Treatment of varicocele with microsurgical subinguinal varicocelectomy in Marien Hospital Duesseldorf

About the department

The Department of Adult and Pediatric Urology at the Marien Hospital Duesseldorf offers the full range of medical services in the field of prevention, diagnostics and treatment of urologic diseases. The department's team of doctors admits not only adults, but also children with diseases of the reproductive (men) and urinary (men and women) systems. The specialists of the medical facility successfully perform open and endoscopic, percutaneous and minimally invasive surgical interventions. The department is part of the Center for Interdisciplinary Robotic Surgery (ZIRO), which provides patients with high-tech medical care at the highest international level. The department is equipped with the innovative da Vinci-X® robotic surgery system, which is the most modern model of the da Vinci surgical system for minimally invasive interventions that are currently the gold standard for the surgical treatment of many urologic diseases. The department has 45 beds for patient hospitalization. The department's doctors make sure that each patient receives effective treatment, taking into account his individual needs and wishes. The department is headed by Prof. Dr. med. Patrick Bastian.

The department's specialists pay due attention to updating the equipment and improving the skills of working with it. This is one of the few departments in Germany where the da Vinci-X® surgical system is successfully used. The da Vinci-X® system is equipped with two independent optical systems transmitting a Full HD (3D) image to the screen. In addition, the cameras provide image zooming up to 15 times. This creates conditions for filigree accurate microsurgery. Performing prostate surgery with the da Vinci-X® surgical system is a guarantee of maintaining normal urination and sexual function. Other advantages of robot-assisted surgery include the absence of severe pain, minimal blood loss, good aesthetic results of the intervention, and a reduced hospitalization period. The department's urologists successfully perform robot-assisted interventions for prostate cancer, organ-preserving surgery for kidney tumors, and total bladder removal in the case of cancer. Robot-assisted techniques can also be used in reconstructive surgery: replantation of the ureter into the bladder, reconstructive surgery for renal pelvis and ureteral stenosis.

An important focus of ​​work of the department's specialists is on the provision of medical care to patients with malignant diseases of the reproductive system (men) and urinary system (men and women). Prostate cancer is the most common type of oncology in men. The doctor determines the treatment tactics depending on the stage of the oncological process – the more advanced the stage, the more radical treatment it requires. In the early stages, the focus is on accurate diagnostics (up to genetic tests), endoscopic treatment methods and elimination of risk factors for disease recurrence. In the advanced stages, priority is given to surgical interventions with the preservation of fertility and sexual function, as well as to adjuvant chemotherapy with the use innovative drugs. In addition to the department's own developments, the medical facility actively uses the results of world and European research. The treatment is carried out in close cooperation with oncologists, radiation therapists and general practitioners. The department's team of doctors specializes in the treatment of other malignant diseases, including bladder, adrenal, kidney, testicular and penile cancers. For the above mentioned cancers, the main treatment method is usually surgical resection of the tumor or the affected organ. The operation is often supplemented with chemotherapy, radiation therapy and other conservative treatments.

Benign urologic diseases are also common in the department's clinical practice. These include benign prostatic hyperplasia, kidney stone disease, urinary incontinence in men and women. In the early stages, pathologies are eliminated with conservative methods, while the advanced forms usually require surgical interventions. As a rule, the department performs low traumatic and minimally invasive operations.

Specially trained department's doctors provide medical care to young patients with urologic diseases. Particular attention is paid to the repair of congenital and acquired genitourinary malformations in boys. The department's team has successful experience in the treatment of enuresis (urinary incontinence) in children.

The department's main clinical activities include:

• Diagnostics and treatment of urologic cancers
  • Prostate cancer
    • Total prostate removal (radical prostatectomy)
    • Radiation therapy (percutaneous irradiation with a linear accelerator, brachytherapy)
    • Chemotherapy
    • Hormone therapy
  • Bladder cancer
    • Transurethral resection, injection of special drugs (for example, mitomycin, BCG) for superficial tumors
    • Total bladder removal (radical cystectomy)
    • Chemotherapy
    • Radiation therapy
  • Kidney cancer
    • Surgical kidney removal
    • Tumor removal (in small tumors) with kidney preservation
    • Tumor embolization
  • Adrenal cancer
    • Surgical removal of the tumor or the affected organ
    • Chemotherapy
    • Radiation therapy
  • Testicular cancer
    • Surgical removal of the tumor
    • Radiation therapy
    • Chemotherapy
  • Penile cancer
    • Local surgical removal of the tumor (in the early stages)
    • Major surgical interventions
    • Radiation therapy
    • Chemotherapy
• Diagnostics and treatment of benign prostatic hyperplasia
  • Conservative treatment methods (alpha-adrenergic blockers, 5-alpha-reductase inhibitors, etc.) and surgical treatment
• Diagnostics and treatment of kidney stone disease
  • Drug therapy in combination with concomitant antibacterial therapy
  • Extracorporeal shock wave lithotripsy (ESWL)
  • Minimally invasive interventions
  • Open surgery
• Diagnostics and treatment of urinary incontinence in men and women (within the specialized center)
  • Conservative treatment methods: biofeedback, electrostimulation, drug therapy, etc.
  • Surgical treatment methods: Botox injections, TVT sling procedures, laparoscopic rectocolposacropexy, sacral neuromodulation, etc.
• Diagnostics and treatment of urologic diseases in children
  • Laparoscopic percutaneous and transurethral surgery
  • Correction of congenital genitourinary malformations
  • Treatment of urinary incontinence in children, reconstructive and plastic genital surgery 
• Other medical services