Diagnostic tests for urinary bladder neck obstruction in Alexianer St. Hedwig Hospital Berlin

About the department

The Department of Urology at the Alexianer St. Hedwig Hospital Berlin provides a full range of medical services to patients with diseases of the kidneys, bladder, ureters, and urethra. The department also provides qualified medical care to representatives of the stronger sex with pathologies of the prostate gland, testicles, and penis. The specialists of the department are focused on effective and at the same time sparing treatment with the use of the latest medical technologies. If a patient has indications for surgical treatment, laparoscopic or robotic surgeries using the state-of-the-art Da Vinci system are performed whenever possible. The department's team of urologists has unique competences in the treatment of benign prostatic hyperplasia: both standard treatment procedures (transurethral resection of the prostate) and innovative interventions (HoLEP, Rezum and others) are performed here. Of particular interest to the department's specialists is also the treatment of urolithiasis using extracorporeal shock wave lithotripsy (EWLT), ureterorenoscopy with laser lithotripsy, percutaneous nephrolitholapaxy, and robotic nephrolithotomy. It should be noted that the Department of Urology at the Alexianer St. Hedwig Hospital Berlin first opened its doors to patients in 1922 and for decades of work still confidently occupies a leading position among the top urological clinics in Germany, providing patients with excellent medical care. The Head physician of the department is Prof. Dr. med. Steffen Weikert.

One of the key focuses of the department's urology team is to perform minimally invasive surgical interventions that spare tissue using the innovative Da Vinci robotic system. These surgeries offer several significant advantages over traditional open procedures, including reduced blood loss, minimal pain, a quicker postoperative recovery, and a lower risk of complications after the intervention. It is important to note that Da Vinci robotic surgeries are performed under the control of a specially trained surgeon. The surgeon operates the robotic system by giving commands from the control console. The Da Vinci robot's arms are equipped with special instruments that execute all commands given by the surgeon with perfect precision. During the operation, the surgeon sees 3D images of the operating field. These images are transmitted in real time through a camera installed on one of the robotic arms. A significant advantage of robotic surgery is the ability of the Da Vinci system's robotic arms to reach hard-to-access areas with minimal trauma to nearby anatomical structures. Additionally, hand tremor is eliminated, contributing to precise and effective surgical results.

Over the years of work with the innovative Da Vinci system, the team of urologists at the department has gained impressive experience in performing these interventions. They most often carry out these surgeries for prostate and kidney malignancies. Before prescribing surgery to a patient, the attending physician conducts a comprehensive diagnostic examination and an individual consultation. During this consultation, the physician discusses the advantages of the surgical technique, the expected results of the treatment, the peculiarities of the recovery period, and the potential risks of the procedure. The surgeons at the medical facility specialize in such robotic surgeries as radical prostatectomy, partial and radical nephrectomy, cystectomy, pyeloplasty, ureter reimplantation, and nephroureterectomy.

The department is one of the leading medical facilities in Germany for treating benign prostatic hyperplasia (BPH). The department's urologists successfully perform transurethral resection of the prostate, which is considered the gold standard for the treatment of prostate adenoma. The department also practices innovative BPH treatment methods, particularly holmium laser enucleation of the prostate (HoLEP) and the Rezum minimally invasive procedure. HoLEP uses laser energy to precisely remove excess prostate tissue with minimal blood loss. The department's urology team has already performed more than 3,000 HoLEP procedures with high success rates. The Rezum procedure uses hot water vapor to reduce the volume of the prostate gland. This therapeutic manipulation takes only 5-10 minutes, and you can expect significant symptom relief 2-3 weeks after the procedure. HoLEP and Rezum are most often performed under local anesthesia, but general anesthesia is also possible if indicated. These therapeutic procedures are characterized by a low trauma rate and high efficiency. Unlike transurethral resection of the prostate, they completely eliminate the risk of potency problems.

The priority areas of the department's specialization also include the treatment of urolithiasis. Depending on the complexity of the clinical case and the stage of the disease, effective drug treatment regimens or modern minimally invasive procedures are used. For small stones in the kidneys and ureters, ureterorenoscopy, an endoscopic technique, is primarily employed. Larger concretions are crushed using laser lithotripsy with a holmium or thulium laser. Laser lithotripsy is usually performed on an outpatient basis, though hospitalization for one to two days may be required in some cases. If large stones are detected in the renal pelvis, doctors in the department recommend percutaneous nephrolithotomy under ultrasound or X-ray guidance. This procedure is performed in a hospital setting.

The department's main clinical focuses are as follows:

• Diagnostics and treatment of prostate diseases
  • Prostate fusion biopsy
  • Nerve-sparing prostatectomy
  • Holmium laser enucleation of the prostate (HoLEP)
  • Rezum therapy
  • Transurethral resection of the prostate (TURP)
• Diagnostics and treatment of testicular and penile diseases
  • Organ-preserving surgery for penile cancer
  • Inguinal and pelvic lymphadenectomy
  • Radical inguinal orchiectomy
  • Retroperitoneal lymphadenectomy
  • Chemotherapy and radiation therapy for penile and testicular tumors
• Diagnostics and treatment of kidney diseases
  • Partial or total nephrectomy
  • Microwave ablation of kidney tumors
  • Targeted therapy and immunotherapy for kidney tumors
• Diagnostics and treatment of bladder diseases
  • Transurethral resection (TUR) of the bladder
  • Radical cystectomy
  • Cystectomy with ileal conduit or neobladder formation
  • Bladder resection
  • Chemotherapy and immunotherapy for bladder tumors
• Diagnostics and treatment of ureteral diseases
  • Allium and Resonance stenting for complex ureteral strictures
  • Ureteroplasty and ureteral reimplantation surgery
  • Pyeloplasty
• Diagnostics and treatment of urethral diseases
  • End-to-end anastomotic urethroplasty
  • Oral mucosal flap urethroplasty
  • Penile skin flap urethroplasty
  • Plastic surgery of the external opening of the urethra in men
  • Innovative Optilume therapy for urethral stricture (mechanical dilation of the urethra with local administration of a drug)
• Diagnostics and treatment of urolithiasis
  • Extracorporeal shock wave lithotripsy (ESWL)
  • Rigid and flexible primary ureterorenoscopy with lithotripsy
  • Percutaneous nephrolitholapaxy
  • Robot-assisted nephrolithotomy
• Da Vinci robotic surgery
  • Radical prostatectomy
  • Partial and total nephrectomy
  • Pyeloplasty and ureteroplasty
  • Cystectomy with the formation of ileal conduit or neobladder
  • Retroperitoneal lymphadenectomy and metastasis removal
• Reconstructive plastic surgery on the urinary system and penis
  • Complex plastic reconstructive surgeries for urethral strictures
  • Installation of Allium and Resonance stents for complex ureteral strictures
  • Implantation of the AMS 700 penile prosthesis
  • Implantation of the AMS 800 artificial sphincter
• Diagnostics and treatment of other urological diseases, other surgical procedures