Department of Adult and Pediatric Urology, Andrology - PAN Clinic Cologne

About the Department of Adult and Pediatric Urology, Andrology at PAN Clinic Cologne

The Department of Adult and Pediatric Urology, Andrology at the PAN Clinic Cologne offers prevention, diagnostics and treatment of the full range of diseases of the urinary tract in men and women, as well as pathologies of the reproductive organs in men. The department has earned international recognition in the treatment of urological cancers – prostate, kidney, bladder, testicular, penile cancers. The urologists of the medical facility also provide effective treatment for common urological conditions, including kidney stone disease, urinary tract infections, sexually transmitted diseases and urinary incontinence. Particular attention is paid to the treatment of men suffering from infertility, erectile dysfunction and other andrological pathologies. The department's therapeutic options are also complemented by the treatment of young patients with enuresis, genitourinary anomalies, undescended testes and phimosis. The department's specialists have in their arsenal many conservative and surgical treatments, which allow them to achieve excellent therapeutic results even in especially complex clinical cases. The department is headed by Dr. med. Johan Denil.

The primary focus of the department's clinical activities is the treatment of prostate cancer. If this diagnosis is suspected, the patient will then undergo the PSA test and MRI-guided prostate biopsy, which is the most advanced and reliable diagnostic method in this area as for today. If the examination confirms that a man has oncology, the doctors begin to plan his treatment. Since cancer is one of the most severe diseases and requires an interdisciplinary approach, a treatment regimen is developed for each patient individually, at the tumor boards with the participation of urologists, oncologists, radiologists, radiation therapists and other specialists. The standard treatment protocol for prostate cancer includes radical prostatectomy, chemotherapy and other drug treatments. Radiation therapy is also often used. In especially complex clinical cases, the doctors from the Department of Urology of the University Hospital Cologne are involved in the therapeutic process. The department's medical team also admits patients with testicular, penile, kidney and bladder malignancies. Should cancer of these organs be detected, the patient will undergo surgical resection of the tumor, chemotherapy and other therapeutic procedures.

The department's specialists have an excellent reputation in medical care for men with andrological disorders. The focus is on the patients with erectile dysfunction, hypogonadism and sexually transmitted diseases. In addition, in cooperation with the specialists in reproductive medicine, the urologists of the medical facility are engaged in the diagnostics and treatment of male infertility. In case of confirmed infertility, the department's doctors often perform testicular sperm extraction (TESE), which is currently one of the most effective treatment methods for male infertility. Those men who do not want to have children in the future are offered vasectomy – a surgical procedure, during which the doctor cuts the vas deferens that excludes fertilization during intercourse. Surgery for reproductive function restoration in men (vasovasostomy, tubulovasostomy) are also within the competence of the department's medical team.

The department admits both adults and young patients. The department's urologists are engaged in the diagnostics and treatment of urinary tract malformations and various diseases of the kidneys, ureters, bladder, urethra and male reproductive organs in newborns and young children. The most common pediatric urological diseases in the department's clinical practice are enuresis, undescended testicles and phimosis. The treatment of nocturnal enuresis usually involves behavioral therapy and drug therapy. In some cases, as the child grows up, the problem with urinary incontinence can resolve on its own. Cryptorchidism (undescended testicles) is characterized by the location of the testicles outside the scrotum – in the abdominal cavity or in the inguinal canal. Until the age of 6 months, the doctors recommend refraining from any treatment. If before this time the testicles do not descend, the surgical correction of the defect will be performed. The optimal time for the surgical treatment of cryptorchidism (orchiopexy) is the child's age up to 1 year. The treatment of undescended testes at a later age can lead to poor sperm quality, infertility or the development of a testicular tumor in the future. In case of phimosis (narrowing of the penile foreskin), which persists in boys after the age of 3 years, the department's doctors provide conservative treatment with cortisone ointments. If this type of therapy does not give the desired result, the specialists resort to surgery (circumcision).

The department specializes in the diagnostics and treatment of the following diseases:

• Prostate, testicular, penile, bladder and kidney cancers
• Benign prostatic hyperplasia
• Kidney stone disease
• Urinary tract infections
• Urinary incontinence (in men and women)
• Sexually transmitted diseases
• Male hormonal disorders
• Transsexuality
• Age-related changes in men
• Male infertility
• Erectile dysfunction
• Pediatric urological disorders (focus on enuresis, genitourinary anomalies in boys, undescended testicles and phimosis)
• Other pathologies

The department's diagnostic and therapeutic options include:

• Diagnostics
  • MRI-guided fusion biopsy for suspected prostate cancer
  • Ultrasound-guided fine needle aspiration prostate biopsy
  • Select MDx genetic test for detecting predisposition to the development of prostate cancer
  • Cystoscopy
  • Transrectal ultrasound scanning
  • Color-coded 3D ultrasound scanning
  • Hormone tests
  • Spermogram
  • Urinalysis
• Treatment
  • Conservative therapy
    • Chemotherapy and drug therapy for urological cancers (on an outpatient basis)
    • Drug therapy (for example, for urinary tract infections, urinary incontinence, male hormonal disorders)
    • Extracorporeal shock wave therapy for erectile dysfunction
  • Surgical treatment
    • Surgery for prostate diseases
      • Radical prostatectomy for prostate cancer
      • Transurethral resection in saline (TURis) for benign prostatic hyperplasia
      • Bipolar transurethral resection for benign prostatic hyperplasia
      • UroLift procedure for benign prostatic hyperplasia (on an outpatient basis)
    • Surgery for diseases of the urinary tract 
      • Transurethral interventions for urethral stenosis (for example, urethrotomy)
    • Surgery for diseases of the kidneys and ureters
      • Minimally invasive/endoscopic ureteroscopy (ureterorenoscopy) with stone removal
      • Implantation and removal of a ureteral stent
    • Surgery for bladder diseases
      • Transurethral resection for bladder tumors
      • Removal of bladder stones (transurethral cystolithotripsy)
      • Botox injections into the bladder
      • Minimally invasive treatment of urinary incontinence in women (TVT and TOT sling procedures)
    • Surgery for testicular disease
      • Sterilization (vasectomy)
      • Fertility restoration after vasectomy (vasovasostomy, tubulovasostomy)
      • Testicular sperm extraction (TESE)
      • Surgery for hydrocele 
      • Surgery for varicocele
      • Removal of testicles in case of testicular tumors (orchiectomy)
      • Surgery for undescended testicles in children (orchidopexy)
    • Surgery for penile diseases
      • Circumcision
      • Penile straightening in case of its curvature (Nesbit's procedure)
      • Removal of genital warts
• Other diagnostic and therapeutic options