Operation hämatogener Metastasen

Urological malignancies represent approximately 40?% of all solid tumors. Synchronous or metachronous organ metastases develop in 30?% of patients. Depending on the tumor entity and tumor characteristics, resection of metastases can improve patient survival. Surgical resection of residual tumors is an integral part of the multimodal therapy concept of patients with nonseminomatous metastatic germ-cell cancer. Surgical inoperability is the only reason not to resect. Resection of hematogenous metastases from renal cell carcinoma has been postulated as a standard therapy for decades. Appropriate patient selection is the key for a survival benefit. Prognosticators such as patient’s general condition as well as number, location, and size of metastases help to counsel and select patients accordingly. Metastases of transitional cell or penile carcinoma should only be resected when a response to systemic treatment is evident in the individual case. There is no evidence in favor of resecting organ-metastases of prostate cancer in the current guidelines and the literature. In this article, arguments against resection of metastases following the current literature and guidelines are described.     

Dokumentation der Dachverbands Prostatazentren (DVPZ)

For certification of a prostate center according to the guidelines of the Governing Body of Prostate Centers (DVPZ) an amalgamation of at least five practicing urologists with a main urology department of a hospital and further cooperation partners for the interdisciplinary approach to prostate cancer is necessary. The DVPZ certificate incorporates benign prostatic syndrome and prostatitis in addition to prostate cancer and is therefore a real organ certificate in the urological sense. The aim of the DVPZ certificate is the integrated, interdisciplinary and interinstitutional treatment of patients with diseases of the prostate.     

Spontane H?matomneigung und Hüftschmerzen bei einer 65-j?hrigen Patientin

The case of a 65-year-old woman with acquired hemophilia is reported. Acquired hemophilia is characterized by the development of inhibitors directed against coagulation factors. Impairment of plasmatic hemostasis leads to a severe bleeding tendency in individuals without a preexisting coagulation defect with considerable mortality. Pathophysiology, diagnostic work-up, and treatment are summarized and discussed.