496 results on '"Hubert, John"'
Search Results
2. Investigation of new strategies for identifying causal mechanisms in schizophrenia taking bioinformatics approaches beyond genome-wide association studies
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Hubert, John
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The goal of the research presented here is to provide support towards finding true precision medicine for patients with schizophrenia. In ideal circumstances, and as hinted towards already within oncology (Le Tourneau et al., 2015), this would be to obtain quantitative information from the patient, and use this information to identify an effective treatment option. As the heritability of the genetic liability towards schizophrenia is around 80%, genetic studies are an ideal base to build individualised treatment options. GWA studies have successfully discovered over 150 loci associated with schizophrenia and have confirmed that the condition is polygenic, i.e. each risk variant in an individual's genome has a small effect size, but there are a large number of these variants which contribute to the pathogenesis of schizophrenia. The explanation of how these variants contribute to the biological processes that cause schizophrenia is however, unknown. PRSs provide a metric to measure the genetic liability to any individual disorder and capture a large component of the genetic risk towards schizophrenia. In addition, studies using schizophrenia PRS have found genetic overlap with other disorders. If the PRS was designed to focus on specific genes/pathways, it could give a clearer insight into the biological mechanisms that cause schizophrenia. However, there are many genetic, statistical and computation problems when using multiple PRS across multiple traits. Therefore, I present SurPRSe, a bioinformatics workflow to produce robust gene-set specific PRS that can be compared across multiple traits. I use this method to investigate the relationship between schizophrenia, subcortical brain volume sizes and cognition.
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- 2023
3. The Association of Ischemia Type and Duration with Acute Kidney Injury after Robot-Assisted Partial Nephrectomy
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Fabian Obrecht, Christian Padevit, Gabriel Froelicher, Simon Rauch, Marco Randazzo, Shahrokh F. Shariat, Hubert John, and Beat Foerster
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partial nephrectomy ,robotics ,renal cancer ,acute kidney injury ,ischemia time ,selective artery clamping ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Acute kidney injury (AKI) after robot-assisted partial nephrectomy (RAPN) is a robust surrogate for chronic kidney disease. The objective of this study was to evaluate the association of ischemia type and duration during RAPN with postoperative AKI. Materials and methods: We reviewed all patients who underwent RAPN at our institution since 2011. The ischemia types were warm ischemia (WI), selective artery clamping (SAC), and zero ischemia (ZI). AKI was defined according to the Risk Injury Failure Loss End-Stage (RIFLE) criteria. We calculated ischemia time thresholds for WI and SAC using the Youden and Liu indices. Logistic regression and decision curve analyses were assessed to examine the association with AKI. Results: Overall, 154 patients met the inclusion criteria. Among all RAPNs, 90 (58.4%), 43 (28.0%), and 21 (13.6%) were performed with WI, SAC, and ZI, respectively. Thirty-three (21.4%) patients experienced postoperative AKI. We extrapolated ischemia time thresholds of 17 min for WI and 29 min for SAC associated with the occurrence of postoperative AKI. Multivariable logistic regression analyses revealed that WIT ≤ 17 min (odds ratio [OR] 0.1, p < 0.001), SAC ≤ 29 min (OR 0.12, p = 0.002), and ZI (OR 0.1, p = 0.035) significantly reduced the risk of postoperative AKI. Conclusions: Our results confirm the commonly accepted 20 min threshold for WI time, suggest less than 30 min ischemia time when using SAC, and support a ZI approach if safely performable to reduce the risk of postoperative AKI. Selecting an appropriate ischemia type for patients undergoing RAPN can improve short- and long-term functional kidney outcomes.
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- 2023
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4. Retrospective Analysis of Efficacy and Toxicity of Stereotactic Body Radiotherapy and Surgical Resection of Adrenal Metastases from Solid Tumors
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Jamie Lütscher, Hans Gelpke, Adrian Zehnder, Laetitia Mauti, Christian Padevit, Hubert John, Nidar Batifi, Daniel Rudolf Zwahlen, Robert Förster, and Christina Schröder
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adrenalectomy ,stereotactic body radiation therapy ,adrenal metastases ,local control ,progression free survival ,overall survival ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: This single-center retrospective study aimed to evaluate the efficacy and toxicity profiles of stereotactic body radiotherapy (SBRT) and surgical resection in patients with adrenal metastases originating from solid tumors. Methods/Materials: Patients with advanced tumor conditions or comorbidities typically received SBRT, whereas those considered physically fit underwent standard surgical treatment. Endpoints included local control (LC), progression free survival (PFS), overall survival (OS), and complication rates (CR). Results: 41 patients with 48 adrenal metastases were included, with 27 (65.9%) patients receiving SBRT and 14 (34.1%) patients undergoing adrenalectomy. One- and two-year LC values were 100% for both periods after adrenalectomy, and 70.0% and 52.5% after SBRT (p = 0.001). PFS showed values of 40.2% and 32.1% at one and two years after adrenalectomy and of 10.6% for both periods after SBRT (p = 0.223). OS was 83.3% both one and two years after surgery and 67.0% and 40.2% after SBRT (p = 0.031). There was no statistically significant difference between the two groups regarding acute complications (p = 0.123). Conclusion: Despite potential confounders, adrenalectomy exhibited statistically significant superior LC and OS compared to SBRT in managing adrenal metastases, while both treatment methods displayed acceptable toxicity profiles. However, patient selection bias must be taken into account when directly comparing the two therapy modalities. Nevertheless, the study provides new and important results for the scientific and medical communities regarding oncological outcomes after SBRT or surgical resection of adrenal metastases.
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- 2024
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5. Extraperitoneal extravesical robot-assisted simple prostatectomy (EE-RASP) with intraprostatic urethral reconstruction
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Hubert John, Orlando Burkhardt, Mustafa Tutal, Christian Padevit, and Beat Foerster
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Prostatic adenoma ,Minimally invasive surgical procedures, Robot-assisted simple prostatectomy, RASP, EE-RASP ,Surgery ,RD1-811 ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Objective: To describe a safe and effective robot-assisted surgical technique performing prostate enucleation through extraperitoneal and extravesical approach with reconstruction of the prostatic urethra. Patients: We reviewed the first 17 patients with a minimum follow up of one year who underwent extraperitoneal extravesical robot-assisted simple prostatectomy (EE-RASP) with intraprostatic urethral reconstruction between July 2019 and March 2020. Surgical procedure: : The bladder neck and proximal prostatic urethra are dissected bluntly remaining extravesical. After transection of the proximal prostatic urethra and enucleation, continuous anastomosis of the proximal with the spared distal prostatic urethra was performed thereby excluding the prostatic cavity. Our video shows all surgical key steps in a patient suffering from benign bladder outlet obstruction undergoing EE-RASP. Results: Seventeen patients who received EE-RASP were eligible for analysis. The median operative time was 173 min (interquartile range [IQR] 165–186) with blood loss of 200 ml (IQR 150–300). The transurethral catheter was removed on the first postoperative day. During 30 days follow up, one patient experienced Clavien-Dindo grade I and four patients grade II complications. The median peak urinary flow rate and post void residual volume at the 1-year follow up were 21 ml/s (IQR 16–26) and 0 ml (IQR 0–40), respectively. All patients remained continent and had significant improvement in IPSS, maximum urinary flow rate, and post void residual volume (p
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- 2023
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6. The Relationship Between Polygenic Risk Scores and Cognition in Schizophrenia
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Richards, Alexander L, Pardiñas, Antonio F, Frizzati, Aura, Tansey, Katherine E, Lynham, Amy J, Holmans, Peter, Legge, Sophie E, Savage, Jeanne E, Agartz, Ingrid, Andreassen, Ole A, Blokland, Gabriella AM, Corvin, Aiden, Cosgrove, Donna, Degenhardt, Franziska, Djurovic, Srdjan, Espeseth, Thomas, Ferraro, Laura, Gayer-Anderson, Charlotte, Giegling, Ina, van Haren, Neeltje E, Hartmann, Annette M, Hubert, John J, Jönsson, Erik G, Konte, Bettina, Lennertz, Leonhard, Olde Loohuis, Loes M, Melle, Ingrid, Morgan, Craig, Morris, Derek W, Murray, Robin M, Nyman, Håkan, Ophoff, Roel A, van Os, Jim, Petryshen, Tracey L, Quattrone, Diego, Rietschel, Marcella, Rujescu, Dan, Rutten, Bart PF, Streit, Fabian, Strohmaier, Jana, Sullivan, Patrick F, Sundet, Kjetil, Wagner, Michael, Escott-Price, Valentina, Owen, Michael J, Donohoe, Gary, O’Donovan, Michael C, and Walters, James TR
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Genetics ,Prevention ,Schizophrenia ,Depression ,Behavioral and Social Science ,Mental Health ,Brain Disorders ,Serious Mental Illness ,Human Genome ,2.1 Biological and endogenous factors ,Aetiology ,2.3 Psychological ,social and economic factors ,Mental health ,Bipolar Disorder ,Datasets as Topic ,Depressive Disorder ,Major ,Educational Status ,Genome-Wide Association Study ,Humans ,Intelligence ,Multifactorial Inheritance ,Psychotic Disorders ,psychiatry ,genomics ,intelligence ,bioinformatics ,GROUP Investigators ,EUGEI WP2 Group ,Schizophrenia Working Group of the Psychiatric Genomics Consortium ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Psychiatry - Abstract
BackgroundCognitive impairment is a clinically important feature of schizophrenia. Polygenic risk score (PRS) methods have demonstrated genetic overlap between schizophrenia, bipolar disorder (BD), major depressive disorder (MDD), educational attainment (EA), and IQ, but very few studies have examined associations between these PRS and cognitive phenotypes within schizophrenia cases.MethodsWe combined genetic and cognitive data in 3034 schizophrenia cases from 11 samples using the general intelligence factor g as the primary measure of cognition. We used linear regression to examine the association between cognition and PRS for EA, IQ, schizophrenia, BD, and MDD. The results were then meta-analyzed across all samples. A genome-wide association studies (GWAS) of cognition was conducted in schizophrenia cases.ResultsPRS for both population IQ (P = 4.39 × 10-28) and EA (P = 1.27 × 10-26) were positively correlated with cognition in those with schizophrenia. In contrast, there was no association between cognition in schizophrenia cases and PRS for schizophrenia (P = .39), BD (P = .51), or MDD (P = .49). No individual variant approached genome-wide significance in the GWAS.ConclusionsCognition in schizophrenia cases is more strongly associated with PRS that index cognitive traits in the general population than PRS for neuropsychiatric disorders. This suggests the mechanisms of cognitive variation within schizophrenia are at least partly independent from those that predispose to schizophrenia diagnosis itself. Our findings indicate that this cognitive variation arises at least in part due to genetic factors shared with cognitive performance in populations and is not solely due to illness or treatment-related factors, although our findings are consistent with important contributions from these factors.
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- 2020
7. Prostate Cancer Detection with mpMRI According to PI-RADS v2 Compared with Systematic MRI/TRUS-Fusion Biopsy: A Prospective Study
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Anja Sauck, Isabelle Keller, Nicolin Hainc, Denis Pfofe, Arash Najafi, Hubert John, and Joachim Hohmann
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prostate cancer ,mpMRI ,PI-RADS ,ISUP ,MRI/TRUS-fusion biopsy ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Background: mpMRI assesses prostate lesions through their PI-RADS score. The primary goal of this prospective study was to demonstrate the correlation of PI-RADS v2 score and the volume of a lesion with the presence and clinical significance of prostate cancer (PCa). The secondary goal was to determine the extent of additionally PCa in inconspicuous areas. Methods: All 157 patients underwent a perineal MRI/TRUS-fusion prostate biopsy. Targeted biopsies as well as a systematic biopsy were performed. The presence of PCa in the probes was specified by the ISUP grading system. Results: In total, 258 lesions were biopsied. Of the PI-RADS 3 lesions, 24% were neoplastic. This was also true for 36.9% of the PI-RADS 4 lesions and for 59.5% of the PI-RADS 5 lesions. Correlation between ISUP grades and lesion volume was significant (p < 0.01). In the non-suspicious mpMRI areas carcinoma was revealed in 19.7% of the patients. Conclusions: The study shows that the PI-RADS v2 score and the lesion volume correlate with the presence and clinical significance of PCa. However, there are two major points to consider: First, there is a high number of false positive findings. Second, inconspicuous mpMRI areas revealed PCa.
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- 2022
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8. Quantitative Evaluation of Apparent Diffusion Coefficient Values, ISUP Grades and Prostate-Specific Antigen Density Values of Potentially Malignant PI-RADS Lesions
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Nadine Spadarotto, Anja Sauck, Nicolin Hainc, Isabelle Keller, Hubert John, and Joachim Hohmann
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prostate cancer ,diffusion-weighted MRI ,apparent diffusion coefficient (ADC) ,ISUP grade ,prostate-specific antigen density (PSAD) ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
The aim of this study was to demonstrate the correlation between ADC values and the ADC/PSAD ratio for potentially malignant prostate lesions classified into ISUP grades and to determine threshold values to differentiate benign lesions (noPCa), clinically insignificant (nsPCa) and clinically significant prostate cancer (csPCa). We enrolled a total of 403 patients with 468 prostate lesions, of which 46 patients with 50 lesions were excluded for different reasons. Therefore, 357 patients with a total of 418 prostate lesions remained for the final evaluation. For all lesions, ADC values were measured; they demonstrated a negative correlation with ISUP grades (p < 0.001), with a significant difference between csPCa and a combined group of nsPCa and noPCa (ns-noPCa, p < 0.001). The same was true for the ADC/PSAD ratio, but only the ADC/PSAD ratio proved to be a significant discriminator between nsPCa and noPCa (p = 0.0051). Using the calculated threshold values, up to 31.6% of biopsies could have been avoided. Furthermore, the ADC/PSAD ratio, with the ability to distinguish between nsPCa and noPCa, offers possible active surveillance without prior biopsy.
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- 2023
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9. Early British railway tunnels : the implications for planners, landowners and passengers between 1830 and 1870
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Pragnell, Hubert John, Clayton, David, and Divall, Colin
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385.3 - Abstract
Of the many fears of early railway travellers, speed and a journey through a dark tunnel were among the greatest. This thesis looks at railway tunnels and their place in the minds of travellers, landowners, engineers and navvies, writers, journalists and artists, during the pioneering days of railway development up to 1870. Although tunnels and tunnelling occupy an important place in engineering literature they have been neglected by social historians. The intention of this thesis is to demonstrate that tunnels are worthy of as much attention as any other railway structures such as stations, which have been the subject of railway literature in recent years. Chapter 1 is a review of recent railway literature in which the railway tunnel has been introduced as a secondary topic. Chapter 2 discusses the problems involved in early tunnelling and uses Brunel's Box tunnel as a case study. Chapter 3 discusses the relationship between railway companies, landowners and Parliament. Lord Lichfield and the Trent Valley Railway at Shugborough Hall are used as a case study Chapter 4 discusses tunnels in early railway guide books and literature. it also examines their depiction in railway prints, as an architectural feature in their own right or set into a wider landscape with its own message for the viewer. Particular reference is made to the pictures by J.C.Bourne for his volume on the London & Birmingham and Great Western railways. Chapter 5 looks at the fear of tunnels as promoted by the anti-railway lobby. The chapter suggests that such fears were unjustified in view of the few deaths and injuries actually occurring in a tunnel. Chapter 6 looks at the variety of designs for tunnel portals. This thesis examines designs by Brunel, Stephenson, and others, which are truly masterpieces of the railway Age.
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- 2016
10. Health‐related quality of life in long‐term prostate cancer survivors after nerve‐sparing and non‐nerve‐sparing radical prostatectomy—Results from the multiregional PROCAS study
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Salome Adam, Eva Martin‐Diener, Bertrand Camey, Céline Egger Hayoz, Isabelle Konzelmann, Seyed Mohsen Mousavi, Christian Herrmann, Sabine Rohrmann, Miriam Wanner, Katharina Staehelin, Räto T. Strebel, Marco Randazzo, Hubert John, Hans‐Peter Schmid, and Volker Arndt
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health‐related quality of life ,long‐term survivor ,nerve‐sparing radical prostatectomy ,prostate cancer ,sexual outcomes ,urinary outcomes ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Nerve‐sparing (NS) surgery was developed to improve postoperative sexual and potentially urological outcomes after radical prostatectomy (RP). However, it is largely unknown how NSRP affects health‐related quality of life (HRQoL) including urinary and sexual outcomes in prostate cancer (PC) survivors 5‐10 years after diagnosis in comparison with Non‐NSRP. Methods The study population included 382 stage pT2‐T3N0M0 PC survivors 5‐10 years post diagnosis, who were identified from the multiregional Prostate Cancer Survivorship in Switzerland (PROCAS) study. Briefly, in 2017/2018, PC survivors were identified via six population‐based cancer registries based in both German‐ and French‐speaking Switzerland. HRQoL and PC‐specific symptom burden was assessed using the EORTC QLQ‐C30 and EORTC QLQ‐PR25 questionnaires. Differences in HRQoL outcomes between survivors treated with NSRP (uni‐ & bilateral) and Non‐NSRP were analyzed with multivariable linear regression adjusted for age, years since diagnosis, cancer stage, comorbidities at diagnosis, and further therapies, if appropriate. Multiple imputation was performed to minimize the bias due to missing data. Results Five to ten years after diagnosis, PC survivors treated with NSRP and Non‐NSRP reported similar symptom burden and comparable HRQoL function scores. The only significant differences were reported for sexual activity, whereas PC survivors who underwent NSRP reported statistically significant (P = .031) higher sexual activity than those on Non‐NSRP. NSRP and Non‐NSRP reported similar scores for urinary symptoms and all other HRQoL outcomes. Conclusions Our results support nerve‐sparing techniques as an option to improve postoperative sexual, but not urinary outcomes after RP in long‐term PC survivors.
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- 2020
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11. Robot-assisted radical cystectomy and intracorporeal orthotopic neobladder: 1-year functional outcomes
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Fabian Obrecht, Nadim Abo Youssef, Orlando Burkhardt, Christoph Schregel, Marco Randazzo, Christian Padevit, Peter Wiklund, and Hubert John
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Diseases of the genitourinary system. Urology ,RC870-923 - Published
- 2020
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12. Abiraterone acetate plus prednisolone with or without enzalutamide for patients with metastatic prostate cancer starting androgen deprivation therapy: final results from two randomised phase 3 trials of the STAMPEDE platform protocol
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Gerhardt Attard, Laura Murphy, Noel W Clarke, Ashwin Sachdeva, Craig Jones, Alex Hoyle, William Cross, Robert J Jones, Christopher C Parker, Silke Gillessen, Adrian Cook, Chris Brawley, Clare Gilson, Hannah Rush, Hoda Abdel-Aty, Claire L Amos, Claire Murphy, Simon Chowdhury, Zafar Malik, J Martin Russell, Nazia Parkar, Cheryl Pugh, Carlos Diaz-Montana, Carmel Pezaro, Warren Grant, Helen Saxby, Ian Pedley, Joe M O'Sullivan, Alison Birtle, Joanna Gale, Narayanan Srihari, Carys Thomas, Jacob Tanguay, John Wagstaff, Prantik Das, Emma Gray, Mymoona Alzouebi, Omi Parikh, Angus Robinson, Amir H Montazeri, James Wylie, Anjali Zarkar, Richard Cathomas, Michael D Brown, Yatin Jain, David P Dearnaley, Malcolm D Mason, Duncan Gilbert, Ruth E Langley, Robin Millman, David Matheson, Matthew R Sydes, Louise C Brown, Mahesh K B Parmar, Nicholas D James, Elin Jones, Katherine Hyde, Hilary Glen, Sarah Needleman, Ursula McGovern, Denise Sheehan, Sangeeta Paisey, Richard Shaffer, Mark Beresford, Emilio Porfiri, David Fackrell, Ling Lee, Thiagarajan Sreenivasan, Sue Brock, Simon Brown, Amit Bahl, Mike Smith-Howell, Cathryn Woodward, Mau-Don Phan, Danish Mazhar, Krishna Narahari, Fiona Douglas, Anil Kumar, Abdel Hamid, Azman Ibrahim, Dakshinamoorthy Muthukumar, Matthew Simms, Jane Worlding, Anna Tran, Mohammed Kagzi, Virgil Sivoglo, Benjamin Masters, Pek Keng-Koh, Caroline Manetta, Duncan McLaren, Nishi Gupta, Stergios Boussios, Henry Taylor, John Graham, Carla Perna, Lucinda Melcher, Ami Sabharwal, Uschi Hofmann, Robert Dealey, Neil McPhail, Robert Brierly, Lisa Capaldi, Norma Sidek, Peter Whelan, Peter Robson, Alison Falconer, Sarah Rudman, Sindu Vivekanandan, Vinod Mullessey, Maria Vilarino-Varela, Vincent Khoo, Karen Tipples, Mehran Afshar, Patryk Brulinski, Vijay Sangar, Clive Peedell, Ashraf Azzabi, Peter Hoskin, Viwod Mullassery, Santhanam Sundar, Yakhub Khan, Ruth Conroy, Andrew Protheroe, Judith Carser, Paul Rogers, Kathryn Tarver, Stephanie Gibbs, Mohammad Muneeb Khan, Mohan Hingorani, Simon Crabb, Manal Alameddine, Neeraj Bhalla, Robert Hughes, John Logue, Darren Leaning, Salil Vengalil, Daniel Ford, Georgina Walker, Ahmed Shaheen, Omar Khan, Andrew Chan, Imtiaz Ahmed, Serena Hilman, Ian Sayers, Ashok Nikapota, David Bloomfield, Tim Porter, Joji Joseph, Cyrill Rentsch, Ricardo Pereira Mestre, Enrico Roggero, Jörg Beyer, Markus Borner, Raeto Strebel, Dominik Berthold, Daniel Engeler, Hubert John, Razvan Popescu, and Donat Durr
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Male ,Antineoplastic Combined Chemotherapy Protocols - adverse effects ,Docetaxel - therapeutic use ,Prednisolone ,Abiraterone Acetate ,Androgen Antagonists ,Prostatic Neoplasms - pathology ,Prostatic Neoplasms, Castration-Resistant - drug therapy - pathology ,Clinical Trials, Phase III as Topic ,Meta-Analysis as Topic ,SDG 3 - Good Health and Well-being ,Oncology ,Androgens ,Humans ,Randomized Controlled Trials as Topic - Abstract
Background: Abiraterone acetate plus prednisolone (herein referred to as abiraterone) or enzalutamide added at the start of androgen deprivation therapy improves outcomes for patients with metastatic prostate cancer. Here, we aimed to evaluate long-term outcomes and test whether combining enzalutamide with abiraterone and androgen deprivation therapy improves survival. Methods: We analysed two open-label, randomised, controlled, phase 3 trials of the STAMPEDE platform protocol, with no overlapping controls, conducted at 117 sites in the UK and Switzerland. Eligible patients (no age restriction) had metastatic, histologically-confirmed prostate adenocarcinoma; a WHO performance status of 0–2; and adequate haematological, renal, and liver function. Patients were randomly assigned (1:1) using a computerised algorithm and a minimisation technique to either standard of care (androgen deprivation therapy; docetaxel 75 mg/m 2 intravenously for six cycles with prednisolone 10 mg orally once per day allowed from Dec 17, 2015) or standard of care plus abiraterone acetate 1000 mg and prednisolone 5 mg (in the abiraterone trial) orally or abiraterone acetate and prednisolone plus enzalutamide 160 mg orally once a day (in the abiraterone and enzalutamide trial). Patients were stratified by centre, age, WHO performance status, type of androgen deprivation therapy, use of aspirin or non-steroidal anti-inflammatory drugs, pelvic nodal status, planned radiotherapy, and planned docetaxel use. The primary outcome was overall survival assessed in the intention-to-treat population. Safety was assessed in all patients who started treatment. A fixed-effects meta-analysis of individual patient data was used to compare differences in survival between the two trials. STAMPEDE is registered with ClinicalTrials.gov (NCT00268476) and ISRCTN (ISRCTN78818544). Findings: Between Nov 15, 2011, and Jan 17, 2014, 1003 patients were randomly assigned to standard of care (n=502) or standard of care plus abiraterone (n=501) in the abiraterone trial. Between July 29, 2014, and March 31, 2016, 916 patients were randomly assigned to standard of care (n=454) or standard of care plus abiraterone and enzalutamide (n=462) in the abiraterone and enzalutamide trial. Median follow-up was 96 months (IQR 86–107) in the abiraterone trial and 72 months (61–74) in the abiraterone and enzalutamide trial. In the abiraterone trial, median overall survival was 76·6 months (95% CI 67·8–86·9) in the abiraterone group versus 45·7 months (41·6–52·0) in the standard of care group (hazard ratio [HR] 0·62 [95% CI 0·53–0·73]; pinteraction=0·71) or between-trial heterogeneity (I 2 p=0·70). In the first 5 years of treatment, grade 3–5 toxic effects were higher when abiraterone was added to standard of care (271 [54%] of 498 vs 192 [38%] of 502 with standard of care) and the highest toxic effects were seen when abiraterone and enzalutamide were added to standard of care (302 [68%] of 445 vs 204 [45%] of 454 with standard of care). Cardiac causes were the most common cause of death due to adverse events (five [1%] with standard of care plus abiraterone and enzalutamide [two attributed to treatment] and one (
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- 2023
13. Short and Intermediate-Term Outcome of Robot-Assisted Inverted YV-Plasty for Recurrent Bladder Neck Stenosis - a Single Centre Study
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Nadim Abo Youssef, Fabian Obrecht, Christian Padevit, Jan Brachlow, and Hubert John
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Urology - Published
- 2023
14. Laparoskopisch roboterassistierte Adenomenukleation der Prostata
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Orlando Burkhardt, Christian Padevit, and Hubert John
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General Medicine - Abstract
Zusammenfassung: Die operative Behandlung grosser Prostataadenome (> 80g) bei Männern mit symptomatischer Prostatahyperplasie und Therapieversagen mit einem Alphablocker ist eine Herausforderung im klinisch urologischen Alltag. Der operative Goldstandard, die transurethrale Elektroresektion der Prostata (TUR-P) ist aufgrund verlängerter Resektionszeiten bei grossen Adenomen und der damit vergesellschafteten erhöhten Komplikationsraten zur Behandlung ungeeignet. Über Jahrzehnte hinweg wurden grosse Adenome mittels offener Prostataadenomenukleation behandelt. Die Technik ist zum Teil nach wie vor noch etabliert, jedoch mit erheblichen Morbiditäts- und Komplikationsraten behaftet. Vor diesem Hintergrund wurden in den letzten Jahren zahlreiche minimal invasive Techniken entwickelt. Diese beinhalten transurethrale Interventionen, hauptsächlich mit Anwendung von Lasertechnologien, wie die Holmium-Laser-Enukleation (HoLEP) oder die KTP-Laser-Vaporisation (Greenlight™-Laser). Zudem wurden die sehr früh beschriebenen offenen Enukleationstechniken konventionell laparoskopisch und schliesslich auch laparoskopisch roboterassistiert angewandt, evaluiert und weiterentwickelt. Mittlerweile ist die laparoskopisch roboterassistierte Adenomenukleation der Prostata (RASP) und insbesondere die Modifikation mittels extraperitonealem extravesikalem Zugang und intraprostatischer Rekonstruktion der Urethra (EE-RASP) zur Ausschaltung des offenliegenden Wundbettes aus dem Harntrakt mit konsekutiv deutlicher Reduktion der perioperativen Komplikationen, eine etablierte Methode und eine Alternative der neueren transurethralen Methoden.
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- 2023
15. Clinical Issues for Prostate-Specific Antigen Screening: A Narrative Review
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Marco Randazzo, Anna Höhener, Hubert John, and Yves Wyss
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prostate cancer mortality ,prostate cancer prevalence ,prostate cancer screening ,prostate-specific antigen (psa) ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Prostate cancer, with its remarkably high prevalence, frequently creates clinical problems in terms of screening and diagnosis, as well as identifying the optimal window for treatment. Moreover, the prostate-specific antigen (PSA) blood test, despite being easy to perform, is routinely carried out without the patient’s informed consent. Although PSA-based screening for prostate cancer can reduce cancer-specific mortality, informed decision-making is mandatory; however, the clinician’s daily routine often neglects this critical discussion before performing a PSA blood test. This narrative review discusses the main questions regarding PSA screening and provides information on the epidemiological, clinical, and pathological aspects of prostate cancer.
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- 2018
16. Harnleitersteine – Diagnose und Behandlung
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Christoph Schregel and Hubert John
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General Medicine - Published
- 2023
17. Harnröhrenstriktur: endourologische und operativ offene Therapiemöglichkeiten
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Christian Padevit and Hubert John
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General Medicine - Published
- 2023
18. Harnleiterverletzungen
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Hubert John and Christian Padevit
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General Medicine - Published
- 2023
19. Polygenic risk for schizophrenia and subcortical brain anatomy in the UK Biobank cohort
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Grama, Steluta, Willcocks, Isabella, Hubert, John J., Pardiñas, Antonio F., Legge, Sophie E., Bracher-Smith, Matthew, Menzies, Georgina E., Hall, Lynsey S., Pocklington, Andrew J., Anney, Richard J. L., Bray, Nicholas J., Escott-Price, Valentina, and Caseras, Xavier
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- 2020
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20. Fallvorstellung einer unklaren druckdolenten Läsion der Glans
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Yasmin Trachsel, Corina Dommann-Scherrer, Marianne Lerch, and Hubert John
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General Medicine - Published
- 2022
21. Mapping European Association of Urology Guideline Practice Across Europe: An Audit of Androgen Deprivation Therapy Use Before Prostate Cancer Surgery in 6598 Cases in 187 Hospitals Across 31 European Countries
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Steven MacLennan, Nuno Azevedo, Eilidh Duncan, Jennifer Dunsmore, Louise Fullwood, Nicolaas Lumen, Karin Plass, Maria J. Ribal, Monique J. Roobol, Daan Nieboer, Natasha Schouten, Ted A. Skolarus, Emma Jane Smith, James N'Dow, Nicolas Mottet, Alberto Briganti, Isabel Heidegger, Johannes Mischinger Irene Resch, Simon Turba, Robin Zeder, Braninimir Lodeta, Charles Van Praet, Christophe Ghysel, Harm C. Arentsen, Matthias Beysens, Marie-Hélène Vinckier, Alexandre Mottrie, Ruben de Groote, Aleksandar Ivanov Timev, Marincho Ivanov Georgiev, Krassimir Prodanov Yanev, Boris Mladenov, Atanas Slavchev Ivanov, Petar Antonov, Stanislav Valkanov, Igor Tomašković, Tomislav Kulis, Pero Bokarica, Oliver Pavlović, Vinko Krajina, Marijan Situm, Toni Boban, Tomislav Soric, Ivan Vidic, Goran Benko, Zoran Peršec, Tomislav Sović, Roman Zachoval, Jiri Stejskal, Otakar Capoun, Tomáš Pitra, Marek Gojdič, Marek Babjuk, Vojtěch Novák, Michal Grepl, Marek Broul, Jan Novák, Lars Lund, Ulla Nordström Joensen, Michael Borre, Priit Veskimäe, Peep Baum, Toomas Tamm, Rauno Okas, Pyry Jämsä, Kanerva Lahdensuo, Sirkku Siltari, Heikki Seikkula, Christian Palmberg, Taina Isotalo, Gaelle Fiard, Cecile Verrier, Laura Wiedemann, Emilie Lecornet, Priscilla Leon, Clementine Millet, Charles Ponzio, Guillaume Ploussard, Evanguelos Xylinas, Alexandre Ingels, Pierre Bigot, Vincent Le Corre, François Audenet, Sebastian Berg, Rein-Jueri Palisaar, Axel Heidenreich, Felix Seelemeyer, Susanne Krege, Sami-Ramzi Leyh-Bannurah, Jörn H. Witt, Ayanle Abdirahman, Michael C. Truß, Jennifer Kranz, Karagiannis Andreas, Tzortzis Vassileios, Andreou Andreas, Spyridon Paparidis, Nikolaos Ferakis Niall F. Davis, Kevin G. Keane, Adrian Fuentes, Simone Scuderi, Francesco Barletta, Matteo Manfredi, Francesco Porpiglia, Maria Angela Cerruto, Alessandro Antonelli, Francesco Esperto, Marta Rossanese, Domenico Veneziano, Tommaso Castelli, Roberto La Rocca, Marcello Scarcia, Guglielmo Mantica, Silvia Rebuffo, Giorgio Pomara, Nicola Pavan, Tommaso Silvestri, Giulio Francesco Reale, Andrea Polara, Ugo Giovanni Falagario, Giuseppe Carrieri, Giovanni Ferrari, Maurizio Brausi, Luca Orecchia, Filippo Annino, Gražvydas Kazlauskas, Sotir Stavridis, Nenad Radovic, Marko Vukovic, Margaretha Adriana van der Slot, Harman Maxim Bruins, Inge van Oort, Fred Witjes, Henk van der Poel, Christian Beisland, Gunder Lilleåsenm, Stig Müller, Erik S. Haug, Magne Dimmen, Anna K. Czech, Lukasz Nyk, Jaroslaw Jaskulski, Krzysztof Ratajczyk, Isaac Braga, João Pereira, Rui Lúcio, João Pina, Edgar Miguel Calvo Loureiro Tavares da Silva, Frederico Furriel, Paulo Mota, Miguel Rodrigues, George Daniel Radavoi, Nicolae Crisan, Iulia Andras, Stoica Robert, Ovidiu Bratu, Cristian Surcel, Sergei Kotov, Vigen Malkhasyan, Sergei Petrov, Sergei Reva, Uros Bumbasirevic, Viktor Kováčik, Ivan Perečinský, Ľuboš Rybár, Ján Šulgan, Lukáš Briš, Katarína Jursová, Miroslav Chovan, Tomáš Kička, Milena Taskovska, Rok Kovačič, Andraž Miklavžina, Mario Alvarez-Maestro, Javier Mayor De Castro, Juan Aragón-Chamizo, Raquel Sopeña Sutil, Carmen Garau Perrello, Antoni Vilaseca, Jorge Huguet Perez, Julia Aumatell Ovide, Jacques Planas, Angel Borque-Fernando, Elena Sánchez-Izquierdo, Jose Luis Marenco Jimenez, Guillermo Lendínez-Cano, Ignacio Puche-Sanz, Rodrigo Garcia-Baquero, Mario Domínguez Esteban, Daniel Pérez-Fentes, Patricia Parra Serván, Lotta Renström Koskela, Johan Stranne, Bianca Scholtz, Christian Torbrand, Magnus Wagenius, Henrik Ugge, Joakim Örtegren, Janine Langenauer, Valentin Zumstein, Hans Peter Schmid, Malte Rieken, Karim Saba, Raeto T. Strebel, Ashkan Mortezavi, Cyrill Rentsch, Beat Roth, Daniel Eberli, Oechslin Pascal, Rebecca Auer, Hubert John, George N. Thalmann, Sümer Baltacı, Aydın Mungan, Sinan Sözen, Serhat Cetin, Guven Aslan, Levent Türkeri, Volkan İzol, Çetin Demirdağ, Sami Berk Ozden, Gökhan Toktaş, Şaban Sarikaya, İlker Tinay, Talha Müezzinoğlu, Oguzcan Erbatu, Levent Sagnak, Bülent Akdoğan, Cavit Can, Hayrettin Şahin, Cenk Murat Yazıcı, Serhii Volkov, Olexandr Shulyak, David Douglas, Joshua Hemmant, Omar El-Taji, Imran Ahmad, Sarika Nalagatla, Husay Janebdar, Rajan Veeratterapillay, Bhavan Rai, Samantha Conroy, Marcus Cumberbatch, Sachin Malde, Urology, and Public Health
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SDG 3 - Good Health and Well-being ,Urology ,Androgen deprivation therapy ,Guidelines ,Implementation science ,Prostate cancer - Abstract
Background: Evidence-practice gaps exist in urology. We previously surveyed European Association of Urology (EAU) guidelines for strong recommendations underpinned by high-certainty evidence that impact patient experience for which practice variations were suspected. The recommendation “Do not offer neoadjuvant androgen deprivation therapy (ADT) before surgery for patients with prostate cancer” was prioritised for further investigation. ADT before surgery is neither clinically effective nor cost effective and has serious side effects. The first step in improving implementation problems is to understand their extent. A clear picture of practice regarding ADT before surgery across Europe is not available. Objective: To assess current ADT use before prostate cancer surgery in Europe. Design, setting, and participants: This was an observational cross-sectional study. We retrospectively audited recent ADT practices in a multicentre international setting. We used nonprobability purposive sampling, aiming for breadth in terms of low- versus high-volume, academic, versus community and public versus private centres. Outcome measurements and statistical analysis: Our primary outcome was adherence to the ADT recommendation. Descriptive statistics and a multilevel model were used to investigate differences between countries across different factors (volume, centre type, and funding type). Subgroup analyses were performed for patients with low, intermediate, and high risk, and for those with locally advanced prostate cancer. We also collected reasons for nonadherence. Results and limitations: We included 6598 patients with prostate cancer from 187 hospitals in 31 countries from January 1, 2017 to May 1, 2020. Overall, nonadherence was 2%, (range 0–32%). Most of the variability was found in the high-risk subgroup, for which nonadherence was 4% (range 0–43%). Reasons for nonadherence included attempts to improve oncological outcomes or preoperative tumour parameters; attempts to control the cancer because of long waiting lists; and patient preference (changing one's mind from radiotherapy to surgery after neoadjuvant ADT had commenced or feeling that the side effects were intolerable). Although we purposively sampled for variety within countries (public/private, academic/community, high/low-volume), a selection bias toward centres with awareness of guidelines is possible, so adherence rates may be overestimated. Conclusions: EAU guidelines recommend against ADT use before prostate cancer surgery, yet some guideline-discordant ADT use remains at the cost of patient experience and an additional payer and provider burden. Strategies towards discontinuation of inappropriate preoperative ADT use should be pursued. Patient summary: Androgen deprivation therapy (ADT) is sometimes used in men with prostate cancer who will not benefit from it. ADT causes side effects such as weight gain and emotional changes and increases the risk of cardiovascular disease, diabetes, and osteoporosis. Guidelines strongly recommend that men opting for surgery should not receive ADT, but it is unclear how well the guidance is followed. We asked urologists across Europe how patients in their institutions were treated over the past few years. Most do not use ADT before surgery, but this still happens in some places. More research is needed to help doctors to stop using ADT in patients who will not benefit from it.
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- 2023
22. Unilateral Pelvic Lymph Node Dissection in Prostate Cancer Patients Diagnosed in the Era of Magnetic Resonance Imaging–targeted Biopsy: A Study That Challenges the Dogma
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Alberto Martini, Lieke Wever, Timo F. W. Soeterik, Arnas Rakauskas, Christian Daniel Fankhauser, Josias Bastian Grogg, Enrico Checcucci, Daniele Amparore, Luciano Haiquel, Lara Rodriguez-Sanchez, Guillaume Ploussard, Peng Qiang, Andres Affentranger, Alessandro Marquis, Giancarlo Marra, Otto Ettala, Fabio Zattoni, Ugo Giovanni Falagario, Mario De Angelis, Claudia Kesch, Maria Apfelbeck, Tarek Al-Hammouri, Alexander Kretschmer, Veeru Kasivisvanathan, Felix Preisser, Emilie Lefebvre, Jonathan Olivier, Jan Philipp Radtke, Alberto Briganti, Francesco Montorsi, Giuseppe Carrieri, Fabrizio Dal Moro, Peter Boström, Ivan Jambor, Paolo Gontero, Peter K. Chiu, Hubert John, Petr Macek, Francesco Porpiglia, Thomas Hermanns, Roderick C.N. van den Bergh, Jean-Paul A. van Basten, Giorgio Gandaglia, and Massimo Valerio
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magnetic resonance imaging ,prostatic neoplasms ,Urology - Published
- 2023
23. V01-11 ROBOT-ASSISTED BILATERAL URETERAL RE-IMPLANTATION AFTER CYSTECTOMY AND ORTHOTOPIC NEOBLADDER FOR DISTAL URETERAL FIBROSIS
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Gabriel Frölicher, Christoph Schregel, Yasmin Trachsel, Tutal Mustafa, and Hubert John
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Urology - Published
- 2023
24. Erratum zu: Editorial
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Hubert John, Yasmin Trachsel, and Ladislav Prikler
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General Medicine - Published
- 2023
25. Therapie des hormonsensitiven, metastasierten Adenokarzinoms der Prostata
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Donat Jost and Hubert John
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Urology ,Obstetrics and Gynecology - Published
- 2022
26. Blickdiagnose Urologie
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Pia Kraft, Donat Jost, Yasmin Trachsel, and Hubert John
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- 2022
27. Does seminal vesicle-sparing robotic radical prostatectomy influence postoperative prostate-specific antigen measured with an ultrasensitive immunoassay?
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Orlando Burkhardt, Julia Neuenschwander, Hubert John, and Marco Randazzo
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prostate cancer ,radical prostatectomy ,seminal vesicles ,ultrasensitive PSA ,Medicine - Abstract
PURPOSE Sparing of the seminal vesicles during robotic radical prostatectomy (SVRP) is an attempt to reduce potential damage to the hypogastric pelvic nerves. However, the seminal vesicles are known to express prostate-specific antigen (PSA) and it is unknown whether SVRP influences oncological outcome measured with ultrasensitive PSA immunoassays. In a retrospective study we analysed whether SVRP affects oncological outcome in terms of ultrasensitive PSA nadir and biochemical recurrence as compared with standard robotic assisted laparoscopic radical prostatectomy (sRALP). METHODS Overall, 102 patients underwent robotic prostatectomy. Patients were non-randomly allocated to the following surgical techniques: a SVRP group of 39 patients who underwent robotic radical prostatectomy sparing the tips of the seminal vesicles; a standard group of 63 patients who were treated with sRALP. Inclusion criteria were histologically proven negative margins (R0) and negative lymph node status (pN0). PSA was measured with an ultrasensitive assay. The Mann-Whitney U-test was used to compare the differences in PSA nadir and follow-up PSA. Biochemical recurrence was diagnosed if PSA rose to ≥0.2 mg/ml. RESULTS Median (range) follow-up was 31.4 (16.4–43.8) months. Preoperative PSA was 5.8 (0.13–15.29) ng/ml in the SVRP group and 7.1 (0.8–46) ng/ml in the sRALP group. Two cases of biochemical recurrence occurred in the sRALP group during follow-up. One of these two patients presented with locally advanced prostate carcinoma diagnosed from the definitive pathological specimen (pT3b). No patient of the SVRP group had seminal vesicle invasion or biochemical recurrence. No significant between-group difference in terms of PSA nadir and follow-up PSA was recorded. However, the percentage of patients who did not reach PSA nadir values of
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- 2018
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28. Robot-assisted Radical Cystectomy with Orthotopic Neobladder Reconstruction
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Alberto Martini, Ugo Giovanni Falagario, Antonio Russo, Laura S. Mertens, Luca Di Gianfrancesco, Carlo Andrea Bravi, Jonathan Vollemaere, Muhammad Abdeen, Mikolaj Mendrek, Eirik Kjøbli, Stephan Buse, Carl Wijburg, Alae Touzani, Guillaume Ploussard, Alessandro Antonelli, Laura Schwenk, Jan Ebbing, Nikhil Vasdev, Gabriel Froelicher, Hubert John, Abdullah Erdem Canda, Mevlana Derya Balbay, Marcel Stoll, Sebastian Edeling, Jorn H. Witt, Sami-Ramzi Leyh-Bannurah, Stefan Siemer, Michael Stoeckle, Alexander Mottrie, Frederiek D'Hondt, Alessandro Crestani, Angelo Porreca, Hendrik van der Poel, Karel Decaestecker, Richard Gaston, N. Peter Wiklund, Abolfazl Hosseini, and Urology
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Urology - Abstract
Background: Little is known regarding functional outcomes after robot-assisted radical cystectomy (RARC) and intracorporeal neobladder (ICNB) reconstruction. Objective: To report on urinary continence (UC) and erectile function (EF) at 12 mo after RARC and ICNB reconstruction and investigate predictors of these outcomes. Design, setting, and participants: We used data from a multi-institutional database of patients who underwent RARC and ICNB reconstruction for bladder cancer. Surgical procedure: The cystoprostatectomy sensu stricto followed the conventional steps. ICNB reconstruction was performed at the physician's discretion according to the Studer/Wiklund, S pouch, Gaston, vescica ileale Padovana, or Hautmann technique. The techniques are detailed in the video accompanying the article. Measurements: The outcomes measured were UC and EF at 12 mo. Results and limitations: A total of 732 male patients were identified with a median age at diagnosis of 64 yr (interquartile range 58–70). The ICNB reconstruction technique was Studer/Wiklund in 74%, S pouch in 1.5%, Gaston in 19%, vescica ileale Padovana in 1.5%, and Hautmann in 4% of cases. The 12-mo UC rate was 86% for daytime and 66% for nighttime continence, including patients who reported the use of a safety pad (20% and 32%, respectively). The 12-mo EF rate was 55%, including men who reported potency with the aid of phosphodiesterase type 5 inhibitors (24%). After adjusting for potential confounders, neobladder type was not associated with UC. Unilateral nerve-sparing (odds ratio [OR] 3.85, 95% confidence interval [CI] 1.88–7.85; p < 0.001) and bilateral nerve-sparing (OR 6.25, 95% CI 3.55–11.0; p < 0.001), were positively associated with EF, whereas age (OR 0.93, 95% CI 0.91–0.95; p < 0.001) and an American Society of Anesthesiologists score of 3 (OR 0.46, 95% CI 0.25–0.89; p < 0.02) were inversely associated with EF. Conclusions: RARC and ICNB reconstruction are generally associated with good functional outcomes in terms of UC. EF is highly affected by the degree of nerve preservation, age, and comorbidities. Patient summary: We investigated functional outcomes after robot-assisted removal of the bladder in terms of urinary continence and erectile function. We found that, in general, patients have relatively good functional outcomes at 12 months after surgery.
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- 2023
29. Reply by Authors
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Alberto Martini, Lieke Wever, Timo F. W. Soeterik, Arnas Rakauskas, Christian Daniel Fankhauser, Josias Bastian Grogg, Enrico Checcucci, Daniele Amparore, Luciano Haiquel, Lara Rodriguez-Sanchez, Guillaume Ploussard, Peng Qiang, Andres Affentranger, Alessandro Marquis, Giancarlo Marra, Otto Ettala, Fabio Zattoni, Ugo Giovanni Falagario, Mario De Angelis, Claudia Kesch, Maria Apfelbeck, Tarek Al-Hammouri, Alexander Kretschmer, Veeru Kasivisvanathan, Felix Preisser, Emilie Lefebvre, Jonathan Olivier, Jan Philipp Radtke, Alberto Briganti, Francesco Montorsi, Giuseppe Carrieri, Fabrizio Dal Moro, Peter Boström, Ivan Jambor, Paolo Gontero, Peter K. Chiu, Hubert John, Petr Macek, Francesco Porpiglia, Thomas Hermanns, Roderick C.N. van den Bergh, Jean-Paul A. van Basten, Giorgio Gandaglia, and Massimo Valerio
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Urology - Published
- 2023
30. Roboterassistierte radikale Zystektomie mit intrakorporalem orthotopem Blasenersatz: 'time has come'
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Hubert John, Orlando Burkhardt, Gabriel Frölicher, Christoph Schregel, and Christian Padevit
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- 2022
31. Kurative Therapieoptionen des lokal begrenzten Prostatakarzinoms
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Christian Padevit and Hubert John
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- 2022
32. Urothelkarzinom: blasenerhaltende Therapien
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Christoph Schregel and Hubert John
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- 2022
33. Klinische Fachspezialisten in der Urologie: ärztliche Entlastung im stationären Bereich
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Christoph Schregel, Stefan Märki, and Hubert John
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business.industry ,Medicine ,business - Published
- 2021
34. Internal Hernia Underneath an Elongated External Iliac Artery: A Complication After Extended Pelvic Lymphadenectomy and Robotic-assisted Laparoscopic Prostatectomy
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Pascal Viktorin-Baier, Marco Randazzo, Cristoforo Medugno, and Hubert John
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Internal hernia ,Complication ,Lymphadenectomy ,Robotic-assisted radical prostatectomy ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Small bowel herniation underneath the iliac vessel after transperitoneal pelvic lymphadenectomy is a rare complication. This report describes the first case of bowel incarceration behind the external iliac artery after transperitoneal robotic-assisted radical prostatectomy with extended lymph node dissection in a patient with prostate cancer 1 year after surgery. After diagnosis on CT scan, an open resection of the ischemic bowel was performed. Because of thrombosis, the external iliac artery was opened, the clot was removed and the elongated artery was resected with end-to-end anastomosis. In case of a meandering iliac artery, a retroperitonealization after pelvic lymphadenectomy might be discussed.
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- 2016
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35. Laparoskopische roboterassistierte Rekonstruktion vesikovaginaler Fisteln: standardisierte Technik und klinisches Outcome
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Jure Tornic, Beatrice Breu, Hubert John, and Christoph Schregel
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,business - Abstract
Vesikovaginale Fisteln (VVF) treten in der westlichen Welt insbesondere als Komplikation nach operativen Eingriffen im weiblichen Becken oder nach pelviner Radiotherapie auf und stellen eine hohe Einschrankung der Lebensqualitat fur die betroffenen Patientinnen dar. In diesem Artikel prasentieren wir unsere minimal-invasive Technik und das Outcome bezuglich der Rekonstruktion vesikovaginaler Fisteln mit Peritoneallappeninterponat.
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- 2021
36. Überaktive Blase (OAB) beim Mann
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Guido Tenti, Hans-Peter Schmid, Livio Mordasini, Hansjörg Danuser, Daniel Seiler, Marko Kozomara, and Hubert John
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,business - Abstract
Diese Ubersichtsarbeit zeigt den derzeitigen Stand der diagnostischen und therapeutischen Moglichkeiten in der Behandlung der uberaktiven Blase (OAB) beim Mann. Grundsatzlich muss die idiopathische OAB (OAB im engeren Sinn) abgegrenzt werden zur OAB, welcher eine auslosende Ursache zugrundeliegt (OAB im erweiterten Sinn). Insbesondere beim Mann kommt hier eine Vielzahl von Differenzialdiagnosen in Frage. Grundvoraussetzung einer korrekten Abklarung ist eine grundliche Anamnese, bei welcher wegweisende Informationen gesammelt und erste Differenzialdiagnosen gestellt werden. Nebst der klinischen Untersuchung, einem Basisblutbild (inklusive PSA, Nierenwerte) und einer Urinanalyse soll die Diagnostik durch Spezialuntersuchungen durch den Facharzt fur Urologie erweitert werden (Zystoskopie/Video-Urodynamik). Die Therapie richtet sich nach der zugrundeliegenden Erkrankung im Falle einer OAB im erweiterten Sinn und sofern behandelbar. Ansonsten erfolgt eine symptomorientierte Therapie im Falle einer idiopathischen OAB. Konservative Therapieansatze umfassen die Beckenboden-Physiotherapie, nichtinvasive Elektrostimulationstherapien oder Lifestyle-Modifikationen, aber auch Medikamente wie Antimuskarinika oder Beta-Sympathomimetika. Invasivere Therapiemoglichkeiten wie Botox-Injektionen in die Harnblase oder die sakrale Neuromodulation sind je nach Ursache als sekundare Therapien zu sehen. Operative Ansatze wie die Blasenaugmentation oder Zystektomie sind bei Therapieversagen in Erwagung zu ziehen. Neben diesen Therapieansatzen nimmt die Patientenberatung eine zentrale Bedeutung ein, da ein Therapieerfolg oft erst nach langerer Zeit und nach mehreren frustranen Therapieversuchen verzeichnet werden kann.
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- 2021
37. MP14-12 SPONTANEOUS PASSAGE RATE OF URETERAL STONES AND PREDICTIVE FACTORS AFTER PRE-STENTING
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Yasmin Trachsel, Beat Förster, Hubert John, and Christoph Schregel
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Urology - Published
- 2022
38. MP15-15 IS POSTOPERATIVE PELVIC PAIN AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY ASSOCIATED WITH SUTURE MATERIAL USED FOR SEWING THE ANASTOMOSIS? A PROSPECTIVE RANDOMIZED TRIAL
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Beatrice Breu, Beat Förster, Donat Jost, Roman Rechner, and Hubert John
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Urology - Published
- 2022
39. PD54-04 CHALLENGING THE DOGMA: SHOULD UNILATERAL PELVIC LYMPH NODE DISSECTION BE ENVISIONED IN THE MULTIPARAMETRIC PROSTATE MRI ERA?
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Alberto Martini, Lieke Wever, Arnas Rakauskas, Christian Daniel Fankhauser, Josias Bastian Grogg, Enrico Checcucci, Daniele Amparore, Guillaume Ploussard, Claudia Kesch, Fabio Zattoni, Alessandro Marquis, Giancarlo Marra, Maria Apfelbeck, Ugo Giovanni Falagario, Otto Ettala, Mario de Angelis, Donato Cannoletta, Alberto Briganti, Francesco Montorsi, Ivan Jambor, Alexander Kretschmer, Veeru Kasivisvanathan, Jan Philipp Radtke, Hubert John, Peter K Chiu, Francesco Porpiglia, Thomas Hermanns, Roderick C. N. Van den Bergh, Giorgio Gandaglia, and Massimo Valerio
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Urology - Published
- 2022
40. Nierenteilresektion und Nephrektomie bei Nierentumoren
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Christian Padevit, Fabian Obrecht, and Hubert John
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,business - Published
- 2021
41. Nieren- und Harnleitersteine: Diagnostik, Therapie und Metaphylaxe
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Hubert John, Christoph Schregel, and Anja Sauck
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,business - Published
- 2021
42. Die roboterassistierte Adrenalektomie: Stand 2021
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Hubert John and Christian Padevit
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,business - Abstract
Nebennierentumoren uber 4 cm Grosse und mit kleiner Dichte in der nativen Computertomographie unter 10 Hounsfield-Einheiten bedurfen einer eingehenden klinischen und endokrinologischen Abklarung. Hyperkortisolismus, primarer Hyperaldosteronismus, Phaochromozytome und Nebennierenmetastasen sind mogliche Operationsindikationen. Die laparoskopische Adrenalektomie ist heute Therapiestandard. Die roboterunterstutzte Laparoskopie wird zunehmend entsprechend ihrer Verfugbarkeit dank verbesserter Sicht, Vergrosserung und Instrumentenbeweglichkeit in Anspruch genommen und auch bei grossen Tumoren, Phaochromozytomen, Nierenrindenkarzinomen, partiellen Adrenalektomien oder Metastasektomien sinnvoll eingesetzt. Die laparoskopisch-roboterassistierte Adrenalektomie wird bereits heute in vielen Zentren mit etablierter urologischer Robotik in der Routine bevorzugt.
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- 2021
43. Inflammatory Myofibroblastic Tumor of the Bladder With FN1-ALK Gene Fusion: Different Response to ALK Inhibition
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Ulrich Wagner, Sophie Reinhart, Yasmin Trachsel, Christine Fritz, Miklos Pless, Hubert John, Beata Bode-Lesniewska, University of Zurich, and Reinhart, Sophie
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2748 Urology ,Adult ,Lactams ,Oncogene Proteins, Fusion ,medicine.drug_class ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Aminopyridines ,610 Medicine & health ,Antineoplastic Agents ,Cystectomy ,Neoplasms, Muscle Tissue ,03 medical and health sciences ,0302 clinical medicine ,Crizotinib ,10049 Institute of Pathology and Molecular Pathology ,hemic and lymphatic diseases ,Humans ,Medicine ,Anaplastic lymphoma kinase ,Anaplastic Lymphoma Kinase ,Myofibroblasts ,Protein Kinase Inhibitors ,Inflammation ,business.industry ,Myofibroblastic tumors ,Cystoscopy ,Gene rearrangement ,Lorlatinib ,First generation ,Fibronectins ,ALK inhibitor ,Treatment Outcome ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Cancer research ,Pyrazoles ,Female ,Gene Fusion ,business ,medicine.drug - Abstract
Inflammatory myofibroblastic tumors are rare tumors with an ALK (anaplastic lymphoma kinase) gene rearrangement in up to 65% of all cases. In our patient, the tumor was not primary resectable due to its extension. Under neoadjuvant treatment with the first generation ALK inhibitor crizotinib no tumor response was seen, but the following therapy with the next generation ALK inhibitor lorlatinib led to a rapid and deep response, enabling a complete tumor resection by partial cystectomy. Our case indicates that ALK positive inflammatory myofibroblastic tumors which do not respond to ALK inhibition with crizotinib can be successfully treated with newer agents.
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- 2020
44. Nierenteilresektion: von der offenen Nephrektomie zur roboterassistierten Nierenteilresektion
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Christian Padevit, Anja Sauck, Hubert John, and Fabian Obrecht
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,business - Abstract
In der Schweiz erkranken rund 1000 Patienten pro Jahr an einem Nierenzellkarzinom, was gut 3 % aller Krebserkrankungen ausmacht. Aufgrund haufiger durchgefuhrter Bildgebungen sowie besserer Qualitat derselben werden Nierentumoren heute oft als Zufallsbefund entdeckt. Die Nierenteilresektion loste in den letzten Jahren die radikale Nephrektomie als Therapie der Wahl bei Nierentumoren bis 7 cm ab. Hierbei steht der Erhalt der Nierenfunktion im Vordergrund, wobei im Vergleich zur radikalen Nephrektomie moglichst viele Nephronen erhalten werden. Die roboterassistierte Nierenteilresektion als minimal-invasive Variante zeigt hierbei gegenuber der offenen Nierenteilresektion ebenburtige onkologische und funktionelle Resultate mit den Vorteilen der minimal-invasiven Chirurgie. Alternative Behandlungsformen wie Kryoablation oder Radiofrequenzablation sind nichtoperablen Patienten vorbehalten. Die Rezidivrate nach Nierenteilresektion bei Nierenzellkarzinom ist tief, auch bei mikroskopisch nachweisbaren Tumoranteilen im Resektionsrand (R1-Resektion). Die Nachsorge mittels Computertomographie soll individuell gemass Risikostratifizierung erfolgen.
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- 2020
45. Éditorial
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Hubert John, Yasmin Trachsel, and Ladislav Prikler
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General Medicine - Published
- 2023
46. Editorial
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Hubert John
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General Medicine - Published
- 2022
47. Best Practices in Robotic-assisted Repair of Vesicovaginal Fistula: A Consensus Report from the European Association of Urology Robotic Urology Section Scientific Working Group for Reconstructive Urology
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Peter Wiklund, Hubert John, Charles-Henry Rochat, Marco Randazzo, Linda Lengauer, Nicolò Maria Buffi, Jens Rassweiler, Alexandre Mottrie, Darko Kröpfl, and Achilles Ploumidis
- Subjects
medicine.medical_specialty ,Urology ,Fistula ,Best practice ,030232 urology & nephrology ,Context (language use) ,Vesicovaginal fistula ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,medicine ,Humans ,Robotic surgery ,Societies, Medical ,Surgical repair ,Vesicovaginal Fistula ,business.industry ,medicine.disease ,Reconstructive urology ,Europe ,Benchmarking ,Dissection ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Urologic Surgical Procedures ,Female ,business - Abstract
Context Surgical repair of a vesicovaginal fistula (VVF) has been described extensively in the literature for several decades. Advances in robotic repair have been adopted since 2005. Objective A consensus review of existing data based on published case series, expert opinion, and a survey monkey. Evidence acquisition This document summarizes the consensus group meeting and survey monkey results convened by the European Association of Urology Robotic Urology Section (ERUS) relating to the robotic management of VVF. Evidence synthesis Current data underline the successful robotic repair of supratrigonal nonobstetric VVF. The panel recommends preoperative marking of the fistula by a guidewire or ureteral catheter, and placement of a protective ureteral JJ stent. An extravesical robotic approach usually provides a good anatomic view for adequate and wide dissection of the vesicovaginal space, as well as bladder and vaginal mobilization. Careful sharp dissection of fistula edges should be performed. Tension-free closure of the bladder is of utmost importance. Tissue interposition seems to be beneficial. The success rate of published series often reaches near 100%. An indwelling bladder catheter should be placed for about 10 d postoperatively. Conclusions When considering robotic repair for VVF, it is essential to establish the size, number, location, and etiology of the VVF. Robotic assistance facilitates dissection of the vesicovaginal space, harvesting of a well-vascularized tissue flap, and a tension-free closure of the bladder with low morbidity for the patient being operated in the deep pelvis with delicate anatomical structures. Patient summary Robotic repair of a vesicovaginal fistula can be applied safely with an excellent success rate and very low morbidity. This confirms the use of robotic surgery for vesicovaginal fistula repair, which is recommended in a consensus by the European Association of Urology Robotic Section Scientific Working Group for reconstructive urology.
- Published
- 2020
48. Stellenwert der Phytotherapeutika in der Therapie von Miktionsbeschwerden
- Author
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Alexander Müller, Hans-Peter Schmid, Stephen Wyler, Malte Rieken, Thomas Bschleipfer, and Hubert John
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Gynecology ,medicine.medical_specialty ,business.industry ,Medicine ,business - Abstract
Die medikamentose Therapie hat einen grossen Stellenwert in der Behandlung von Patienten mit Symptomen des unteren Harntrakts („lower urinary tract symptoms“, LUTS) bei Prostatavergrosserung. Neben synthetischen Praparaten stehen zahlreiche Phytotherapeutika zur Verfugung. Die Datenlage zu Phytotherapeutika in der Therapie von LUTS zeigt eine grosse Varianz und ist teils sogar widerspruchlich. Grundsatzlich muss jedes Praparat isoliert betrachtet werden, da sich Extraktionsverfahren und Zusammensetzung unterscheiden. Einzelne Praparate wie der hexanische Extrakt der Sagepalmfrucht (HESr) und das Kombinationspraparat aus Sagepalmfruchtextrakt und Brennnesselwurzelextrakt (PRO 160/120) konnten im Vergleich zu Plazebo eine signifikante Verbesserung sowie eine vergleichbare Wirkung wie synthetisch-medikamentose Standardtherapien auf LUTS erzielen. Phytotherapeutika zeichnen sich durch eine gute Vertraglichkeit, geringe Nebenwirkungen und eine unbeeinflusste Sexualfunktion aus. Phytotherapeutika, welche uber suffiziente Daten aus randomisierten Studien verfugen, kommen fur Patienten mit geringer bis moderater Symptomatik in Betracht, insbesondere wenn synthetische Praparate abgelehnt werden oder aufgrund ihres Nebenwirkungsspektrums fur den Patienten nicht tolerabel sind.
- Published
- 2020
49. Harnblasenkarzinom: Leben nach Zystektomie mit Ileumconduit und Ersatzblase
- Author
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Christian Padevit and Hubert John
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,business - Published
- 2020
50. Die Harninkontinenz bei der Frau im Alter
- Author
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Hubert John and Anja Sauck
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,business - Published
- 2020
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