The partial androgen deficiency in aging male (PADAM) has been of great interest to investigators and the public in the last few years. For males, androgens are said to be essential for the maintenance of quality of life (QoL) but there are no data available with respect to QoL and PADAM yet. In order to evaluate changes of individual well-being of males older than 50 years and with subnormal levels of free testosterone (FT) (<200 pmol l(-1)), these men were asked to fill in a questionnaire regarding QoL. The objective of this study was to compare age-matched males with androgen deficiency (group 1; n = 24) and normoandrogenic elderly men (group 2; n = 24) with respect to QoL and somatic indicators of the endocrine status. Participants suffered from benign prostatic hyperplasia (BPH) and were hospitalized for prostate surgery. Health-related QoL was assessed by the SF-12 Health Survey, including the physical health index and the mental health index. The SF-12 was enlarged by the scales 'vitality' and 'psychological well-being' of the SF-36. Additionally, patients were asked about social and clinical items. There were no statistically significant differences between the two groups regarding social and clinical parameters. The physical health index was reduced in group 1 (P < 0.05; effect size was medium (d = 0.57)) whereas the mental health index was similar in both groups. The correlation between the two health indices was very low and not statistically significant (r = 0.05, P = 0.72). Patients of group 1 described a lower vitality compared to group 2 (P < 0.05), but no differences could be observed regarding psychological well-being. Therefore, androgen-deficient patients seem to have the impression of a reduced physical ability. Our data emphasize that the subjective description of health-related aspects of QoL is a very sensitive methodological approach to discover psychological differences between patients. For the differentiation between androgen-deficient patients and those with normal testosterone levels the physical health index seems to be more sensitive than the mental health index. A question of interest is whether this difference remains detectable if testosterone is supplemented to androgen-deficient men. Whether testosterone supplementation is beneficial to these patients has to be carefully considered.

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ZusammenfassungDie „aktuelle“ Krebsregistermeldung, wie sie im Jahr 2015 in Deutschland verpflichtend eingeführt wurde, hat ihren Ausgangpunkt auch im Nationalen Krebsplan aus dem Jahr 2008. Weitere Meilensteine sind das Bundeskrebsregisterdatengesetz (2009), das Krebsfrüherkennungs- und -registergesetz (2013), der einheitliche Onkologische Basisdatensatz (2014/2021) mit den Modulen (z.B. Modul Prostatakarzinom 2017) sowie das Gesetz zur Zusammenführung von Krebsregisterdaten (2021). Deutsche Uro-Onkologen (d-uo) hatten bereits Anfang 2017 die Idee, eine Dokumentationsplattform zu konzipieren, mit der die Mitglieder von d-uo einerseits die Meldung an das Krebsregister ermöglicht wird und andererseits Daten in die eigene Datenbank von d-uo überführt werden können – ohne doppelten Aufwand. Das Krebsregister vergütet die Erstmeldung einer Tumorerkrankung mit 18€. Als weiterhin einziger Anbieter vergütet d-uo seinen Mitgliedern den mit der zusätzlichen Meldung an d-uo verbunden Dokumentationsaufwand mit weiteren 18€. Zusätzlich zum Onkologischen Basisdatensatz wurden weitere Parameter von d-uo definiert. Diese Daten werden im Rahmen der sogenannten VERSUS-Studie erhoben, ausgewertet und interpretiert. Die Erkenntnis, dass die Parameter des Basisdatensatzes in ihrer Aussagefähigkeit limitiert sind, hat seitens d-uo zur Etablierung der beiden Nationalen Register Urothelkarzinom (UroNAT) und Prostatakarzinom (ProNAT) geführt. Damit unterstreicht d-uo seine führende Position in der uro-onkologischen Versorgungsforschung in Deutschland.

Laser prostatectomy shows an improvement in peak urinary flow rates, in post-void residual urine volumes and also a symptomatic improvement when compared to the transurethral resection of the prostate (TUR-P). Time to achieve symptomatic improvement is delayed with many established laser procedures compared to standard resection. However, this disadvantage can be solved with a new resection technique using a pulsed holmium laser. Nevertheless, this advanced technique shows a few problems in a first clinical trial. Besides this clinical study, in vitro experiments were carried out in order to determine the optimal irradiation parameters with respect to resection rate, incision/ablation quality and handling. Prostate tissue of radical prostatectomies and chicken breast as model were irradiated with a pulsed holmiumlaser in vitro with different laser parameters using a bare fiber in contact to tissue. The incision quality (depths and coagulation/vaporisation effects) was analysed with regard to pulse energy (speed of incision, angle of incision) and fiber diameter. Fast flash photography was performed to analyse thermo-mechanical side-effects. Fast flash photography reveals cavitation bubble up to 7 mm length in water and dissections in tissue. The ablation rate increases proportional to the laser pulse energy. The Holmium Laser Resection of the Prostate (HOLRP) in humans with available instrumentation right now shows equieffective results compared to the transurethral resection, no need for transfusion, no transurethral resection syndrom, short time for catheterization. Further technical approvement may significantly improve holmium laser prostate resection. We present a new application system for the laser resection.

BackgroundWe investigated the use of the gonadotropin-releasing hormone (GnRH) antagonist degarelix in everyday clinical practice using registry data from uro-oncology practices in Germany.MethodsData were analysed retrospectively from the IQUO (Association for uro-oncological quality assurance) patient registry. Data were prospectively collected from all consecutive PCa patients treated with degarelix (n = 1010) in 138 uro-oncology practices in Germany between May 2009 and December 2013.ResultsMedian overall survival had not yet been reached in the all-patient group or in subgroups who had or had not received prior hormonal therapy (HT). Cox regression analysis showed that patients who had received prior HT (n = 542) had a 58 % increased mortality risk (hazard ratio 1.58, 95 % CI 1.20–2.09) versus patients who had not (n = 468) (p = 0.001). Also, in patients who had received prior luteinizing hormone-releasing hormone (LHRH) analogue therapy (LHRH agonists or GnRH antagonists), median time to PSA progression was shorter (209 weeks) than in those who had not received prior LHRH analogues (n = 555; median PSA progression-free survival not yet reached). Degarelix was generally well tolerated.ConclusionsDegarelix was effective and well tolerated in everyday clinical practice, confirming observations from clinical studies. Patients who received prior HT appeared to have a significantly higher mortality risk.