AKTUELLE UROLOGIE当前泌尿学
AKTUELLE UROLOGIE(英文缩写 AKTUEL UROL),ISSN 0001-7868,eISSN 1438-8820,中文译名:当前泌尿学 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 0.465 | Q4 |
| 2022 | 0.300 | Q4 |
| 2023 | 0.300 | Q4 |
| 2024 | 0.400 | Q4 |
| 2025 | 0.500 | Q4 |
AKTUELLE UROLOGIE 最新收录文献
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1. [Current Treatment of Metastatic Renal Cell Carcinoma: Results of a Germany-Wide Survey by the German Society for Immune and Targeted Therapy].
PMID:日期:2026-09-22The therapeutic landscape of metastatic renal cell carcinoma (mRCC) is diverse. The aim of this survey conducted by the German Society for Immuno- and Targeted Therapy e.V. (DGFIT) was to collect data on the treatment reality (real-world data) of mRCC in Germany. Between August and September 2023, a standardized questionnaire was sent via email and QR code to urologists and oncologists throughout Germany. The survey included 18 questions regarding the initial therapy, adjuvant therapy and the treatment of mRCC. A total of 105 physicians participated in the survey, the majority being urologists (97%). Adjuvant immunotherapy is regularly administered in most cases (85%), and cytoreductive kidney surgery is also frequently performed. The IMDC score is routinely assessed before initiating mRCC therapy in the majority of cases (69.5%). As first-line therapy, over 70% use a tyrosinkinase-inhibitor (TKI) / immunotherapy (IO) combination, 20% use an IO/IO combination, and 6% use TKI monotherapy. IO/IO combinations and TKI monotherapies are more frequently applied in outpatient practices. Only a limited number of patients receive second-line therapy, most commonly a TKI monotherapy with Cabozantinib. The DGFIT survey represents the first systematic collection of data in Germany on the real-world treatment landscape of mRCC and on the implementation of adjuvant immunotherapy in "high-risk" RCC following curative therapy. These real-world data are of great interest for better understanding existing treatment pathways and improving patient care. Moreover, the results highlight that the collection of comprehensive real-world data remains a major challenge and should be further structured and improved in the future.
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2. [Polidocanol Sclerotherapy for the Treatment of Symptomatic Hydroceles: Establishment of a Minimally Invasive Treatment Concept at a German Center].
2. [聚多卡醇硬化疗法治疗症状性鞘膜积液：德国某中心微创治疗概念的建立]PMID:日期:2026-09-17Hydrocele is a common cause of scrotal swelling in adult men. Surgical treatment is considered the gold standard but is invasive and associated with perioperative morbidity and prolonged recovery. Aspiration followed by sclerotherapy represents a minimally invasive alternative, for which data from German-speaking countries are limited. This study aimed to establish hydrocele sclerotherapy at our center and evaluate its safety and effectiveness. This monocentric observational study consecutively included men aged ≥18 years with symptomatic primary hydrocele treated between December 1, 2024 and December 31, 2025. After complete ultrasound-guided aspiration, 4 mL of 3% polidocanol were instilled under local anesthesia in an outpatient setting. The primary endpoint was a clinically satisfactory reduction in hydrocele size or complete regression. In cases of recurrence, repeat sclerotherapy or surgery was offered depending on symptoms. Follow-up included a clinical examination and ultrasound after 6 weeks and telephone follow-up on June 1, 2026. Complications were classified according to the Clavien-Dindo classification. A total of 32 patients with a mean age of 61.6 ± 15.7 years were treated. Mean aspirated volume was 460.0 ± 382.2 mL. After primary sclerotherapy, 23/32 patients (71.9%) achieved the primary endpoint. Recurrence requiring treatment occurred in 9/32 patients (28.1%), and 7 underwent repeat sclerotherapy. Overall, 28/32 patients (87.5%) were successfully treated with a maximum of 2 procedures, while 4 underwent surgery. Pain occurred in 2 patients (Clavien-Dindo grade I) after primary sclerotherapy. Following repeat treatment, infectious complications occurred in 2 patients, including 1 case requiring surgical revision (Clavien-Dindo grade IIIb). Aspiration followed by polidocanol sclerotherapy is an effective outpatient treatment for symptomatic hydrocele. The success rate was 71.9% after a single treatment and 87.5% after a maximum of 2 treatments. Surgery remains the gold standard, while sclerotherapy represents an effective minimally invasive alternative.
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3. [Molecular Diagnostics and Personalized Therapy for Metastatic Castration-Resistant Prostate Cancer (mCRPC)].
3. [转移性去势抵抗性前列腺癌（mCRPC）的分子诊断与个体化治疗]PMID:日期:2026-09-16Metastatic castration-resistant prostate cancer (mCRPC) is a biologically heterogeneous tumor disease. Alterations in homologous recombination repair (HRR) genes, defects in the mismatch repair (MMR) system, alterations in the classical tumor suppressor genes TP53, RB1, and PTEN, and androgen receptor-mediated resistance mechanisms, promote aggressive disease courses and may influence treatment response. Molecular diagnostic approaches are gaining relevance and enable an increasingly individualized tumor characterization. Based on these insights, targeted treatment options are increasingly becoming available or are being investigated. Innovative therapeutic concepts such as T-cell engagers, chimeric antigen receptor (CAR) T-cell therapy, and androgen receptor (AR) degraders are currently under preclinical or early clinical investigation. This overview summarizes the current state of molecular diagnostics and personalized therapy in mCRPC and discusses why patient-specific, tumor-informed therapeutic approaches are becoming increasingly important in the management of mCRPC.
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4. [HIFU: Best Practices for Optimal Performance].
4. [HIFU：最佳性能的最佳实践]PMID:日期:2026-09-01High-intensity focused ultrasound (HIFU) is a minimally invasive treatment option for selected patients with localized prostate cancer. This article is not intended as an original outcome study but as a practice-oriented expert review and institutional experience report on focal and hemiablative HIFU. We describe patient selection, preoperative diagnostic assessment and biopsy mapping, intraoperative planning, safety margins, HIFU ablation using EDAP/Focal One(R), the double tap strategy, documentation and follow-up. Institutional practice is explicitly distinguished from evidence-based standards and consensus recommendations. Reproducible outcomes require concordance between imaging and histological findings, an adequate safety margin around the index lesion, structured intraoperative documentation and a follow-up strategy including PSA kinetics, mpMRI and biopsy when indicated. The double tap strategy is presented as an institutionally established technical modification, with a brief summary of the available group data. HIFU can be performed safely when carried out in a standardized manner. Treatment quality depends substantially on patient selection, treatment planning, technical execution, and post-treatment follow-up.
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5. [Focal Therapy for Prostate Cancer in Germany: Progress or Illusion?]
PMID:日期:2026-09-01Over the past two decades, focal therapy for localized prostate cancer has evolved from an experimental approach into a structured treatment option within the framework of risk-adapted prostate cancer management. The aim of this article is to provide a critical appraisal of the current role of focal therapy in light of contemporary guidelines, available evidence, and health-economic considerations. The introduction of multiparametric MRI and MRI-targeted fusion biopsy has substantially improved the accurate identification of clinically significant index lesions, thereby establishing the technical foundation for selective ablative approaches. Despite these advances, the evidence base remains heterogeneous, and large randomized comparative trials are still lacking. The largest comparative study to date (HIFI trial) demonstrated oncological non-inferiority compared with radical prostatectomy, albeit with important methodological limitations, while achieving superior functional outcomes. Initial randomized data from the FARP trial has so far been presented only in abstract format at scientific meetings, and a full peer-reviewed publication is pending. Within the contemporary therapeutic landscape, active surveillance, focal therapy, and radical treatments should not be viewed as strictly competing strategies but rather as components of a risk-adapted continuum. While active surveillance remains the standard of care for patients with low-risk disease, focal therapy may represent a suitable option for carefully selected patients with a clearly localized, biologically relevant index lesion and a strong preference for functional preservation. Optimal outcomes depend on rigorous patient selection using modern imaging, fusion biopsy techniques, and structured follow-up protocols. At the same time, considerable structural disincentives persist: pretherapeutic precision diagnostics are frequently inadequately reimbursed, and hospital reimbursement for focal procedures remains substantially lower than for radical standard treatments. In summary, focal therapy should no longer be regarded primarily as an experimental approach but as a selective component of a differentiated precision oncology concept. Its appropriate application remains indication-dependent and requires further high-quality prospective studies as well as supportive structural and economic frameworks.
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6. [Which Focal Therapy for Whom and When?]
PMID:日期:2026-09-01Focal therapy (FT) is used to selectively ablate tumor-bearing regions while preserving as much healthy prostatic tissue as possible. This approach seeks to maintain the functional advantages over radical treatment options - such as radical prostatectomy or radiation therapy - without significantly compromising local tumor control. At present, FT is offered primarily to carefully selected patients with low-risk or early intermediate-risk prostate cancer who do not wish to undergo active surveillance or are considered unsuitable candidates for this approach. Reliable patient selection requires multiparametric magnetic resonance imaging, targeted and systematic biopsies, and a precise assessment of tumor location, tumor volume, and prostatic anatomy.FT procedures can be divided into thermal (e.g., high-intensity focused ultrasound (HIFU) or cryotherapy) and non-thermal ablation methods (vascular-targeted photo-dynamic therapy (VTP) or irreversible electroporation (IRE)). These procedures differ in terms of their mechanism of action, technical implementation, and suitability for specific tumor locations. Consequently, the choice of procedure must be made on a case-by-case basis, taking into account the anatomical characteristics and the physical limitations of the respective technology.The aim of this review is to present the currently available focal therapy techniques with regard to their indications, technical characteristics, limitations, and suitability for different tumor locations. Particular emphasis is placed on identifying the most appropriate treatment modality for a given tumor location. Precise diagnostic evaluation, consideration of tumor location, and the selection of an appropriate ablation technique are essential determinants of treatment success. Given the varying strengths and limitations of the available technologies, centers should offer several complementary techniques to enable individualized treatment tailored to the specific tumor.
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7. [From Opportunistic PSA Testing to Individualized, Risk-Adapted Early Detection of Prostate Cancer in Germany].
PMID:日期:2026-09-01Early detection of prostate cancer in Germany remains predominantly opportunistic. An organized, quality-assured, invitation-based program has not yet been established. Instead, current practice is characterized by heterogeneous prostate-specific antigen (PSA) testing, variable counseling, and inconsistent downstream diagnostic pathways. However, both the evidence base and the guideline landscape have evolved substantially. The updated German S3 guideline recommends a PSA-based, risk-adapted early detection strategy from the age of 45 years following informed, non-directive counseling. This approach includes a baseline PSA measurement, interval-based reassessment, and a clearly defined diagnostic workup. The 2026 European Association of Urology guidelines follow the same overarching principle of individualized, risk-adapted early detection, but adopts a more conservative starting age of 50 years for men without additional risk factors. The key question is therefore no longer whether unselected annual PSA testing for all men is justified, but whether Germany should now consistently transition from opportunistic testing to a structured, individualized, and quality-assured early detection strategy. There are compelling arguments in favor of initiating this pathway at the age of 45 years with structured counseling and a baseline PSA measurement, not as an invitation to overtesting, but as the entry point to a strategy that can subsequently be de-intensified according to individual risk. Such an approach is clinically plausible, epidemiologically well founded, increasingly supported by contemporary German and European data, and more convincing from a health policy perspective than perpetuating the current gray zone between statutory early detection based on digital rectal examination and the de facto opportunistic use of PSA testing.
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8. [New Prostate Cancer Guideline: Is Biopsy of PI-RADS 3 Lesions Meaningful? The Role of Multiparametric MRI-Ultrasound Fusion Biopsy in Detecting Clinically Significant Prostate Cancer].
PMID:日期:2026-09-01The study included a total of 476 patients who underwent both a systematic 12-core punch biopsy and multiparametric MRI-guided fusion biopsies from at least one region of interest between January 2022 and December 2024. The primary endpoint was the detection of clinically significant prostate cancer (Gleason ≥3+4=7a). Lesions were classified according to their PI-RADS scores, and histological analysis of each lesion, obtained by multiparametric MRI fusion biopsy, was performed separately. Statistical analysis was performed using binomial logistic regression, and p-values <0.05 were considered statistically significant. Targeted multiparametric MRI fusion biopsy, based on PI-RADS score, was a significant predictor of clinically relevant carcinoma (p<0.001). The number needed to test for the combined biopsy (systematic plus multiparametric MRI fusion) was 2.4, compared with 3.6 for systematic biopsy alone. The number needed to test for detecting clinically relevant carcinoma was 13.7 for PI-RADS-3 lesions, 3.8 for PI-RADS-4 lesions, and 1.7 for PI-RADS-5 lesions. Lesions with PI-RADS scores of 4 and 5 should consistently undergo biopsy, whereas PI-RADS 3 lesions require individualised consideration to minimise overdiagnosis and unnecessary interventions. Our results confirm the recommendations of the current consultative version of the S3 guideline on prostate cancer (version 8.01, AWMF register number 043-022OL) and underline the clinical relevance of a risk-adapted diagnostic procedure.
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9. [Giant Scrotal Elephantiasis as a Septic Focus in Generalized Lymphedema: Radical Resection Following Initial Suspicion of Malignancy].
PMID:日期:2026-08-14This case report describes a rare and clinically highly complex constellation of massive scrotal elephantiasis, generalized lymphedema, and septic deterioration, which initially raised the suspicion of a malignant soft tissue tumor. The report highlights the diagnostic pitfalls associated with extreme scrotal enlargement, the nuanced decision-making regarding timing and extent of surgical intervention in a persistent septic setting, and the urological, pathological, and reconstructive implications of radical resection under extraordinary anatomical conditions. Reports of scrotal elephantiasis presenting as a primary septic focus in non-endemic regions remain rare and are largely limited to isolated case descriptions. This case illustrates clinically relevant diagnostic and therapeutic decision-making in the management of this unusual constellation.
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10. Comparison of Sex-Specific Treatment Outcomes in Clinical Trials and Subsequent Real-World Data on Systemic Therapies for Urothelial Carcinoma: A Systematic Review.
PMID:日期:2026-08-04Treatment outcomes after systemic cancer therapies exhibit sex-specific differences. Real-world data do not necessarily reflect the results of randomized clinical trials (RCTs). To compare sex-specific outcomes between RCTs and subsequent real-world data in patients with urothelial cancer (UC) receiving systemic therapies. A systematic literature search on systemic therapies for UC was conducted in Embase, PubMed, MEDLINE, and Scopus up to February 2025. Eligible studies included phase II/III trials, RCTs, prospective non-interventional studies, retrospective studies, and case series. Extracted parameters comprised hazard ratios for overall survival and progression-free survival (or disease-free survival for adjuvant therapies), sex-specific enrollment rates, and discontinuation rates due to adverse effects. This review is registered with PROSPERO and was conducted in accordance with PRISMA guidelines. A total of 52 articles were included. The proportion of female patients enrolled in UC RCTs did not reflect epidemiologic data, and only a few real-world studies reached the expected benchmark. The following approval studies showed a survival benefit for men compared with women: JAVELIN Bladder 100 (Avelumab), Keynote 045 (Pembrolizumab), EV-301 (Enfortumab Vedotin), CheckMate 901 (Gemcitabine + Cisplatin + Nivolumab), and CheckMate 274 (adjuvant Nivolumab). Only a limited number of real-world studies reported sex-specific outcome analyses, and none demonstrated a clear benefit for either sex. No sex-specific toxicity analyses were published. Several approval studies investigating therapies for urothelial cancer suggest a survival benefit for male patients. However, this finding was not confirmed in real-world data. Female patients remain underrepresented in approval trials for UC, and sex-specific toxicity analyses are lacking. Such analyses should be mandatory in future RCTs.