German-speaking Regions Research Articles

The e-biking in Switzerland (EBIS) study: methods and dataset

AbstractThis article presents the EBIS (e-Biking in Switzerland) study, including its methodology, the resulting dataset, and an initial descriptive analysis of the population surveyed. The EBIS study is a Switzerland-wide GPS-tracking study with the aim of investigating the scope of carbon savings in the transport sector due to e-biking. Participants consisted of cyclists and e-bikers across the French- and German-speaking regions of Switzerland. In addition to extensive GPS tracking, the study included a randomized controlled trial (RCT) on transport pricing’s role in substituting e-bike trips for car trips, a retrospective survey on mode shift, and a stated preference survey on cycling infrastructure preferences. We here report participant attrition and engagement rates and compare the EBIS population to the 2021 Swiss Mobility and Transport Microcensus (MTMC) in terms of socio-demographic characteristics and travel behavior. In doing so, we present a unique dataset of 3,940 participants, 324 thousand user-days of tracking data, and over half a million stages by bike or e-bike.

“Zu einem Muster vnnd Fürbilde”

Abstract Julius Wilhelm Zincgref’s supplement to Martin Opitz’s Deutsche Pöemata, the “Anhange Underschiedlicher außgesuchter Getichten anderer mehr teutschen Poeten” (1624), is considered the first German-language anthology. Like Opitz’ Buch von der Deutschen Poeterey and his collection of poetry, it served to establish German as a language of poetry in the European context and to position Zincgref in the cultural field alongside – and in unspoken competition with – Opitz. It also helped to commemorate older German-language poetry from the southwest German-speaking region. The anthology thus appears as a central literary document in the transition between humanism, the Reformation period and the Baroque. The article deals with the editorial presentation in the first edition, determines cultural-historical contexts and explains central functions of the anthology against the background of current research.

Sociodemographic and regional differences in neonatal and infant mortality in Switzerland in 2011–2018: the Swiss National Cohort

BACKGROUND AND AIMS: Despite a well-funded healthcare system with universal insurance coverage, Switzerland has one of the highest neonatal and infant mortality rates among high-income countries. Identifying avoidable risk factors targeted by evidence-based policies is a public health priority. We describe neonatal and infant mortality in Switzerland from 2011 to 2018 and explore associations with neonatal- and pregnancy-related variables, parental sociodemographic information, regional factors and socioeconomic position (SEP) using data from a long-term nationwide cohort study. METHODS: We included 680,077 live births, representing 99.3% of all infants born in Switzerland between January 2011 and December 2018. We deterministically linked the national live birth register with the mortality register and with census and survey data to create a longitudinal dataset of neonatal- and pregnancy-related variables; parental sociodemographic information, such as civil status, age, religion, education, nationality; regional factors, such as urbanity, language region; and the Swiss neighbourhood index of socioeconomic position (Swiss-SEP index). Information on maternal education was available for a random subset of 242,949 infants. We investigated associations with neonatal and infant mortality by fitting multivariable Poisson regression models with robust standard errors. Several sensitivity analyses assessed the robustness of our findings. RESULTS: Overall, neonatal mortality rates between 2011 and 2018 were 3.0 per 1000 live births, with regional variations: 3.2 in German-speaking, 2.4 in French-speaking and 2.1 in Italian-speaking Switzerland. For infant mortality, the rates were 3.7 per 1000 live births overall, and 3.9 in the German-speaking, 3.3 in the French-speaking and 2.9 in the Italian-speaking region. After adjusting for sex, maternal age, multiple birth and birth rank, neonatal mortality remained significantly associated with language region (adjusted rate ratio [aRR] 0.72, 95% confidence interval [CI]: 0.64–0.80 for the French-speaking region and aRR 0.66, 95% CI: 0.51–0.87 for the Italian-speaking region vs German-speaking region), with marital status (aRR 1.55, 95% CI: 1.40–1.71 for unmarried vs married), nationality (aRR 1.40, 95% CI: 1.21–1.62 for non-European Economic Area vs Swiss) and the Swiss-SEP index (aRR 1.17, 95% CI: 1.00–1.36 for lowest vs highest SEP quintile). In the subset, we showed a possible association of neonatal mortality with maternal education (aRR 1.24, 95% CI: 0.95–1.61 for compulsory vs tertiary education). CONCLUSION: We provide detailed evidence about the social patterning of neonatal and infant mortality in Switzerland and reveal important regional differences with about 30% lower risks in French- and Italian-speaking compared with German-speaking regions. Underlying causes for such regional differences, such as cultural, lifestyle or healthcare-related factors, warrant further exploration to inform and provide an evidence base for public health policies.

Digital tools in primary total knee arthroplasty-Prevalence in the German-speaking region

Digital tools are being increasingly used worldwide in primary knee arthroplasty. This study aimed to analyze the utilization density of digital tools, the preferred alignment strategies, and the obstacles and benefits of implementing these technologies in German-speaking countries. An online survey with 57questions about digital tools in primary knee arthroplasty and their usage was conducted among members of the Arthroplasty Working Group (AE). The survey included questions on navigation, robotics, patient-specific instruments, individualized implants, and augmented reality. The survey revealed that 18% of hospitals use navigation and 17% use robotic systems in primary total knee arthroplasty surgery. The main reasons for not implementing supportive technologies were high acquisition and ongoing costs, as well as longer surgical duration. Patient-specific instruments and individualized implants currently play aminor role. Patient-specific alignment strategies, such as kinematic (navigation: 35%; robotics: 44%) and functional alignment (navigation: 15%; robotics: 35%), are preferred in this context. With conventional instrumentation predominantly mechanical alignment was applied (79%). The results indicate arelatively high utilization density of digital tools, which are mainly used to perform personalized alignment strategies in primary knee arthroplasty in German-speaking countries. This was particularly evident in high-volume hospitals. Economic aspects were the main reasons for not using these technologies. Future developments should aim to simplify the systems and thus achieve improved cost efficiency.

Religion in Right-Wing Ecological Discourse. A Critical Content Analysis of a Far Right Periodical

Abstract While the climate crisis was denied for many years in right-wing movements, shifts in discourse have become apparent recently. Right-wing populists and extremists are developing their own narratives, such as population growth in the Global South. Religious references also become relevant in these right-wing narratives but empirical studies on religion in right-wing environmental discourse have been rare for the German-speaking region so far. The paper examines religious motifs and arguments in the new-right periodical Die Kehre representing the line of thought of the new-right discourse on ecology. 15 issues of the journal are analysed with the help of the structuring qualitative content analysis. The analysis aims to develop a first descriptive assessment of the significance of religion in the right-wing ecological discourse. Therefore, this paper is also critical to the thesis that religion contributes substantially to global climate justice.

On the Strategies and Efficiency of Care and Support Systems for Elderly Across Cantons in Switzerland

The Swiss Federal Council has formulated a policy requiring each canton to establish housing conducive to independent living during old age. Maintaining the independence of older adults at home rather than transitioning to more expensive institutional care has gained traction. This study investigates the heterogeneity of strategies arising from the autonomy granted to each canton. Using mandatory statistics from the Swiss Federal Statistical Office for 2020 on 1550 institutions for the elderly and 2546 at-home care providers, we rank the 26 cantons by permanent and temporary care and support, distinguishing between at-home and institutional care. We use univariate regressions to explain differences and perform efficiency analyses of the respective systems. We find that the French- and Italian-speaking cantons prioritise at-home care, while the German-speaking regions rely more on institutional care. The analyses reveal an inefficient stationary approach in German-speaking cantons, which often places elderly individuals with minimal care needs in institutions. Conversely, with an ambulatory approach favouring independence, cantons like Vaud and Valais prioritize counselling and at-home services, deferring entry into institutions and allowing for short convalescence stays. Our findings are relevant for governmental infrastructure planning and the property owners, investors, and property managers involved in senior housing decisions.

Monitored and Cared for at Home? Privacy Concerns When Using Smart Home Health Technologies to Care for Older Persons

Background States and families are facing growing challenges provide adequate care for older persons. Smart home health technologies (SHHTs) in the forms of sensor or robotic devices have been discussed as technical solutions for caregiving. Ethical and social concerns are raised with the use of such technologies for caregiving purposes, a particularly prominent one being privacy. This paper contributes to the literature by distinguishing privacy concerns into both the type of technologies and conceptual dimensions. Methods Data for this paper stem from sixty semi-structured interviews with older persons, informal, and formal caregivers living in the German-speaking regions of Switzerland. All information related to privacy, that were initially inductively coded, were thematically sorted into four dimensions of privacy (physical, psychological, social, and informational) and by the type of technologies studied. Results Participants were especially concerned about privacy intrusions from smart wearables and ambient sensors than robotic technologies, which may be due to the relative lack of familiarity with the latter. Informational privacy was evident in the context of data collection capacities and potential for misuses of data. The installation and implementation of both visual and ambient sensors induced discomfort to their senses of physical space. Alerts of smart wearables and obtrusive sightings of SHHTs garnered worries related to stigmatization and manipulation, indicating intrusions into end-users’ psychological privacy. Little discussions of social dimensions of privacy were evident in the data, even toward robotic technologies for their functions to promote social interactions for older persons. Conclusions This paper is one of the first that use the stratification approach on empirical data to highlight the multi-faceted privacy concerns when technologies may be implemented in elder care. Our paper could thus supports potential end-users in deciding which technologies to use and how to balance different privacy concerns against other values that they may hold important.

Toward Centrality Evaluation of Yearning Symptoms for Prolonged Grief Disorder: A Cross-Cultural Approach

Background: The new ICD-11 diagnosis of prolonged grief disorder (PGD) is characterized by the prominent role of yearning as hallmark symptom. A secondary analysis of eight international datasets on PGD was conducted to evaluate this assumption. Additionally, cross-cultural comparison explored whether the centrality of yearning differs across world regions. Methods: Primary studies originated from German-speaking countries (n = 4 samples), other European countries and Israel (n = 3 samples), as well as China (n = 1 samples). Different PGD measures were used, including yearning and longing as symptoms. For the centrality assessment of yearning, PGD symptoms were ranked by their factor loadings from confirmatory factor analyses, followed by statistical testing to determine significant differences between yearning and other symptoms of PGD in their factor loading estimates. Subsequently, ranking positions of yearning in three world regions (German-speaking, other Europe-Israel, and China) were compared. Finally, proxy thresholds for individuals at high-risk states for PGD were defined for the different datasets, and sensitivity-specificity analyses of yearning were performed. Results: Yearning was ranked high in five out of 12 models tested. In the German-speaking region, it was predominantly ranked among the most central symptoms; in the other Europe-Israel region as well as China, it tended to fall into the middle or lower rankings of symptom centrality. Sensitivity values were consistently high, while specificity values indicated moderate levels. Discussion: In line with previous research on the general outcomes of grief, the present study showed that yearning may be subject to a culture-specific distribution. Other central symptoms such as feeling as if a part of oneself died have also been shown to potentially play a central role in PGD across world regions. On the other hand, the sensitivity-specificity analyses revealed that yearning can be considered a significant (diagnostically highly sensitive) symptom for individuals in high-risk states for PGD, although it has only moderate specificity (i.e., its absence does not necessarily indicate individuals experiencing normative grief). Nonetheless, a culture-sensitive approach to psychopathology should consider the cultural differences in the centrality of this symptom group. More research is needed to better understand the role of yearning and its determinants across world regions.

Post-pandemic consumption of outpatient antibiotics in Switzerland up to pre-pandemic levels, 2018–2023: An interrupted time series analysis

BackgroundThe COVID-19 pandemic has been a challenge for health-care systems and antibiotic stewards as uncertainty regarding treatment and bacterial coinfections raised concern. MethodsThis retrospective observational study examined the association of the pandemic on outpatient antibiotic sales and prescriptions in Switzerland using interrupted time series (ITS) analyses. Data from IQVIA™ and the Sentinella Network were used to analyze antibiotic consumption and prescription patterns over a 72-month period from January 2018 to December 2023, divided into pre-pandemic, pandemic, and post-pandemic periods. ResultsAntibiotic consumption decreased during the pandemic and returned to pre-pandemic levels in the post-pandemic period. A decrease in level was most pronounced in the French-speaking region (−2.82 defined daily doses per 1,000 inhabitants per day (DID) per month, 95 %CI [−4.34, −1.30], p < 0.001) and the Italian-speaking region (−2.80 DID per month, 95 %CI [−4.78, −0.82], p < 0.01), followed by the German-speaking region (−1.72 DID per month, 95 %CI [−2.71, −0.74], p < 0.01). Similarly, in the ITS, the relative change of model estimates in antibiotic prescriptions by GPs and pediatricians for upper respiratory tract infections, was of −36.0 % and −50.3 % resp. in the pandemic period and +10.1 % and −2.6 % in the post-pandemic period compared with the pre-pandemic period. ConclusionsA decrease of antibiotic prescriptions was observed in GPs and pediatricians during the COVID-19 pandemic, followed by a return to pre-pandemic levels. The patterns in antibiotic prescriptions aligned with the epidemiology of respiratory infections and demonstrated a pronounced association with the implementation and subsequent removal of non-pharmaceutical interventions.

Smartphone-based intervention for postpartum depressive symptoms (Smart-e-Moms): study protocol for a randomized controlled trial

BackgroundPostpartum depression constitutes a significant public health issue, with prevalence rates ranging between 8 and 19% in high-income nations. Nevertheless, numerous barriers, including time constraints, societal stigmatization, and feelings of shame, contribute to the limited utilization of healthcare services during the postpartum period. Digital interventions offer an opportunity to enhance care for women experiencing postpartum depressive symptoms.MethodsWe will conduct a two-arm randomized controlled trial to assess the effectiveness of a smartphone-based intervention in comparison to a treatment-as-usual control group in Germany. Our aim is to randomize 556 participants in a 1:1 ratio. Participants in the intervention group will be provided access to a preventive smartphone-based intervention called “Smart-e-Moms,” which incorporates therapeutic support and comprises 10 concise modules rooted in cognitive-behavioral therapy. For the intervention group, evaluations will take place at baseline (t0), prior to sessions 4 and 8 (intermediate assessments), and upon completing the intervention 6 weeks after baseline (t1). The control group’s assessments will be at baseline (t0) and 6 weeks after baseline. Follow-up assessments are scheduled at 12 and 24 weeks from baseline to examine the short-term stability of any observed effects. We anticipate that participants in the intervention group will exhibit improvements in their postpartum depressive symptoms (as measured with the Edinburgh Postnatal Depression Scale). Additionally, we will analyze secondary outcomes, including maternal bonding, stress levels, self-efficacy, satisfaction with the intervention, and healthcare utilization.DiscussionIf Smart-e-Moms proves to be effective, it has the potential to play a significant role in postpartum depression care within German-speaking regions. Ideally, this intervention could not only benefit maternal well-being but also improve the prospects for healthy child development.Trial registrationGerman clinical trials registry DRKS00032324. Registered on January 26, 2024.

Ready to Care for Pregnant Women with Breech Presentation? - Results from an Online Survey for Midwives and Midwifery Students in Germany, Austria, and Switzerland

The vaginal birth of breech presentation is an option for pregnant women supported by current German and international guidelines when favorable conditions and appropriately trained personnel are available. According to midwifery laws in the D-A-CH region, midwives should be able to provide care for a vaginal breech birth in emergencies. Therefore, imparting skills for breech delivery is enshrined in the curriculum for midwifery students. This study evaluated the knowledge and training needs of midwives and midwifery students in the German-speaking region. In May 2022, experiences, specific knowledge, and further training needs regarding vaginal breech birth were assessed through an online survey. Analysis of 467 questionnaires showed that only 30% of respondents currently attend vaginal breech births in their professional environment, but 50% would like to offer this service. 94% of respondents indicated that they would feel more confident if regular training opportunities, particularly simulations and virtual offerings, were provided for vaginal breech birth. However, currently only 10% of respondents receive regular training opportunities for vaginal breech births. The results suggest an increased provision of training opportunities for vaginal breech births to enhance midwives' safety in managing such births.

Swiss chiropractic cohort (Swiss ChiCo) pilot study: feasibility for a musculoskeletal cohort study conducted within a nationwide practice-based research network

PurposePractice-based research networks are collaborations between clinicians and researchers to advance primary care research. This study aims to assess the feasibility for longitudinal data collection within a newly established chiropractic PBRN in Switzerland.MethodsA prospective observational cohort feasibility study was performed. PBRN participating chiropractors were asked to recruit patients seeking new conservative health care for musculoskeletal pain from March 28, 2022, to September 28, 2022. Participants completed clinically oriented survey questions and patient-reported outcome measures before the initial chiropractic assessment as well as 1 h, 2 weeks, 6 weeks, and 12 weeks thereafter. Feasibility was assessed through a variety of process, resource, and management metrics. Patient clinical outcomes were also assessed.ResultsA total of 76 clinicians from 35 unique primary care chiropractic clinics across Switzerland participated. A total of 1431 patients were invited to participate, of which 573 (mean age 47 years, 51% female) were enrolled. Patient survey response proportions were 76%, 64%, 61%, and 56%, at the 1-h, 2-, 6-, and 12-week survey follow-ups, respectively. Evidence of an association was found between increased patient age (OR = 1.03, 95%CI 1.01–1.04), patient from a German-speaking region (OR = 1.81, 95%CI 1.17–2.86), non-smokers (OR = 1.89, 95%CI 1.13–3.17), and increased pain impact score at baseline (OR = 1.18, 95%CI 1.01–1.38) and response to all surveys.ConclusionThe Swiss ChiCo pilot study exceeded its prespecified feasibility objectives. Nationwide longitudinal data capture was highly feasible. Similar to other practice-based cohorts, participant retention remains a challenge.Trial registration Swiss chiropractic cohort (Swiss ChiCo) pilot study (ClinicalTrials.gov identifier: NCT05116020).

Supporting multilingual children with language impairment in a multilingual environment: experience and perspectives from speech and language therapists in Switzerland

ABSTRACT This work reports the results of a survey study conducted with French-, German-, and Italian-speaking speech and language therapists (SLTs) in Switzerland. In this survey we asked respondents about their language background, training in multilingual matters, and practices with multilingual patients, as well as their opinions on the current SLT provisions for multilingual children in Switzerland. The main results showed that despite high levels of SLT multilingualism in Switzerland, there is often a mismatch between the additional languages spoken by the SLTs and the heritage languages spoken by their patients. To circumvent the challenges of assessing a multilingual child, SLTs across Switzerland reported using a variety of assessment tools and methods, although therapeutic options are still missing. The results also revealed some differences based on linguistic region, with SLTs working in French-speaking region having the highest number of multilingual caseloads but those working in the German-speaking region receiving the most training on multilingualism. Conclusions drawn are that across Switzerland there is still a need for SLTs to be better trained to work with multilingual children and for suitable tools for assessing and especially treating multilingual patients to be developed. Full results are reported and discussed.

Teachers’ adaptations to COVID-19: perceived preparedness for distance education, frequency of teacher-student contact, and resources in ICT

ABSTRACT The post-COVID The Great Online Transition requires more support for teaching with information and communications technology (ICT) than ever. The present study investigated teachers’ psychological (perceived preparedness for distance education) and behavioural (frequency of teacher – student contact) adaptations to distance education in relation to job (training, collaboration, and equipment) and personal (self-efficacy) resources in the area of ICT during the first wave of school closings in 2020. We surveyed 1103 teachers in German-speaking regions via newsletters and X (formerly Twitter). Results from the recursive path model showed that all job resources were positively associated with teachers’ perceived preparedness, but the actual frequency of contact was only significantly related to ICT collaboration. Lastly, ICT self-efficacy mediated the associations between job resources and teachers’ adaptations. Our findings highlighted policymaking and school administration applications in which focus should be placed on fostering ICT resources, particularly collaboration.

S3 Guideline Atopic dermatitis: Part1 - General aspects, topical and non-drug therapies, special patient groups.

This S3 guideline was created based on the European S3 guideline, with special consideration of the medical conditions in the German-speaking region and incorporating additions from the previous German-language version. The interdisciplinary guideline commission consisted of representatives from the German Dermatological Society, the Professional Association of German Dermatologists, the Austrian Society of Dermatology and Venereology, the Swiss Society of Dermatology and Venereology, the German Society for Allergology and Clinical Immunology, the German Society for Pediatric and Adolescent Medicine, the Professional Association of Pediatricians and Adolescent Medicine, the Society for Pediatric Allergology and Environmental Medicine, the German Society for Pediatric Rehabilitation and Prevention, the German Society for Psychosomatic Medicine and Medical Psychotherapy, the German Network for Health Services Research, the German Eczema Association and the German Allergy and Asthma Association. This first part of the guideline focuses on the definition and diagnostic aspects of atopic dermatitis (AD), addressing topical therapy as well as non-pharmacological treatment approaches such as UV therapy, psychoeducational therapy, dietary interventions for AD, allergen immunotherapy for AD, and complementary medicine. This part of the guideline also covers specific aspects of AD in children and adolescents, during pregnancy and lactation, and in the context of family planning. Additionally, it addresses occupational aspects of AD and highlights the perspective of the patients. The second part of the guideline, published separately, addresses the systemic therapy of AD.

Hen's egg ladder: Therapy option for the gradual introduction of hen's eggs in cases of hen's egg allergy.

More than 10 years ago, the British Society for Allergy and Clinical Immunology (BSACI) published guidelines for the management of egg allergy [1]. For the first time, these included a stepwise plan for the reintroduction of egg for egg-allergic children who could already tolerate well-cooked egg, such as cakes and cookies. Since then, various egg ladders have been developed [2, 3, 4, 5, 6, 7, 8, 9]. In the past 3 years, several studies have been published suggesting that a gradual introduction of highly processed to less processed egg containing foods contribute to the acceleration of tolerance development [2, 3, 4, 5]. However, depending on the study and egg ladder, the egg products vary in their level of processing (wheat matrix, degree, and location of heating (e.g., oven, pan, pot), egg quantity, and egg protein). In the UK, the introduction of the egg ladder is recommended at the age of 12 months or if the last reaction occurred 6 months before. The benefits of introducing egg at home include an early increase in the variety of foods, reduction of food fears, improved nutrient intake, and the avoidance of hospitalization fears in children [10]. Children with mild reactions in the past can start with small amounts of baked goods at home. Food challenges in an inpatient setting to exclude or reconfirm the allergy should be conducted if the patients have previously had severe allergic reactions, i.e., anaphylaxis, or if the smallest amounts triggered an allergic reaction or if existing asthma is poorly controlled [10, 11]. The present work includes, in addition to the evaluation of study results, a presentation of the recent studies regarding egg ladders. From these, a new egg ladder as therapeutic option for the German-speaking region has been developed. As already done for the milk ladder a detailed step-by-step plan, selection criteria, a recipe collection, and also ideas for commercial prepackaged food items can be found in the appendices [11].

S3 guideline Atopic dermatitis: Part 2 - Systemic treatment.

The present S3 guideline was created based on the European English-language S3 guideline, with special consideration given to the medical conditions in the German-speaking region, and with additions from the previous German-language version, in accordance with the criteria of the AWMF. This second part of the guideline addresses the systemic therapy of atopic dermatitis (AD). It covers topics such as the indication for systemic therapy in children, adolescents, and adult patients with AD. Furthermore, it addresses all medications approved for AD, such as the biologics dupilumab and tralokinumab, the Janus kinase inhibitors abrocitinib, baricitinib, and upadacitinib, as well as conventional immunosuppressive therapies with systemic glucocorticosteroids and ciclosporin. Additionally, it discusses systemic off-label therapies. The first part of the guideline, published separately, includes the definition and diagnostic aspects of AD, describes topical therapy, non-drug therapy approaches, and addresses aspects related to special patient groups.

Sprachliche Besonderheiten in ausgewählten deutschen Werbetexten für Getränkeprodukte / Linguistic Particularities in Selected German Advertising Texts for Beverage Products

Advertising or advertising texts belong to mass media communication and are studied in different contexts and perspectives. This article focuses on linguistic analysis, presenting linguistic peculiarities in selected advertising texts for beverage products in the German-speaking region. Characteristic linguistic patterns, stylistic devices, and identified lexical preferences are discussed concerning advertising goals and effects. The results of the corpus analysis show that German beverage advertisements are mainly characterized by the use of various language games, Anglicisms, metaphorical, metonymic, and elliptical or fragmentary expressions. All these linguistic peculiarities draw potential consumers’ attention and communicate specific values effectively, such as taste, freshness, or authenticity.

Binding Waste as Evidence for the Reconstruction of a Lost Aristotelian Manuscript

This note discusses the hypothetically reconstructed content of a fourteenth-century Latin manuscript of Aristotle's Parva naturalia, from which two bifolia survive as flyleaves in an incunable binding. The note argues that the lost manuscript contained a collection of Aristotelian treatises in combination with short texts by Avicenna and Thomas Aquinas, which had a limited circulation in German-speaking regions.

Evaluation and management of urethral strictures-guideline summary 2024 : part1-anterior urethra

In recent years, several international urological societies have published guidelines on the diagnosis, treatment, and follow-up of urethral strictures, but aguideline for the German-speaking region has not been available to date. This summary provides adetailed comparison of the guidelines of the European Association of Urology (EAU), American Urological Association (AUA) and the Société Internationale d'Urologie (SIU) with regard to the treatment of anterior urethral strictures, i.e. from the bulbar urethra to the meatus. In the following work, differences and specific recommendations in the guidelines are highlighted. In particular, the three guidelines largely agree with regard to diagnostic workup and follow-up. However, divergences exist in the management of anterior urethral strictures, particularly with regard to the use of endoscopic therapeutic approaches and the use of urethral stents. In addition, the EAU provides more comprehensive and detailed recommendations on urethroplasty techniques and specific patient follow-up. The EAU guidelines are the most current and were the first to include instructions for urethral strictures in women and individuals with gender incongruence after genital approximation surgery. Reconstructive urology is arapidly evolving specialty and, thus, the clinical approach has been changing accordingly. Although guideline recommendations have become more inclusive and comprehensive, more high-quality data are needed to further improve the level of evidence.