What ' s known on the subject? and What does the study add? Treatment recommendations such as interdisciplinary guidelines are always based on scientifi c publications. However, high-quality studies are very often focused on single-centre series of selected cases. Health care research has failed to provide comprehensive information that describes the clinical reality of prostate cancer management even in smaller centres. This is a health care research study with 17 participating centres. Any prostate cancer centre can use the internet-based database http://prostata-ca.net , at no additional cost, to collect and analyze data for quality management, to conduct consecutive follow-up assessments, and to compare their data with the averages recorded by all other centres. The database also enables time trend analysis of certain quality parameters in an annual comparison.Study Type -Therapy (individual cohort) Level of Evidence 2b OBJECTIVES• To report our experience with an Internet-based multicentre database that enables tumour documentation, as well as the collection of quality-related parameters and follow-up data, in surgically treated patients with prostate cancer.• The system was used to assess the quality of prostate cancer surgery and to analyze possible time-dependent trends in the quality of care. PATIENTS AND METHODS• An Internet-based database system enabled a standardized collection of treatment data and clinical fi ndings from the participating urological centres for the years 2005 -2009. • An analysis was performed aiming to evaluate relevant patient characteristics (age, pathological tumour stage, preoperative International Index of Erectile Function-5 score), intra-operative parameters (operating time, percentage of nerve-sparing operations, complication rate, transfusion rate, number of resected lymph nodes) and postoperative parameters (hospitalization time, re-operation rate, catheter indwelling time).• Mean values were calculated and compared for each annual cohort from 2005 to 2008. The overall survival rate was also calculated for a subgroup of the Berlin patients. RESULTS• A total of 914, 1120, 1434 and 1750
Purpose: For successful long-term rehabilitation of patients with neurogenic lower urinary tract dysfunction (NLUTD), it is necessary to define the objective requirement for urological aids based on a scientifically validated basis. Methods: This was a cross-sectional multicenter study, based on a questionnaire. Data concerning bladder management and daily consumption of urological appliances for patients with NLUTD in a community setting were collected through a standardized survey. Results: Seven hundred and sixty-seven records were analyzed: 543 males, 221 females (N/A = 3). Patients using intermittent catheterization (n= 608) required 5.06 (mean) single-use catheters per day. Out of them, 94 (15.5%) required additional pads (mean: 2.29 per day), 34 patients (5.6%) additionally used pants (mean: 2.55 per day) and 46 patients (7.6%) utilized condom catheters (mean: 3.81 per day) between catheterizations. Among all, 126 patients (16.4%) used pads (mean: 5.03 per day), and 51 patients (6.6%) used pants (mean: 3.03 per day). Women needed both pads (p < 0.0001) and diapers (p = 0.0084) significantly more frequently than men. Eighty-two of the male patients (15.1%) applied condom catheters (mean: 2.8 per day). The target value of the objective daily requirement of incontinence aids for adult patients with NLUTD (based on the upper twofold standard deviation from the mean value) was defined as follows: up to nine single-use catheters, seven condom catheters, nine pads and/or seven pants. A "mixed supply" of different incontinence aids is part of the daily supply for many patients. Conclusion: For the first time, these results allow a reasonable regulation of urological aids and appliances based on scientific data for patients with neurogenic bladder.
<b><i>Introduction:</i></b> The aim of the study is to compare length of hospital stay, transfusion rates, and re-intervention rates during hospitalization for transurethral resection of the prostate (TUR-P), open prostatectomy (OP), and laser therapy (LT) for surgical treatment of benign prostatic obstruction (BPO). <b><i>Methods:</i></b> URO-Cert is an organization, in which clinical data of prostatic diseases from 2 university, 19 public, and 3 private hospitals and 270 office-based urologists are collected in order to document treatment quality. Data on diagnostics, therapy, and course of disease are recorded web based. The analysis includes datasets from 2005 to 2017. <b><i>Results:</i></b> Of 10,420 patients, 8,389 were treated with TUR-P, 1,334 with OP, and 697 with LT. Median length of hospital stay was 6 days (IQR: 4–7) for TUR-P, 9 days (IQR: 7–11) for OP, and 5 days (IQR: 4–6) for LT (<i>p</i> < 0.001). Risk for a hospital stay ≥7 days was higher for OP versus TUR-P (OR: 7.25; 95% CI = 6.27–8.36; <i>p</i> < 0.001) and LT (OR: 17.89; 95% CI = 14.12–22.65; <i>p</i> < 0.001) and higher for TUR-P versus LT (OR: 2.47; 95% CI = 2.03–3.01; <i>p</i> < 0.001). OP had a significantly higher risk for transfusions than TUR-P (OR: 2.44; 95% CI = 1.74–3.41; <i>p</i> < 0.001) and LT (OR: 3.32; 95% CI = 1.56–7.01; <i>p</i> < 0.001). Transfusion rates were not significantly different between TUR-P and LT (OR: 1.36; 95% CI = 0.66–2.79; <i>p</i> = 0.51). Risk of re-intervention was not different between all 3 approaches. <b><i>Conclusion:</i></b> OP was associated with higher transfusion rates and longer hospital stay than TUR-P and LT. Risk of transfusion was not different between TUR-P and LT, but TUR-P was inferior to LT concerning length of hospital stay. Re-intervention rates during hospitalization did not differ between the groups.
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