The current nocturnal penile tumescence (NPT) measurement is based on standard cut‐off levels defined regardless of age. This study was conducted to provide age‐stratified cut‐off points for NPT measurement. Forty sexually active healthy men between 20 and 60 years old were enrolled and divided equally into four groups defined by age (20–29, 30–39, 40–49 and 50–60 years.). None of the candidates had sexual dysfunction or sleep disturbance or used supportive medication to enhance sexual function. Erectile function was evaluated by using the 5‐item version of the international index of erectile function (IIEF‐5). NPT was observed using the nocturnal electrobioimpedance volumetric assessment (NEVA®). The NPT values of healthy men aged 20–60 years varied from 268.7% to 202.3%. The NPT differed significantly between age groups (P < 0.0009); however, no significant differences between men aged 30–39 and 40–49 (P = 0.593) were observed. Age was weakly associated with IIEF‐5 scores (P = 0.004), whereas a strong and negative correlation between age and NPT (P < 0.0001) was found. IEF‐5 scores were not significantly associated with NPT (P = 0.95). Therefore, the standard values for NPT testing should be considered in the evaluation of the nocturnal penile activity of men of all ages.

Zusammenfassung In der vorliegenden Anwendungsbeobachtung mit dem lipophilen Sabal-serrulata-Extrakt Prosta-Urgenin Uno wurden die Daten zur Wirksamkeit und Verträglichkeit von 1533 Patienten mit benigner Prostatahyperplasie ausgewertet; von insgesamt 1047 Patienten konnten die Ergebnisse der subjektiven und objektiven Befunde zu allen Kontrolluntersuchungen dokumentiert werden. Unter der täglichen Einmalgabe von 320 mg Sabal-serrulata-Extrakt über 3 Monate zeigten sich klinisch relevante Verbesserungen von maximalem Uroflow, Miktionsvolumen, Miktionszeit und Restharnmenge. Der I-PSS als validiertes und allgemein anerkanntes Instrument zur Diagnose, Klassifizierung und Therapie der benignen Prostatahyperplasie zeigte eine deutliche Verbesserung derobstruktivenund irritativen Symptomatik mit Abnahme des Gesamtscores um 40% von 18,3 auf 10,9 und eine Verbesserung des Lebensqualitätsindex um 45% von 3,5 auf 1,9. Bei gleichzeitiger Berücksichtigung der geringen Nebenwirkungsrate von unter 1% sind damit die Voraussetzungen für eine sehr gute Compliance des Patienten und somit einer wirksamen Therapie gegeben.

Summary Background: The integrity of collection protocols in biobanking is essential for a high-quality sample preparation process. However, there is not currently a well-defined universal method for integrating collection protocols in the biobanking information system (BIMS). Therefore, an electronic schema of the collection protocol that is based on Extensible Markup Language (XML) is required to maintain the integrity and enable the exchange of collection protocols. Materials and Methods: The development and implementation of an electronic specimen collection protocol schema (eSCPS) was performed at two institutions (Muenster and Cologne) in three stages. First, we analyzed the infrastructure that was already established at both the biorepository and the hospital information systems of these institutions and determined the requirements for the sufficient preparation of specimens and documentation. Second, we designed an eSCPS according to these requirements. Fi -nally, a prospective study was conducted to implement and evaluate the novel schema in the current BIMS. Results: We designed an eSCPS that provides all of the relevant information about collection protocols. Ten electronic collection protocols were generated using the supplementary Protocol Editor tool, and these protocols were successfully implemented in the existing BIMS. Moreover, an electronic list of collection protocols for the current studies being performed at each institution was included, new collection protocols were added, and the existing protocols were redesigned to be modifiable. The documentation time was significantly reduced after implementing the eSCPS (5 ± 2 min vs. 7 ± 3 min; p = 0.0002). Conclusion: The eSCPS improves the integrity and facilitates the exchange of specimen collection protocols in the existing open-source BIMS.

The urodynamics is considered as a standard diagnostic test for urinary incontinence. For this test, transurethral catheter tip sensors are used to measure the pressure inside the bladder. The measurement takes about 25 minutes, and often it is not possible to monitor pathological changes of pressure during this period. Additionally, different psychological factors could affect the results of standard urodynamics. We have developed a new system for catheterless urodynamic measurement. The system consists of an implantable intravesical capsule that measures the pressure for a period of more than 72 hours. It needs no components outside the human body, so an outpatient treatment is possible, which allows measurements under conditions of the patient's daily routine.

The injection of air or water into the scrotum has been described only a few times so far in the literature. Injection of air into the penis and its consequences has not been described at all. Here, we present the case of a young man who, acting on his previously suppressed sexual fantasies, injected air into his penis and caused generalized subcutaneous emphysema.

A retrospective analysis of the long-term success rates of endoluminal therapy of renal artery stenosis in a university hospital was carried out. Preinterventional and postinterventional data contained in the clinical records of all 104 patients who underwent percutaneous transluminal angioplasty (PTA, 25 patients) or stent PTA (79 patients) from 01 January 1994 to 31 December 2007, were documented using an electronically structured questionnaire and a time period classification. Subgroup analyses and statistical calculations were done using t-tests for joint random samples. At day 1 postintervention all patients showed a statistically significant decrease in mean systolic blood pressure (all patients: p=0.002, stent PTA group: p=0.023, PTA group: p=0.022). The significant decrease in mean systolic blood pressure persisted in years 1 and 2 postintervention (all patients: p=0.009 and 0.007, stent PTA group: p=0.039 and 0.015, respectively). Mean blood pressure values remained constant during the other time periods analyzed. In patients with a stent PTA carried out between 2001 and 2007 there was no significant reduction of prescribed antihypertonic drugs (p=0.023 and p=0.046, respectively). Mean serum creatinine concentrations decreased during years 1 and 2 postintervention and increased starting in year 3. In patients with elevated serum creatinine levels prior to the intervention the increase in mean serum creatinine level started in year 5. Endoluminal therapy of arteriosclerotic renal artery stenosis delays further deterioration of renal function and stabilizes blood pressure as well as the number of prescribed antihypertonic drugs. This can be considered a response to treatment in view of the mostly chronic progressive course of the disease.

Urodynamics is considered as a standard diagnostic test for urinary incontinence using catheter tip sensors to measure the bladder pressure. Standard urodynamic measurement takes about 30 minutes, thus it is often not possible to monitor pathological change of pressure during this short period of time. In addition, different psychosocial factors could affect the result of standard urodynamics. In this paper we describe a new system for catheterless urodynamic measurement. The system consists of an implantable intravesical capsule that measures the pressure over a period of up to 72 hours. The system needs no components outside of the human body, so an outpatient treatment is possible, which allows measurements under conditions of the patient's daily routine.

Retrospektive Auswertung der Erfolgsraten der interventionell-radiologischen Behandlung von Nierenarterienstenosen.

Background. We examined the influence of preoperative pain on postoperative pain chronification in urological patients.Methods. Pain was determined before operation, immediately afterwards and 3 or 6 months post-surgically. Acute and chronic pain was analysed in detail with regard to severity, grade of chronification and pain intensity. We also assessed patients with the Hospital Anxiety and Depression Scale.Results. Patients with preoperative pain reported postoperatively higher pain scores compared to patients without preoperative pain. Patients with higher Hospital Anxiety and Depression Scale scores reported higher pain scores for the first 7 days after the operation. Three months after surgery 51.2% of all patients and 6 months after surgery 1.2% of all patients reported about pain.Conclusion. Our results give evidence to the fact that preexisting pain prior to surgery has an influence on the postoperative pain course. To avoid chronification adequate therapy of the preexisting pain should be carried out.

Wir untersuchten den Einfluss präoperativer Schmerzen auf die postoperative Schmerzchronifizierung bei urologischen Patienten.

Objectives: In order to improve the efficacy of targeted therapy trials, the expression profiles of several molecular markers that are potential candidates for targeted therapy were analyzed in patients with progressive castration-resistant prostate cancer.Methods and materials: Paraffin-embedded samples of tumor tissue from 51 patients obtained from biopsies of metastases or remaining prostates were analyzed immunohistochemically for the expression of EGFR, PDGFR beta, Her-2/neu, c-Kit, and VEGF. Staining was analyzed according to the percentage of positively stained tumor cells and the intensity of staining.Results: According to the different cut-off values of 10%, 30%, 50%, or 70% for the percentage of positively stained cells, different rates of expression were found. Expression rates ranged from 30.6% to 61.2% for EGFR, from 34.7% to 57.1% for PDGFR beta, from 9.6% to 28.8% for Her-2/neu, from 12.5% to 22.4% for c-Kit, and from 51.1% to 74.5% for VEGF. Defining positive expression as >= 30% positively stained tumor cells, with an intensity of staining of >= 2+, resulted in positive expression of EGFR in 38.8%, PDGFR beta in 24.5%, Her-2/neu in 13.5%, c-Kit in 6.4%, and VEGF in 44.7% of the patients.Conclusions: Our results demonstrate simultaneous expression of several markers in castration-resistant prostate cancer tissue. Translation of the results into modern, multi-arm clinical trial designs will improve the efficacy of recruiting and obtaining results, compared with multiple double-arm trials. (C) 2011 Elsevier Inc. All rights reserved.

Die epidurale Analgesie zur postoperativen Schmerztherapie wird insbesondere im Rahmen der sog. „Fast-track-Chirurgie“ favorisiert. Zur Optimierung der schmerztherapeutischen Versorgung unserer urologischen Patienten untersuchten wir die Qualität der postoperativen Schmerztherapie mit oder ohne epiduraler Analgesie bei Patienten nach radikaler Prostatektomie. Nach Genehmigung durch die Ethikkommission wurden mit Hilfe eines Fragebogens Patienten nach radikaler Prostatektomie bezüglich ihrer Schmerzen an 7 postoperativen Tagen detailliert befragt. An allen 7 postoperativen Tagen konnte bei Patienten mit epiduraler Analgesie eine signifikant niedrigere Schmerzintensität gemessen werden. Dies konnte für die durchschnittliche und stärkste Schmerzintensität in Ruhe, sowie für Schmerzen unter Belastung gezeigt werden. Patienten mit epiduraler Analgesie konnten im Durchschnitt einen Tag früher aus dem Krankenhaus entlassen werden. Die postoperative Schmerztherapie nach radikaler Prostatektomie mittels epiduraler Analgesie scheint Vorteile bezüglich der Analgesiequalität und der Krankenhausverweildauer der Patienten zu bieten.

Epidural analgesia for postoperative pain treatment is favored, for example, within the scope of so-called fast-track surgery, especially abdominal surgery. To improve pain care for our urological patients, we examined the quality of postoperative pain therapy with and without epidural analgesia after radical prostatectomy. After the investigation was approved by the local ethics committee, patients were questioned in detail about the pain they experienced for 7 days after radical prostatectomy. For all 7 postoperative observation days, significantly less pain was measured for patients receiving epidural analgesia compared with patients without epidural analgesia. This could be shown for the average and strongest pain intensity at rest as well as for pain during mobilization. Patients with epidural analgesia were discharged, on average, 1 day earlier. After radical prostatectomy, postoperative pain therapy with epidural analgesia seems to offer advantages with regard to the quality of analgesia and the average length of hospital stay.

Die Entstehung von chronischen postoperativen Schmerzen in der Urologie wurde bisher unzureichend untersucht. Über die Häufigkeit präoperativer Schmerzen gibt es zudem keine Untersuchungen. Wir entwickelten einen Schmerzfragebogen zur Analyse präoperativer Schmerzen.

BACKGROUND:The genesis of chronic pain in urology has so far been insufficiently investigated. No investigations have focused on the occurrence of preoperative pain. We developed an epidemiological questionnaire to analyze preoperative pain.METHODS:In this questionnaire, preoperative pain in all patients scheduled for urologic surgery (n=165) was analyzed. Acute and chronic pain was analyzed as main or adjoint pain, with the registration of severity, chronification states, and duration. We registered depression and anxiety, well-being, and somatic and psychological efficiency.RESULTS:Eighty percent of the patients reported pain within the previous 12 months. Acute preoperative pain was reported by 17% of the patients and chronic pain by 64%. Significant differences in quality of life were detected between patients with or without preoperative pain. Well-being was also significantly affected in patients having pain.CONCLUSION:The pain severity and states of chronification not only explain a reduction in somatic and psychological well-being but also emphasize that preoperative pain should be identified thoroughly prior to surgery.