Grosshadern Hospital
Grosshadern Hospital ©Klinikum der Universität München, Klinikum Großhadern

UROLOGY

Grosshadern Campus, Munich University Hospital

Specialist field: Urology

Prof. Dr. med. Christian G. Stief

Marchioninistraße 15
81377 München
PD Dr. med. Alexander Roosen
+ 49 (0) 89 7095 8744

www.klinikum.uni-muenchen.de

Professor Christian Stief

Director of the Urological Clinic and Department, Grosshadern Campus, Munich University Hospital


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Medical travel

Expert medical care at hospitals and rehabilitation clinics

Professor Christian G. Stief: Focal therapy for prostate carcinoma – a European phase III trial

In cases of prostate cancer, the use of active surveillance (or ’watchful waiting’) can delay or prevent entirely the need for a radical operation that – despite improved surgical techniques – can cause incontinence and impotence. It should not be underestimated, however, how stressful it can be knowing you have cancer but not actively doing anything about it.

The newly developed procedure of focal therapy for prostate carcinoma offers a third way: targeted elimination of the primary cancer in a way that leaves the organ intact and retains its function. We are offering this concept as part of a European multicentre phase III trial aimed at obtaining regulatory approval for the treatment.

What type of patients are suitable for focal therapy as a non-aggressive means of treating prostate cancer?

Professor Stief: The same criteria apply as for the clinical trial on active surveillance: the PSA level should be no higher than 10 ng/ml; the Gleason score (a histological grading system indicating the stage of prostate cancer) should be no higher than six; a maximum of only three biopsies should return positive results; the prostate may only be of a certain size and no preliminary treatment of urethral stricture should have taken place – all these criteria indicate the presence of a localised and slow-growing prostate tumour. An MRI scan is also carried out to determine the precise size and location of the tumour. The data for all European hospitals participating in the study is evaluated centrally by a team of highly regarded experts. If the patient proves suitable for focal therapy, the tumour is identified and can then be removed with pinpoint precision.

How is the therapy performed?

Professor Stief: The actual therapy is performed on an inpatient basis involving a single overnight hospital stay. On the day before the operation, the patient is seen by the anaesthetist; on the day of treatment itself, the approx. 90 minute operation is carried out under general anaesthetic. During the operation, a substance is delivered to the tumour that can be activated by a laser, completely destroying the blood vessels that supply nutrients to the tumour. This causes a circumscribed tissue defect that will ideally encompass the entire primary cancer. The patient is then able to leave the hospital the same day after only a short stay in the recovery room.

What are the side effects of the therapy?

Professor Stief: Patients usually report only minor or moderate complaints such as a burning sensation while urinating and/or a more frequent need to urinate for a few days after the operation. In exceptional cases, patients have difficulty urinating and have to be temporarily fitted with a catheter. Continence and potency are unimpaired and the patient can return to work just one day after treatment.

How is the success rate of the treatment monitored?

Professor Stief: The patient must be continually monitored as part of the treatment and should return to us for a check-up every three months for a period of two years. Monitoring PSA levels after the operation tells us less because the bulk of the PSA-producing prostate tissue is preserved. Cross-sectional imaging is the most important tool for evaluating the post-operative situation (MRI: after a week, after 12 and 24 months). A punch biopsy is carried out after one year and again after two. The data gathered in the phase II clinical trial (40 patients) is extremely encouraging: in all cases in which at least 80 per cent of the target volume that was treated is shown to have declined in the post-operative crosssectional imaging, there have been no cases of remaining tumour tissue. Continence and potency are also completely preserved. Should there be evidence of remaining tumour tissue, options include further focal therapy, traditional radiotherapy and radical surgery.

To find out more, prospective patients can attend our prostate carcinoma consultation held every Friday (for appointments call +49 (0)89 7095 3530; Dr A. Roosen).

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Che cosa dicono altri turisti da tutto il mondo

Kunsthofpassage

1000 e 1 passagem

Em Neustadt tem a Kunsthofphpassage, que é uma passagem incrível. Ela tem vários prédios "temáticos". O azul por exemplo quando chove, a água nos canos vira música. Fora os prédios, ainda tem várias lojas bacanas e cafés charmosos para você aproveitar. #youngDresden #mustsees #shopping #cafés

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Obras incríveis

Albertinum: um museu de arte moderna de 125 anos, que foi reaberto em 2010, após uma reforma de 51 milhões de euros. A coleção de retratos começa com um dos pintores alemães mais românticos, Caspar David Friedrich, e termina com seu artista vivo mais famoso, Gerhard Richter, sendo que ambos passaram a infância em Dresden. Você vai encontrar desde a Bailarina de Degas, a Monet, Manet, Rodin, Van Gogh. A entrada Vista 10€

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Zwinger Palace

O Chateau de Versailles de Dresden

O Zwinger Palace é um dos melhores exemplos da arquitetura barroca tardia na Alemanha. Construído entre 1710 e 1728 pelo arquiteto Pöppelmann, o Palácio Zwinger foi usado para grandes festas e torneios. Hoje, o complexo barroco de pavilhões, galerias e pátios interiores é a casa de grandes museus e obras. A Madonna Sistina de Rafael você encontrará lá. O acervo de Porcelana tambem é belíssimo. O Arsenal também é muito interessante se você curte trajes e armas. Se você não quiser entrar em nenhum museu, vá pelo menos para andar pelos jardins e admirar o "Kronentor", que é o portão com a coroa.

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Asisi Panometer

Dresden : 1945

Setenta anos depois do bombardeio de Dresden, na Segunda Guerra Mundial, um panorama de 360 ​​graus que mostra a cidade destruída foi revelado na cidade. O artista Yadegar Asisi criou uma imagem circular de 100 metros de largura e 30 metros de altura que mostra Dresden após os devastadores ataques aéreos dos aliados. Entre 13-15 fevereiro de 1945, apenas alguns meses antes do fim da guerra, os bombardeiros britânicos e norte-americanos destruíram mais de 90 por cento do centro histórico da cidade, matando cerca de 25.000 pessoas. Mais de 3.900 toneladas de bombas de alto poder explosivo e dispositivos incendiários dizimaram marcos importantes do barroco em uma cidade que é considerada "a Florença do Elba". O panorama, Dresden: 1945, fica aberto de 24 de Janeiro à 31 de maio de 2015, no gasômetro Panometer. http://www.asisi.de/en/panoramas/dresden-1945/photo-gallery.html

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martinha@viajoteca.com

Frauenkirche - Church of Our Lady

A Lady de Dresden

A Igreja da Nossa Senhora de Dresden é um espetáculo de linda. É a igreja que vai te impactar no primeiro minuto que você entrar e ver uma igreja branca, super luminada. Se há um lugar cuja história pode mover-lo às lágrimas, será n'a Igreja de Nossa Senhora. Durante a Segunda Guerra Mundial, a igreja foi bombardeada e ficou em escombros até 1994, quando um programa de restauração foi iniciado. Hoje, é um lembrete dos dias antes da guerra e um dos lugares que você vai ter uma história imparcial sobre a Segunda Guerra Mundial.

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Christmas Markets in Cologne

Christmas in Germany

Christmas may be over, but 11 months from now the season will be upon us and you should spend 2015 in Germany! Why? The Christmas season is in Germany is like no other. There is no other place in the world where you can experience countless, and famous, Christmas markets that will without a doubt, put you in the holiday spirit. While the markets are open all day, it’s best to visit at night. Many towns across Germany have decorated the streets and market squares with evergreen-lined stalls, twinkling lights and religious (and not so religious) statues to kick off the holiday season as festively as possible. If you are a foreigner in Germany at this time of year, it's difficult to miss home when Germany puts on an excellent show at Christmas time. No matter what German city you are in, you can find families and friends of all ages, walking around shopping for unique and traditional gifts, sipping on mulled wine and indulging in delicious German food. You will hear laughter amongst the Christmas carols that will make you forget about your toes and fingers tingling from the cold temperature at this time of year. It’s truly a traditional delight for all of the senses. No trip to the German Christmas markets is complete without trying a class of glühwein, which is a combinations of red wine, spices and sugar. This traditional drink will keep you cozy and happy. Hungry? No problem! There are many stalls that sell traditional German Christmas Market food and snacks for you to enjoy such as bratwurst, mutzen, schmachtlappen and reibekuchen. In a world where Christmas present shopping consists of the latest technology and thoughtless gift certificates, it’s nice to be able to find traditional hand carved gifts at several stalls. Not to mention, mountains of oranges and nuts, the original gift that St. Nicholas gave to people hundreds of years ago at this time of year. While many countries around the world celebrate Christmas, no other place does it like Germany. So, if you feel that this time of year has been lacking in holiday spirit, take a trip over to this European country and be reminded what Christmas time is all about.

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Canadians First Time at a Traditional Co-ed Spa

Visiting a co-ed spa was a foreign concept to me, being born and raised in Canada. Nudity in my culture is reserved for your own home where some have issues looking at themselves in the mirror. The gym change room is another publicly acceptable nude room, many of us have mastered the art of undressing by using a towel without exposing our private parts. My wife, Kristen, and I walked into that spa and let go of our Canadian mentalities. I undressed in the co-ed change room next to a woman in her 60s. She had kind eyes, a warm smile and no knowledge of nude shame as she stripped down without embarrassment. Kristen and I entered the spa, dropped our towels and were liberated, free for all to gaze upon! There were adults of all ages and body type, casually conversing as if being nude was more comfortable than being clothed. I had to constantly remind myself that people are not judgemental of bodies here, something I have never experienced in North America. Nudity is very much a part of the culture here. This German spa was the first place I have experienced harmony and equality among class, age, sex. Nobody knows whether you walked in with an Armani suit or a ripped t-shirt, you are all equal, beautiful and free. I immediately felt unjudged and part of the community. The architecture and decor of the spa was heavenly. Stone tiles lead the way to a large open room with lounging chairs and a marble swimming pool. The ambiance is zen, with only the sound of calm conversations and light background music. Buddha heads, candles, bamboo designs and waterfalls decorate the many rooms with relaxation and beauty. The outdoor rooftop contained hot tubs and saunas to keep you warm and steamy as well as cold pools and a bucket of snow used to cool your body down before jumping back into the hot tub. I left with my body relaxed, my skin clean, and my mind at peace. I learned that the human body is a beautiful gift which should be appreciated and accepted. Nudity is our original state and should be more widely accepted.

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Herrenhauser Gärten Grotto

Niki the St.-Phalle at her best

A couple of years ago a very wealthy friend of mine, who owns an work of art by French artist Niki de St.-Phalle, told me included Hannover in a trip to Europe just to see Nikki's art in town. I had totally forgotten this until I came to Hannover and found out that Niki's works are all over the place. There are three Nanas in the Sculpture Mile downtown and an ancient grotto at the Herrenhauser Gardens was redone by Niki, who filled with her Nanas, a colorful Ganesha and a myriad of kaleidoscopic mirrors. Before her death, she donated her private collection to Hannover's Sprengel Museum, and will appear in the new wing due to open late in 2016.

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