Treatment of urethral fistula with operational closure in Hospital Bogenhausen Munich

About the department

The Department of Urology at the Hospital Bogenhausen Munich provides the full range of medical services in its field of competence. The team of the department's doctors specializes in the diagnostics and treatment of diseases of the urinary tract in women and men, as well as pathologies of the male genitalia. The focus is on the patients with prostate, kidney and bladder cancers, as well as on the patients with benign prostatic hyperplasia, kidney stone disease and urinary incontinence. The urologists have at their command both conservative and surgical treatment methods. In addition, laser technologies, 3D laparoscopy and the innovative da Vinci robot-assisted surgery are successfully used in clinical practice. When developing a treatment regimen, the specialists always give preference to those techniques that will allow achieving an optimal therapeutic result and maximally preserve the function of the affected organ. With over 2,700 patients every year, the department is the largest and leading clinic of its kind in southern Germany. During the therapeutic process, the doctors strictly adhere to the current clinical protocols and requirements of professional societies. The Chief Physician of the department is PD Dr. med. Atiqullah Aziz.

The department's medical team is proud of its long successful experience in the treatment of prostate cancer, which is one of the most common types of cancer in men. The patients usually require surgical removal of the tumor, which is complemented by chemotherapy and/or radiation therapy. The availability of modern technologies in the department allows the doctors to perform operations for prostate cancer using the da Vinci Xi Surgical System. Robot-assisted surgery is a real breakthrough in modern medicine and has a number of advantages over classic open interventions. The first and main advantage of the da Vinci surgery is its high precision, which allows the patient to maintain potency and normal urination after the operation. This is due to the fact that the sphincter muscle and small neurovascular plexuses located in the immediate vicinity of the prostate gland are not damaged. In addition, robot-assisted surgery is performed through several small skin incisions, which facilitates rapid postoperative recovery. Surgical manipulations during the operation are performed by a robot, but the commands are given by a surgeon sitting at a special control panel. During the intervention, the surgeon can see the operating field in multiple zooming, which ensures high accuracy. In addition, da Vinci robot-assisted surgical procedures are safer for the patient, because the robot ensures the absence of even minor tremors in the surgeon's hands.

Benign prostatic hyperplasia is also a fairly common disease in men. After receiving the diagnostic results and determining the stage of the pathology, urologists choose the most appropriate treatment tactics – conservative therapy or surgery. If, according to the examination results, the patient is indicated for the surgical treatment, then transurethral resection of the prostate gland is mostly performed. The intervention is performed endoscopically, and therefore trauma to healthy tissues is almost excluded. When diagnosed with a large prostate adenoma, the patient undergoes laparoscopic enucleation, which allows maintaining potency and excludes the development of urination disorders after surgery.

The department provides effective treatment for kidney and bladder cancer. To achieve a successful result, tumor resection is usually required. Surgery for kidney and bladder cancer is performed using minimally invasive techniques. Robot-assisted surgery is also often performed for kidney cancer. Urologists always strive to preserve the kidney by removing only the tissue affected by the oncological process. In addition, modern fluorescent technology FireFly is used in clinical practice, which makes it possible to accurately image the blood vessels of the kidney, which eliminates the risk of haemorrhage. In case of the advanced stages of cancer, the specialists have to resort to total kidney removal using 3D laparoscopic intervention. Open surgery for kidney cancer is extremely rare. If surgery is contraindicated for the patient (for example, due to serious concomitant diseases), radiofrequency or microwave ablation may be performed in collaboration with radiologists. In patients with bladder cancer, transurethral tumor resection is most often performed. The treatment regimen for kidney and bladder cancer is developed for each patient individually, at the interdisciplinary tumor board with the participation of doctors from related medical fields.

The department's range of medical services includes:

• Diagnostics and treatment of urologic cancers
  • Prostate cancer
  • Kidney cancer
  • Bladder cancer
  • Adrenal cancer
  • Retroperitoneal cancer
  • Ureteral cancer
  • Seminal vesicle cancer
  • Urethral cancer
  • Testicular cancer
    • 3D laparoscopy
    • Da Vinci robotic surgery
    • Open surgery (extremely rare)
    • Radiofrequency or microwave ablation in contraindications to kidney surgery
• Diagnostics and treatment of benign prostatic hyperplasia
  • Conservative treatment
  • Transurethral prostate resection
  • Laparoscopic enucleation of prostate adenoma
• Diagnostics and treatment of kidney stone disease
  • Conservative treatment
  • Minimally invasive interventions
• Diagnostics and treatment of urinary incontinence in men and women
• Diagnostics and treatment of acute infectious diseases of the urinary tract and male reproductive organs
• Diagnostics and treatment of other urologic diseases