Search

Marta Julia Fernández-González,1 Anne-Catherine Radauer-Plank,1 Anja Borgmann-Staudt,1 Waldemar Geiger,2 Irena Goranova,2 Stephanie Klco-Brosius,1 Bernhard Ralla,2 Cornelia Stelzer,2 Ina Wilkemeyer,2 Magdalena Balcerek1,3 1Charité-Universitätsmedizin Berlin, Cooperation member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatric Oncology and Hematology, Berlin, Germany; 2Charité-Universitätsmedizin Berlin, Cooperate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Clinic for Urology, Berlin, Germany; 3Berlin Institute of Health (BIH), Berlin, GermanyCorrespondence: Ina Wilkemeyer, Charité-Universitätsmedizin Berlin, Clinic for Urology, Cryobank, Augustenburger Platz 1, Berlin, 13353, Germany, Tel +49 30 450 615034, Email ina.wilkemeyer@charite.dePurpose: This retrospective cohort study assessed semen and testicular tissue quality from adult and adolescent cancer patients who had samples cryopreserved in the Cryobank of Charité-Universitätsmedizin before and/or after cancer treatment.Methods and Materials: Medical and cryopreservation data for all samples stored between 03/2004 and 05/2019 were collected retrospectively.Results: We included information on 601 samples cryopreserved from 506 cancer patients for whom oncologic treatment data were available. The majority of the samples were cryopreserved prior to cancer treatment (460/600, 77%, median 5 days before treatment). Semen quality had a predisposed reduction in those collected from adolescents with testicular and/or hematological malignancies. Analyses of the 140 (23%) samples cryopreserved after treatment initiation (median of 84 days) revealed decreased median concentration and motility following high gonadotoxic-risk treatment. Rate of oligoasthenozoospermia was comparable in samples collected prior to treatment with those provided during follow-up spermiograms within 1 year after treatment initiation (45.5% vs 45.5%). However, an increase was seen in samples collected 1– 2 (9.1% to 90.9%) and 2– 3 (50.0% to 100.0%) years after treatment initiation.Conclusion: Cancer diagnosis and treatment may impair spermatogenesis; therefore, patient counseling prior to cancer treatment by an oncologist and/or fertility specialist is crucial.Keywords: cancer, fertility preservation, adolescent, men

Josef Mang,1 Linda Hennig,1 lutz Liefeldt,2 Michael Duerr,2 Lukas J Lehner,2 Anna Bichmann,3 Bernhard Ralla,1 Hannes Cash,4 Martin Christopher Kanne,5 Robert Peters,1 Andreas Maxeiner,1,* Frank Friedersdorff1,5,* 1Department of Urology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; 2Department of Nephrology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; 3Department of Anesthesiology and Operative Intensive Care Medicine, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; 4PROURO, Berlin, Germany; 5Department of Urology, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany*These authors contributed equally to this workCorrespondence: Linda HennigDepartment of Urology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin, 10117, GermanyEmail linda.hennig@charite.dePurpose: Focal segmental glomerulosclerosis (FSGS) is a common cause for end-stage renal disease that can recur in the graft after kidney transplantation. The incidence of FSGS recurrence is reported in up to 47% of patients, predisposing those to possible poorer transplantation outcomes. Hence, we examined the incidence of FSGS recurrence and the effect on graft outcome in our patient cohort of living donor kidney transplantations (LDKT).Patients and Methods: We analyzed 194 adult patients who received a LDKT between 2011 and 2017 of which 22 (11%) had FSGS as underlying disease. Demographic data and clinical outcomes, especially regarding recurrence of FSGS, were evaluated.Results: FSGS recurrence was identified in three (14%) patients within three months after transplantation, of whom two patients (9%) lost their graft. There was no significant difference in graft survival comparing FSGS to other reasons for end-stage renal disease.Conclusion: Incidence of FSGS recurrence in the present patient cohort was within the range reported in the literature and comparatively low. Our data support LDKT as a treatment option in patients with end-stage renal disease due to FSGS.Keywords: FSGS, living donor nephrectomy, recurrence

Nora Köhler, Nasrin El-Bandar, Andreas Maxeiner, Bernhard Ralla, Kurt Miller, Jonas Busch,* Frank Friedersdorff* Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität Zu Berlin, and Berlin Institute of Health, Berlin 10117, Germany*These authors contributed equally to this workCorrespondence: Frank Friedersdorff Tel +49 30 450615219Fax +49 30 450515910Email frank.friedersdorff@charite.dePurpose: To compare running suture (RS) and interrupted suture (IS) of vesicourethral anastomosis (VUA) during open retropubic radical prostatectomy (RRP) on early urinary continence and extravasation.Patients and Methods: Single center analysis of 211 patients who underwent RRP performed by a single surgeon during 2008 to 2017 was retrospectively analyzed. For VUA, we used the standard interrupted suture technique (n=100) with a 3– 0 PDS suture. The RS (n=111) was performed with 12-bite suture using 3– 0 PDS. The primary endpoints were extravasation and early continence. Demographic and peri-operative data were collected and analyzed using Pearson’s chi-square, t-Test and Mann–Whitney U-test. A binary logistic regression analysis was carried out to explore predictors that affected early continence after catheter removal.Results: The rates of early urinary incontinence (UI) were 7.7% vs 42.2% (p< 0.001). The duration of catheterization and hospitalization was significantly shorter in the interrupted group (4 days vs 5 days, p< 0.001 and 5 days vs 6 days, p< 0.001). The groups did not differ significantly in body mass index or prostate volume. There were older patients and higher PSA levels in the group with RS technique. No significant difference was found in the postoperative extravasation rates between both groups (13.5% vs 12%, p=0.742).Conclusion: Running vesicourethral anastomosis increased the rate of early urinary incontinence. Both anastomosis techniques provided a similar rate of postoperative urine extravasation. VUA should only be one of the many criteria that must be considered for the preservation of urinary continence of patients after RRP.Keywords: retropubic prostatectomy, vesicourethral anastomosis, suturing technique, continence, tightness

Bernhard Ralla, Christoph Holtmann, Gerd GeerlingDepartment of Ophthalmology, University of Düsseldorf, Düsseldorf, GermanyIt is with great interest that we read the publication by Kanellopoulos.1 In this the author shows in a group of 21 patients with 46 months of mean follow-up that the new CXL protocol described, where higher fluence UV light is used with shorter exposure, appears to be a safe, comfortable and effective treatment for stabilizing a progressive keratoconus. This is a very valuable observation. The author also concludes, that collagen cross linking may be a promising adjunct treatment in cases, where a risk of post-LASIK-keratectasia is suspected. LASIK for correction of keratectasia is still controversially discussed. If used as a prophylactic treatment to prevent post-LASIK keratectasia, we would like to point out that the cross linking should be performed preferably after the LASIK procedure because the first will impact various steps of the refractive laser treatment.View original paper by Kanellopoulos.

ErratumRalla B, Holtmann C, Geerling G. Letter to the Editor. Clinical Ophthalmology. 2013;7:243–246.The title of the paper should have been "The combination of corneal collagen crosslinking with riboflavin and ultraviolet-a irridation and excimer laser surgery."Read the original Letter to the Editor