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Documents Health and Medicine diseases Prostatitis. Mark Schrader Histopathologische Befundberichte von Prostatastanzbiopsien. Thomas Wirth 1.
Berichterstatter: PD Dr. Ludwig Rinnab 2. Berichterstatter: Prof. Jochen Jackowski Tag der Promotion: Einleitung 1. Material und Methoden 2.
Ergebnisse 3. Diskussion 4. Zusammenfassung 60 6. Als Risikofaktoren sind gesichert: Das Alter. So verdoppelt sich das Risiko, wenn ein Verwandter ersten Grades betroffen ist.
Dem Urologen stehen dabei als Leitlinie bzw. Lohr ; Maattanen et al. Nach Ito et al. Cable ]. Schaefer ]. Die Folgen sind neben der Beunruhigung von Patienten auch ein Anstieg der therapiebedingten Nebenwirkungen, der Komplikationen und ganz besonders der Kosten und der damit verbundenen Belastung der Gesundheitskassen [Barry ].
Lohr ; Horninger et al. Weitere Subgruppenanalysen bleiben abzuwarten. Metastasen im Knochen lassen sich aufgrund des lokal gesteigerten Mineralstoffwechsels durch knochenaffine Radionukliden in Form von Technetium-Phosphatverbindungen erfassen.
Trotz unklarer Datenlage kann tendenziell nach einer fachgerechten Erstbiopsie auch bei der Rebiopsie auf eine Biopsie der Transitionalzone verzichtet werden [Pelzer et al.
MRT verbessert werden. Nach Wullich et al. Welche Regionen sollten dabei rebiopsiert werden? Mellinger ; Mellinger et al.
Befundberichten Situationen abzufragen. Angeschrieben wurden randomisiert Urologen aus ganz Deutschland.
Darin enthalten sind 4 hypothetische klinische Situationen. Dieser Fragetyp ist z. Ebenso sind die Fragen 8, 13, 16, 19 und 20 dichotom aufgebaut.
Dies ist z. Quantitative Fragen Hier werden Zahlen als Antwort eingefordert. Im Ergebnis lassen sich diese auf einer metrischen Skala darstellen.
Der arithmetische Mittelwert ist somit anwendbar. Fragen dieses Fragetypus sind die Fragen 1 bis 5. Diese Form wurde z.
Material und Methoden - 15 - 2. Der Fragebogen beginnt mit einer allgemeinen Erhebung von demografischen Daten. Auch soll die Anzahl der Stanzzylinder bei Erstbiopsie diskutiert werden.
Ein solcher Fall wurde konstruiert, um das Vorgehen deutscher Urologen bei solch einer Problemstellung darzustellen.
Von Interesse war gewesen, zu erfahren, welches Volumen die bei einem positiven Stanzzylinder entnommenen Tumore durchschnittlich besitzen; jedoch konnten die hierzu nur selten gemachten Angaben nicht brauchbar verwendet werden.
Wir wollten von den Urologen wissen, wie oft und wann sie diese veranlassen. Ludwig Rinnab. Zur besseren Veranschaulichung wurden diese statistischen Kennwerte in Form von Excel-Tabellen dargestellt.
Ergebnisse - 19 - 3. Nicht Beantwortet Ergebnisse 3. Im Rahmen der statistischen Auswertung wurde im nachfolgenden Statistikteil dieser Arbeit zuerst auf die Urologen selbst eingegangen.
Die 95 Urologen weisen eine Berufserfahrungsspanne von 6 Monaten bis 38 Jahren auf mit einer durchschnittlichen Berufserfahrung von 13,1 Jahren.
Abbildung 4 zeigt die Berufserfahrung der Urologen. Ergebnisse - 22 - 3. Die Darstellung erfolgt in Abbildung 4. Ergebnisse - 23 - 3.
Zum besseren Vergleich wurden alle Zahlenangaben in Prozentwerte umgerechnet. Die grafische Darstellung findet sich in Abbildung 5. Die Zahlenwerte stehen dabei jeweils in Bezug zu den Angaben in Abbildung 6 und werden im Einzelnen in Tabelle 4 dargestellt.
Absolutwerte sind also in Prozentwerte umgerechnet. Biopsie vor 6, 10, 12 oder mehr? Die grafische Darstellung dazu ist in Abbildung 6 wiedergegeben.
Ergebnisse - 27 - 3. Ein Urologe machte keine Angaben grafische Darstellung in Abbildung 8. Ergebnisse - 28 - 3. Die grafische Darstellung findet sich in Abbildung 9.
Ergebnisse - 29 - 3. In den Vorbiopsien wurde kein Karzinom nachgewiesen. Ergebnisse - 30 - 3. Die unter 2.
So wurden teilweise Angaben in ml, in cm sowie in Prozentwerten angegeben, so dass eine Verarbeitung uns als nicht sinnvoll erschien.
Die Angaben sind dabei in vier Kategorien unterteilt. Fall 1 3. Bei einem hypothetischen Fall wurden die oben genannten Angaben zu Patient und histopathologischem Befund gemacht.
Zudem wurden teilweise Mehrfachangaben gemacht. Die Auswertung ist nachfolgend in Abbildung 16 dargestellt.
Die grafische Darstellung findet sich in Abbildung Ergebnisse - 36 - 3. Ergebnisse - 37 - 3. Ergebnisse - 38 - Fall 3 3.
Insgesamt sind die Angaben von 89 Urologen mit in die Statistik eingeflossen. Ergebnisse - 39 - 3.
Dabei wurden Angaben von 89 Urologen in die Statistik mit einbezogen. Ergebnisse - 40 - Fall 4 3. Ergebnisse - 41 - 3. Hierzu machten 82 Urologen teilweise Mehrfachangaben.
Angaben von 82 Urologen. Zeitmangel vermutet werden. Diskussion - 43 - 4. So geben auf die Frage nach der Berufserfahrung bzw.
Als Konsequenz der Ergebnisse eines umfangreich angelegten systematischen Reviews von Eichler et al.
Dabei muss auch die Zone der Prostata angegeben werden laterale periphere, mittlere periphere, transitionale Zone , aus der die Probe entnommen wurde.
TRUS entnommen werden, wobei diese individuell anzupassen sind. Dies sollte eigentlich bedeuten, dass der Biopsie der Transitionalzone eine eher geringere Bedeutung zukommt.
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