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Genitale: Penis

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Komplikationen in der Urologie

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Zusammenfassung

Den benignen Erkrankungen des Penis unterliegen sehr unterschiedliche Ätiologien und Pathogenesen. Dementsprechend heterogen sind auch die Komplikationen und die ihrer Behandlungen. Insbesondere die Ansprüche an ein perfektes Timing der Therapie sind hoch, die Umstände oft schambehaftet und Grund für Verzögerungen. Einige Erkrankungen sind so selten und einzigartig z. B. im Verletzungsmuster, dass evidenzbasierte Empfehlungen nicht gegeben werden können. In vielen Fällen entscheidet daher die Erfahrung des Behandlers über den Erfolg der Therapie. In der Behandlung spielen funktionelle, kosmetische und psychosexuelle Aspekte eine Rolle. Dementsprechend sorgfältig sollte die Aufklärung bei einer realistisch formulierten Erwartungshaltung erfolgen. Organerhalt hat beim Peniskarzinom neben der Kuration die größte Bedeutung. Für die operative Therapie des Peniskarzinoms gilt, dass so wenig wie möglich und so viel wie nötig exzidiert werden soll. Knappe Schnittränder im Millimeterbereich sind ausreichend, dabei besteht aber ein erhöhtes Lokalrezidiv-Risiko. Diese werden wie ein Primärtumor erneut nach Möglichkeit organerhaltend therapiert. Die Prognose des Patienten wird durch das richtige und zeitgerechte Lymphknotenmanagement bestimmt. Die inguinale Lymphadenektomie bleibt trotz gewebeschonender Technik komplikationsträchtig.

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Authors and Affiliations

  1. Urologie an der Paulskirche, Frankfurt am Main, Deutschland

    Elmar Gerharz

  2. Urologische Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Deutschland

    Oliver Hakenberg

  3. Klinik für Urologie und Kinderurologie, St.-Antonius Hospital gGmbH, Eschweiler, Deutschland

    Jennifer Kranz & Joachim A. Steffens

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  4. Joachim A. Steffens
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Correspondence to Elmar Gerharz .

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  1. Klinik für Urologie und Kinderurologie, St.-Antonius Hospital gGmbH, Eschweiler, Nordrhein-Westfalen, Deutschland

    Jennifer Kranz

  2. Klinik für Urologie, Asklepios Klinik Wandsbek, Hamburg, Deutschland

    Petra Anheuser

  3. Klinik für Urologie und Kinderurologie, St.-Antonius Hospital gGmbH, Eschweiler, Nordrhein-Westfalen, Deutschland

    Joachim A. Steffens

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Gerharz, E., Hakenberg, O., Kranz, J., Steffens, J.A. (2021). Genitale: Penis. In: Kranz, J., Anheuser, P., Steffens, J.A. (eds) Komplikationen in der Urologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-60625-4_19

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