrossRef
17.
Solberg A, Angelsen A, Bergan U, Haugen OA, Viset T, Klepp O. Frequency of lymphoceles after open and laparoscopic pelvic lymph node dissection in patients with prostate cancer. Scand J Urol Nephrol. 2003;37(3):218–21.PubMedCrossRef
18.
Khoder WY, Trottmann M, Buchner A, et al. Risk factors for pelvic lymphoceles post-radical prostatectomy. Int J Urol Off J Jpn Urol Assoc. 2011;18(9):638–43.
19.
Liss MA, Palazzi K, Stroup SP, Jabaji R, Raheem OA, Kane CJ. Outcomes and complications of pelvic lymph node dissection during robotic-assisted radical prostatectomy. World J Urol. 2013;31(3):481–8.PubMedCrossRef
20.
Rabbani F, Yunis LH, Pinochet R, et al. Comprehensive standardized report of complications of retropubic and laparoscopic radical prostatectomy. Eur Urol. 2010;57(3):371–86.PubMedCrossRef
21.
Kowalczyk KJ, Levy JM, Caplan CF, et al. Temporal national trends of minimally invasive and retropubic radical prostatectomy outcomes from 2003 to 2007: results from the 100 % Medicare sample. Eur Urol. 2012;61(4):803–9.PubMedCrossRef
22.
Briganti A, Bianchi M, Sun M, et al. Impact of the introduction of a robotic training programme on prostate cancer stage migration at a single tertiary referral centre. BJU Int. 2013;111(8):1222–30.PubMedCrossRef
23.
Zorn KC, Katz MH, Bernstein A, et al. Pelvic lymphadenectomy during robot-assisted radical prostatectomy: Assessing nodal yield, perioperative outcomes, and complications. Urology. 2009;74(2):296–302.PubMedCrossRef
24.••
Cooperberg MR, Kane CJ, Cowan JE, Carroll PR. Adequacy of lymphadenectomy among men undergoing robot-assisted laparoscopic radical prostatectomy. BJU Int. 2010;105(1):88–92.Retrospective data comparing rates of lymph node dissection and nodal yields for open radical prostatectomy vs. robotic assisted prostatectomy form a single institution. Demonstrated in a large contempory series that nodal yield was adeaquate for both approaches. PubMedCrossRef
25.
Silberstein JL, Vickers AJ, Power NE, et al. Pelvic lymph node dissection for patients with elevated risk of lymph node invasion during radical prostatectomy: comparison of open, laparoscopic and robot-assisted procedures. J Endourol. 2012;26(6):748–53.PubMedPubMedCentralCrossRef
26.
Katz DJ, Yee DS, Godoy G, Nogueira L, Chong KT, Coleman JA. Lymph node dissection during robotic-assisted laparoscopic prostatectomy: comparison of lymph node yield and clinical outcomes when including common iliac nodes with standard template dissection. BJU Int. 2010;106(3):391–6.PubMedCrossRef
27.
Polcari AJ, Hugen CM, Sivarajan G, et al. Comparison of open and robot-assisted pelvic lymphadenectomy for prostate cancer. J Endourol. 2009;23(8):1313–7.PubMedCrossRef
28.
Truesdale MD, Lee DJ, Cheetham PJ, Hruby GW, Turk AT, Badani KK. Assessment of lymph node yield after pelvic lymph node dissection in men with prostate cancer: a comparison between robot-assisted radical prostatectomy and open radical prostatectomy in the modern era. J Endourol. 2010;24(7):1055–60.PubMedCrossRef
29.
Association AU. Guideline for the managment of clinically localized prostate cancer: 2007 Update. 2007 Update.
30.
Heidenreich A, Bastian PJ, Bellmunt J, et al. EAU guidelines on prostate cancer. part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol. 2014;65(1):124–37.PubMedCrossRef
31.
32.
Abdollah F, Sun M, Suardi N, et al. National Comprehensive Cancer Network practice guidelines 2011: Need for more accurate recommendations for pelvic lymph node dissection in prostate cancer. J Urol. 2012;188(2):423–8.PubMedCrossRef
33.
Mori N. Clinical and experimental studies on the so-called lymphocyst which develops after radical hysterectomy in cancer of the uterine cervix. J Jpn Obstet Gynecol Soc. 1955;2(2):178–203.PubMed
34.
35.
Miller GJ, Howarth DJ, Attfield JC, et al. Haemostatic factors in human peripheral afferent lymph. Thromb Haemost. 2000;83(3):427–32.PubMed
36.
White M, Mueller PR, Ferrucci Jr JT, et al. Percutaneous drainage of postoperative abdominal and pelvic lymphoceles. AJR Am J Roentgenol. 1985;145(5):1065–9.PubMedCrossRef
37.
Lima ML, Cotrim CA, Moro JC, Miyaoka R, D'Ancona CA. Laparoscopic treatment of lymphoceles after renal transplantation. Int braz J Urol Off J Braz Soc Urol. 2012;38(2):215–21. discussion 221.CrossRef
38.•
Weingartner K, Ramaswamy A, Bittinger A, Gerharz EW, Voge D, Riedmiller H. Anatomical basis for pelvic lymphadenectomy in prostate cancer: results of an autopsy study and implications for the clinic. J Urol. 1996;156(6):1969–71. Comparing cadaveric vs open prostatectomy patients with clinically organ confined prostate cancer to establish an accepted number, size and distribution of regional lymph nodes in prostate cancer compared to a normal prostate. PubMedCrossRef
39.•
Bochner BH, Cho D, Herr HW, Donat M, Kattan MW, Dalbagni G. Prospectively packaged lymph node dissections with radical cystectomy: evaluation of node count variability and node mapping. J Urol. 2004;172(4 Pt 1):1286–90. Extent of the lymph node dissection determined the lymph node yield. The type of lymh node dissection was associated with the overall node yield.
40.
Yuh BE, Ruel NH, Mejia R, Novara G, Wilson TG. Standardized comparison of robot-assisted limited and extended pelvic lymphadenectomy for prostate cancer. BJU Int. 2013;112(1):81–8.PubMedCrossRef
41.
Lee JY, Diaz RR, Cho KS, et al. Lymphocele after extraperitoneal robot-assisted radical prostatectomy: a propensity score-matching study. Int J Urol Off J Jpn Urol Assoc. 2013;20(12):1169–76.
42.
Park SC, Lee JW, Park SA, Lee YH, So BJ, Rim JS. The deep vein thrombosis caused by lymphocele after endoscopic extraperitoneal radical prostatectomy and pelvic lymph node dissection. Can Urol Assoc J J de l’Assoc des Urol du Can. 2011;5(3):E40–3.
43.
Warncke SH, Mattei A, Fuechsel FG, Z'Brun S, Krause T, Studer UE. Detection rate and operating time required for gamma probe-guided sentinel lymph node resection after injection of technetium-99 m nanocolloid into the prostate with and without preoperative imaging. Eur Urol. 2007;52(1):126–32.PubMedCrossRef
44.
Mattei A, Fuechsel FG, Bhatta Dhar N, et al. The template of the primary lymphatic landing sites of the prostate should be revisited: results of a multimodality mapping study. Eur Urol. 2008;53(1):118–25.PubMedCrossRef
45.
Weckermann D, Dorn R, Trefz M, Wagner T, Wawroschek F, Harzmann R. Sentinel lymph node dissection for prostate cancer: experience with more than 1,000 patients. J Urol. 2007;177(3):916–20.PubMedCrossRef
46.
Pagliarulo V, Hawes D, Brands FH, et al. Detection of occult lymph node metastases in locally advanced node-negative prostate cancer. J Clin Oncol. 2006;24(18):2735–42.PubMedCrossRef
47.
Ji J, Yuan H, Wang L, Hou J. Is the impact of the extent of lymphadenectomy in radical prostatectomy related to the disease risk? A single center prospective study. J Surg Res. 2012;178(2):779–84.PubMedCrossRef
48.
Clark T, Parekh DJ, Cookson MS, et al. Randomized prospective evaluation of extended versus limited lymph node dissection in patients with clinically localized prostate cancer. J Urol. 2003;169(1):145–7. discussion 147–148.PubMedCrossRef
49.
Danuser H, Di Pierro GB, Stucki P, Mattei A. Extended pelvic lymphadenectomy and various radical prostatectomy techniques: is pelvic drainage necessary? BJU Int. 2013;111(6):963–9.PubMedCrossRef
50.
Stolzenburg JU, Wasserscheid J, Rabenalt R, et al. Reduction in incidence of lymphocele following extraperitoneal radical prostatectomy and pelvic lymph node dissection by bilateral peritoneal fenestration. World J Urol. 2008;26(6):581–6.PubMedCrossRef
51.
Beyer J, Wessela S, Hakenberg OW, et al. Incidence, risk profile and morphological pattern of venous thromboembolism after prostate cancer surgery. J Thromb Haemost JTH. 2009;7(4):597–604.CrossRef
52.
Lundin C, Bersztel A, Wahlberg J, Wadstrom J. Low molecular weight heparin prophylaxis increases the incidence of lymphocele after kidney transplantation. Ups J Med Sci. 2002;107(1):9–15.PubMedCrossRef
53.
Gotto GT, Yunis LH, Guillonneau B, et al. Predictors of symptomatic lymphocele after radical prostatectomy and bilateral pelvic lymph node dissection. Int J Urol Off J Jpn Urol Assoc. Feb 10 2011.
54.
Bigg SW, Catalona WJ. Prophylactic mini-dose heparin in patients undergoing radical retropubic prostatectomy. A prospective trial. Urology. 1992;39(4):309–13.PubMedCrossRef
55.
Tomic R, Granfors T, Sjodin JG, Ohberg L. Lymph leakage after staging pelvic lymphadenectomy for prostatic carcinoma with and without heparin prophylaxis. Scand J Urol Nephrol. 1994;28(3):273–5.PubMed
56.
Kropfl D, Krause R, Hartung R, Pfeiffer R, Behrendt H. Subcutaneous heparin injection in the upper arm as a method of avoiding lymphoceles after lymphadenectomies in the lower part of the body. Urol Int. 1987;42(6):416–23.PubMedCrossRef
57.
Sieber PR, Rommel FM, Agusta VE, et al. Is heparin contraindicated in pelvic lymphadenectomy and radical prostatectomy? J Urol. 1997;158(3 Pt 1):869–71.PubMedCrossRef
58.
Chalmers DJ, Scarpato KR, Staff I, et al. Does heparin prophylaxis reduce the risk of venous thromboembolism in patients undergoing robot-assisted prostatectomy? J Endourol. 2013;27(6):800–3.PubMedCrossRef
59.
Koch Jr MO, JAS. Low molecular weight heparin and radical prostatectomy: a prospective analysis of safety and side effects. Prostate Cancer Prostatic Dis. 1997;1(2):101.PubMedCrossRef
60.•
Hu JC, Gold KF, Pashos CL, Mehta SS, Litwin MS. Role of surgeon volume in radical prostatectomy outcomes. J Clin Oncol. 2003;21(3):401–5. Evaluating the role of surgeon volume in radical prostatectomy outcomes from National Medicare beneficiary database. Surgeon volume is inversely related to in-hospital complications and hospital length of stay after radical prostatectomy. PubMedCrossRef
61.
Hu JC, Gold KF, Pashos CL, Mehta SS, Litwin MS. Temporal trends in radical prostatectomy complications from 1991 to 1998. J Urol. 2003;169(4):1443–8.PubMedCrossRef
62.
Davis JW, Kreaden US, Gabbert J, Thomas R. Learning Curve Assessment of Robot-Assisted Radical Prostatectomy Compared with Open-Surgery Controls from the Premier Perspective Database. J Endourol. Feb 6 2014.
63.
Thompson JE, Egger S, Bohm M, et al. Superior Quality of Life and Improved Surgical Margins Are Achievable with Robotic Radical Prostatectomy After a Long Learning Curve: A Prospective Single-surgeon Study of 1552 Consecutive Cases. Eur Urol. 2014;65(3):521–31.PubMedCrossRef
64.
Ghazi A, Scosyrev E, Patel H, Messing EM, Joseph JV. Complications associated with extraperitoneal robot-assisted radical prostatectomy using the standardized Martin classification. Urology. 2013;81(2):324–31.PubMedCrossRef
65.
Sharma S, Kim HL, Mohler JL. Routine pelvic drainage not required after open or robotic radical prostatectomy. Urology. 2007;69(2):330–3.PubMedCrossRef
66.
Araki M, Manoharan M, Vyas S, Nieder AM, Soloway MS. A pelvic drain can often be avoided after radical retropubic prostatectomy–an update in 552 cases. Eur Urol. 2006;50(6):1241–7. discussion 1246–1247.PubMedCrossRef
67.
Savoie M, Soloway MS, Kim SS, Manoharan M. A pelvic drain may be avoided after radical retropubic prostatectomy. J Urol. 2003;170(1):112–4.PubMedCrossRef
68.
Box GN, Lee HJ, Abraham JB, et al. Comparative study of in vivo lymphatic sealing capability of the porcine thoracic duct using laparoscopic dissection devices. J Urol. 2009;181(1):387–91.PubMedCrossRef
69.
Simonato A, Varca V, Esposito M, Venzano F, Carmignani G. The use of a surgical patch in the prevention of lymphoceles after extraperitoneal pelvic lymphadenectomy for prostate cancer: a randomized prospective pilot study. J Urol. 2009;182(5):2285–90.PubMedCrossRef
70.
Scholz HS, Petru E, Benedicic C, Haas J, Tamussino K, Winter R. Fibrin application for preventing lymphocysts after retroperitoneal lymphadenectomy in patients with gynecologic malignancies. Gynecol Oncol. 2002;84(1):43–6.PubMedCrossRef
71.
Furrer M, Inderbitzi R, Nachbur B. Does administration of fibrin glue prevent development of lymphoceles after radical lymphadenectomy? Der Chirurg Zeitschrift fur alle Gebiete der operativen Medizen. 1993;64(12):1044–9.PubMed
72.
Waldert M, Remzi M, Klatte T, Klingler HC. FloSeal reduces the incidence of lymphoceles after lymphadenectomies in laparoscopic and robot-assisted extraperitoneal radical prostatectomy. J Endourol. 2011;25(6):969–73.PubMedCrossRef
73.
Gilliland JD, Spies JB, Brown SB, Yrizarry JM, Greenwood LH. Lymphoceles: percutaneous treatment with povidone-iodine sclerosis. Radiology. 1989;171(1):227–9.PubMedCrossRef
74.
Kim JK, Jeong YY, Kim YH, Kim YC, Kang HK, Choi HS. Postoperative pelvic lymphocele: treatment with simple percutaneous catheter drainage. Radiology. 1999;212(2):390–4.PubMedCrossRef
75.
Akhan O, Karcaaltincaba M, Ozmen MN, Akinci D, Karcaaltincaba D, Ayhan A. Percutaneous transcatheter ethanol sclerotherapy and catheter drainage of postoperative pelvic lymphoceles. Cardiovasc Intervent Radiol. 2007;30(2):237–40.PubMedCrossRef
76.
Kerlan Jr RK, LaBerge JM, Gordon RL, Ring EJ. Bleomycin sclerosis of pelvic lymphoceles. J Vasc Interv Radiol JVIR. 1997;8(5):885–7.CrossRef
77.
Caliendo MV, Lee DE, Queiroz R, Waldman DL. Sclerotherapy with use of doxycycline after percutaneous drainage of postoperative lymphoceles. J Vasc Interv Radiol JVIR. 2001;12(1):73–7.CrossRef
78.
Alago Jr W, Deodhar A, Michell H, et al. Management of postoperative lymphoceles after lymphadenectomy: percutaneous catheter drainage with and without povidone-iodine sclerotherapy. Cardiovasc Intervent Radiol. 2013;36(2):466–71.PubMedCrossRef
79.
Chin A, Ragavendra N, Hilborne L, Gritsch HA. Fibrin sealant sclerotherapy for treatment of lymphoceles following renal transplantation. J Urol. 2003;170(2 Pt 1):380–3.PubMedCrossRef
80.
Raheem OA, Bazzi WM, Parsons JK, Kane CJ. Management of pelvic lymphoceles following robot-assisted laparoscopic radical prostatectomy. Urol Ann. 2012;4(2):111–4.PubMedPubMedCentralCrossRef
81.
Khoder WY, Becker AJ, Seitz M, Haseke N, Schlenker B, Stief CG. Modified laparoscopic lymphocele marsupialization for the treatment of lymphoceles after radical prostatectomy: first results. J Laparoendosc Adv Surg Tech A. 2011;21(2):145–8.PubMedCrossRef
82.
Treiyer A, Haben B, Stark E, Breitling P, Steffens J. Uni- vs. multiloculated pelvic lymphoceles: differences in the treatment of symptomatic pelvic lymphoceles after open radical retropubic prostatectomy. Int Braz J Urol Off J Braz Soc Urol. 2009;35(2):164–9. discussion 170.CrossRef
Metadaten
Titel
How to Minimize Lymphoceles and Treat Clinically Symptomatic Lymphoceles After Radical Prostatectomy
verfasst von
Hak J. Lee
Christopher J. Kane
Publikationsdatum
01.10.2014
Verlag
Springer US
Erschienen in
Current Urology Reports / Ausgabe 10/2014
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-014-0445-y

Weitere Artikel der Ausgabe 10/2014

Current Urology Reports 10/2014 Zur Ausgabe

Lower Urinary Tract Symptoms & Voiding Dysfunction (H Goldman and G Badlani, Section Editors)

Lower Urinary Tract Symptoms in Women with Diabetes Mellitus: A Current Review

Benign Prostatic Hyperplasia (K McVary, Section Editor)

Robotic-Assisted Simple Prostatectomy: Is there Evidence to go Beyond the Experimental Stage?

Pediatric Urology (M Castellan and R Gosalbez, Section Editors)

Vesicoureteral Reflux: Current Management in Children

Lower Urinary Tract Symptoms & Voiding Dysfunction (H Goldman and G Badlani, Section Editors)

Neurogenic Bladder: from Diagnosis to Management

Office Urology (N Shore, Section Editor)

Optimizing Urology Group Partnerships: Collaboration Strategies and Compensation Best Practices

Men's Health (R Carrion and C Yang, Section Editors)

Surgical Management of Peyronie’s Disease

Neu im Fachgebiet Urologie

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise