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Treatment of bladder cancer with embolization or chemoembolization (688854) | University Hospital Freiburg - BookingHealth
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After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan, CT scan and MRI. This will allow the doctor to determine which vessels are feeding the tumor and its metastases, as well as determine how well you will tolerate the procedure.<\/p>\n\n<p style=\"text-align:justify\"><strong>Chemoembolization <\/strong>begins with local anesthesia and catheterization of the femoral artery. The thin catheter is inserted through a few centimeters long incision of the blood vessel. The doctor gradually moves the catheter to the vessel feeding the primary tumor or its metastases. The procedure is carried out under visual control, an angiographic device is used for this. The vascular bed and the position of the catheter in it are displayed on the screen of the angiograph.<\/p>\n\n<p style=\"text-align:justify\">When the catheter reaches a suspected artery, a contrast agent is injected through it. Due to the introduction of the contrast agent, the doctor clearly sees the smallest vessels of the tumor and the surrounding healthy tissues on the screen of the angiograph. After that, he injects emboli into the tumor vessels through the same catheter.<\/p>\n\n<p style=\"text-align:justify\">Emboli are the spirals or the liquid microspheres. The type of embolus is selected individually, taking into account the diameter of the target vessel. When carrying out chemoembolization, a solution of a chemotherapy drug is additionally injected into the tumor vessel. Due to the subsequent closure of the vessel lumen with an embolus, the chemotherapy drug influences the tumor for a long time. In addition, the drug does not enter the systemic circulation, which allows doctors to use high doses of chemotherapeutic agents without the development of serious side effects. Chemoembolization leads to the destruction of the tumor or slowing down its progression.<\/p>\n\n<p style=\"text-align:justify\">After that, the catheter is removed from the artery. The doctor puts a vascular suture on the femoral artery and closes it with a sterile dressing. During chemoembolization, you will be awake. General anesthesia is not used, which significantly reduces the risks of the procedure and allows performing it on an outpatient basis, avoiding long hospital stay.<\/p>\n\n<p style=\"text-align:justify\"><strong>After the first procedure<\/strong>, you will stay under the supervision of an interventional oncologist and general practitioner. If necessary, you will receive symptomatic treatment. As a rule, a second chemoembolization procedure is performed in 3-5 days after the first one in order to consolidate the therapeutic effect. After that, you will receive recommendations for further follow-up and treatment.<\/p>\n<\/div><div class=\"program_required_documents mt-4\"><h4>Required documents<\/h4><ul>\n\t<li style=\"text-align: justify;\">Medical records<\/li>\n\t<li style=\"text-align: justify;\">MRI\/CT scan (not older than 3 months)<\/li>\n\t<li style=\"text-align: justify;\">Biopsy results (if available)<\/li>\n<\/ul>\n<\/div>","program_full_story_crm":"<ul>\n\t<li>Initial presentation in the hospital<\/li>\n\t<li>Clinical history taking<\/li>\n\t<li>Review of available medical records<\/li>\n\t<li>Physical examination<\/li>\n\t<li>Laboratory tests:\n\t<ul>\n\t\t<li>Complete blood count<\/li>\n\t\t<li>General urine analysis<\/li>\n\t\t<li>Biochemical analysis of blood<\/li>\n\t\t<li>Tumor markers<\/li>\n\t\t<li>Inflammation indicators (CRP, ESR)<\/li>\n\t\t<li>Coagulogram<\/li>\n\t<\/ul>\n\t<\/li>\n\t<li>Ultrasound\u200b scan<\/li>\n\t<li>CT scan \/ MRI<\/li>\n\t<li>Preoperative care<\/li>\n\t<li>Embolization or chemoembolization, 2 procedures<\/li>\n\t<li>Symptomatic treatment<\/li>\n\t<li>Cost of essential medicines<\/li>\n\t<li>Nursing services<\/li>\n\t<li>Elaboration of further recommendations<\/li>\n<\/ul>\n<div class=\"program_how_program_going mt-4\"><h4>How program is carried out<\/h4><p style=\"text-align:justify\"><strong>During the first visit<\/strong>, the doctor will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan, CT scan and MRI. This will allow the doctor to determine which vessels are feeding the tumor and its metastases, as well as determine how well you will tolerate the procedure.<\/p>\n\n<p style=\"text-align:justify\"><strong>Chemoembolization <\/strong>begins with local anesthesia and catheterization of the femoral artery. The thin catheter is inserted through a few centimeters long incision of the blood vessel. The doctor gradually moves the catheter to the vessel feeding the primary tumor or its metastases. The procedure is carried out under visual control, an angiographic device is used for this. The vascular bed and the position of the catheter in it are displayed on the screen of the angiograph.<\/p>\n\n<p style=\"text-align:justify\">When the catheter reaches a suspected artery, a contrast agent is injected through it. Due to the introduction of the contrast agent, the doctor clearly sees the smallest vessels of the tumor and the surrounding healthy tissues on the screen of the angiograph. After that, he injects emboli into the tumor vessels through the same catheter.<\/p>\n\n<p style=\"text-align:justify\">Emboli are the spirals or the liquid microspheres. The type of embolus is selected individually, taking into account the diameter of the target vessel. When carrying out chemoembolization, a solution of a chemotherapy drug is additionally injected into the tumor vessel. Due to the subsequent closure of the vessel lumen with an embolus, the chemotherapy drug influences the tumor for a long time. In addition, the drug does not enter the systemic circulation, which allows doctors to use high doses of chemotherapeutic agents without the development of serious side effects. 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Treatment of bladder cancer with embolization or chemoembolization in University Hospital Freiburg

University Hospital Freiburg

Freibung, Germany
Program id # 688854
Doctor photo
Prof. Dr. med. Christian Gratzke
Department of Adult and Pediatric Urology
Specialized in: adult and pediatric urology

The program includes:

  • Initial presentation in the hospital
  • Clinical history taking
  • Review of available medical records
  • Physical examination
  • Laboratory tests:
    • Complete blood count
    • General urine analysis
    • Biochemical analysis of blood
    • Tumor markers
    • Inflammation indicators (CRP, ESR)
    • Coagulogram
  • Ultrasound​ scan
  • CT scan / MRI
  • Preoperative care
  • Embolization or chemoembolization, 2 procedures
  • Symptomatic treatment
  • Cost of essential medicines
  • Nursing services
  • Elaboration of further recommendations

How program is carried out

During the first visit, the doctor will conduct a clinical examination and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the assessment of liver and kidney function, ultrasound scan, CT scan and MRI. This will allow the doctor to determine which vessels are feeding the tumor and its metastases, as well as determine how well you will tolerate the procedure.

Chemoembolization begins with local anesthesia and catheterization of the femoral artery. The thin catheter is inserted through a few centimeters long incision of the blood vessel. The doctor gradually moves the catheter to the vessel feeding the primary tumor or its metastases. The procedure is carried out under visual control, an angiographic device is used for this. The vascular bed and the position of the catheter in it are displayed on the screen of the angiograph.

When the catheter reaches a suspected artery, a contrast agent is injected through it. Due to the introduction of the contrast agent, the doctor clearly sees the smallest vessels of the tumor and the surrounding healthy tissues on the screen of the angiograph. After that, he injects emboli into the tumor vessels through the same catheter.

Emboli are the spirals or the liquid microspheres. The type of embolus is selected individually, taking into account the diameter of the target vessel. When carrying out chemoembolization, a solution of a chemotherapy drug is additionally injected into the tumor vessel. Due to the subsequent closure of the vessel lumen with an embolus, the chemotherapy drug influences the tumor for a long time. In addition, the drug does not enter the systemic circulation, which allows doctors to use high doses of chemotherapeutic agents without the development of serious side effects. Chemoembolization leads to the destruction of the tumor or slowing down its progression.

After that, the catheter is removed from the artery. The doctor puts a vascular suture on the femoral artery and closes it with a sterile dressing. During chemoembolization, you will be awake. General anesthesia is not used, which significantly reduces the risks of the procedure and allows performing it on an outpatient basis, avoiding long hospital stay.

After the first procedure, you will stay under the supervision of an interventional oncologist and general practitioner. If necessary, you will receive symptomatic treatment. As a rule, a second chemoembolization procedure is performed in 3-5 days after the first one in order to consolidate the therapeutic effect. After that, you will receive recommendations for further follow-up and treatment.

Required documents

  • Medical records
  • MRI/CT scan (not older than 3 months)
  • Biopsy results (if available)

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About the department

The Department of Adult and Pediatric Urology at the University Hospital Freiburg offers the full range of services in the field of diagnostics and treatment of diseases and malformations of the kidney, bladder, urinary tract and prostate gland. Of particular interest are prevention, early detection and treatment of functional disorders, infectious and inflammatory processes, benign changes in the male genitalia, as well as interdisciplinary treatment of urologic cancers. In addition, the department’s specialists have extensive experience in the field of reconstructive surgery. The department provides care for patients of all age groups, from infants to very elderly people. The department is headed by Prof. Dr. med. Christian Gratzke.

It goes without saying that one of the key focuses of the department is prevention, diagnostics and treatment of prostate cancer. All necessary specialists, including urologists, radiation therapists, oncologists, radiologists, nuclear medicine doctors, rehabilitologists, etc. work together to treat this pathology. Therapy is carried out in accordance with the international guidelines of specialized societies and in close cooperation with the Comprehensive Cancer Center Freiburg. To effectively combat prostate cancer, doctors use innovative treatments that directly affect the tumor without damaging healthy tissues and preserving its maximal functionality. Such methods include, in particular, targeted radiation therapy and cryotherapy. If the patient is indicated surgical treatment, preference is always given to sparing (minimally invasive) surgical techniques.

The service range of the department includes:

  • Andrology
    • Erectile dysfunction. The main treatment methods include medication therapy (four different PDE-5 inhibitors), intracavernous injections, the use of vacuum pumps, installation of penile implants.
    • Peyronie's disease. In the treatment of this disorder, preference is given to surgical intervention, while a new treatment method with enzyme preparations (Xiapex®) is also effective.
    • Premature ejaculation. The main treatment methods include special ejaculation delaying pills, excitability threshold lowering measures (for example, use of local anesthetics or special condoms), behavioral therapy/sexual therapy, medication therapy with PDE-5 inhibitors.
    • Testosterone deficiency syndrome (hypogonadism). In most cases, testosterone replacement therapy is prescribed.
    • Varicocele. The most commonly used methods are endovascular obliteration of the testicular vein, surgical removal of the enlarged testicular veins (microsurgical methods).
    • Male infertility (identification of the causes of infertility and selection of appropriate methods of modern reproductive medicine, for example, testicular sperm extraction).
    • Sex reassignment surgery (male becomes female).
    • Vasectomy (male sterilization).
    • Vasovasostomy (surgery intended to restore fertility).
  • Urologic oncology
    • Diagnostics and treatment of benign and malignant tumors of the genitourinary system (kidneys, bladder, prostate, penis)
  • Diagnostics and treatment of urinary incontinence in men and women
  • Minimally invasive treatment of urologic diseases and urolithiasis therapy
    • Laparoscopy
    • Endoscopy
    • Laser surgery (for example, the use of a holmium laser to treat benign prostatic hyperplasia: holmium laser enucleation of the prostate)
    • Shock wave therapy (a stone breaking method)
    • Innovative UroLift® procedure for treating benign prostate hyperplasia (BPH) – implantation of small tissue retractors into the prostate that restore normal urination
    • Other treatment methods
  • Reconstructive urology
    • Implant surgery for erectile dysfunction (penile cavernous body implant)
    • Installation of a special implant in urinary incontinence (artificial sphincter or special systems for sphincter replacement)
    • Reconstructive interventions in the prolapse of the female pelvic organs
    • Surgery to treat hypospadias and epispadias
    • Urethral stricture surgery (endourological and open interventions for urethral reconstruction, urethroplasty with the patient's own tissues, for example, buccal mucosa)
    • Reconstructive interventions to correct other defects in the external genital area (for example, penile curvature correction)
    • Surgery in ureteral obstruction (endoscopic, laparoscopic and open interventions
    • Other reconstructive operations
  • Diagnostics and treatment of pediatric urologic diseases
    • Hydrocele
    • Vesicoureteral reflux
    • Hypospadias
    • Ureteral stenosis
    • Duplex kidney
    • Ureterocele
    • Obstructive megaureter
    • Urethral valves
    • Kidney stones
    • Cancers (nephroblastoma, rhabdomyosarcoma)
    • Other pediatric urologic pathologies
  • Other diagnostic and therapeutic options

Curriculum vitae

​Since November 2018, Prof. Dr. med. Christian Gratzke has been the Professor of Urology at the Faculty of Medicine at the University of Freiburg, as well as the Head of the Department of Adult and Pediatric Urology.

Prof. Gratzke studied medicine in Munich and Vienna. The doctor underwent clinical training at Ludwig Maximilian University of Munich. Here he also had his habilitation and took the position of the Leading Senior Physician in the Department of Urology. His clinical focuses include the diagnostics and treatment of prostate cancer and benign prostatic hyperplasia. The focus is on new minimally invasive methods, such as robotic laparoscopic surgery of the prostate and kidney.

The professor is also actively engaged in research activities. He conducted research at Wake Forest University (USA) and at Lund University (Sweden), which were funded by the German Research Foundation. His scientific work is focused on the individual treatment of prostate cancer, the use of new methods and systemic therapy in the treatment of localized, but, above all, progressive prostate cancer. In addition, the doctor is engaged in the study of new forms of therapy and the search for new approaches for the treatment of impaired bladder emptying.

Photo of the doctor: (с) Universitätsklinikum Freiburg


About hospital

The University Hospital Freiburg is famous for its rich history and is one of the oldest and most prestigious medical facilities in Germany (one of the three best medical institutions in the country). The hospital was based on the Faculty of Medicine of the Albert Ludwig University of Freiburg, which celebrated its 550th anniversary in 2007. It should be noted that the hospital is proud of its world-renowned specialists, many of whom during their work here have become Nobel laureates.

The medical facility represents all fields of modern medicine. It consists of 42 departments, 11 institutes and 10 interdisciplinary centers. The highly qualified doctors of the hospital deal with the treatment and rehabilitation of patients with both common and rare diseases. All departments and institutes of the hospital take an active part in fundamental researches of international scale, due to which patients have access to the very latest achievements of medicine, advanced diagnostic methods, state-of-the-art medical equipment and proven effective methods of therapy.

The hospital has a variety of medical achievements, for example, the world's first TIPS procedure, the first implantation of the Jarvik-2000 artificial heart in Europe, the first robotic-assisted surgery on the brain, and the first combined cardiopulmonary transplantation in the land of Baden-Württemberg. In 2004, the University Hospital Freiburg became the first German hospital, which performed kidney transplantation in the incompatibility of blood groups. At the moment, the hospital belongs to medical centers with the greatest experience in performing such an operation.

An interdisciplinary approach to treatment, highly qualified staff, as well as individual patient care and a pleasant environment are key to the hospital’s success.

Photo: (c) depositphotos

Accommodation in hospital

Patients rooms

The patients of the hospital are provided with comfortable rooms with a pleasant design, which create a conducive atmosphere for recovery. The standard furnishing of the patient room includes a telephone, a free radio and TV, a device for calling medical staff, lockers and a safe, an adjustable bed, a chair and a table. The pediatric departments are designed with play areas. The patient may be accommodated in a single or double enhanced-comfort room (for example, with an ensuite bathroom) at an additional cost.

Meals and Menus

The patients are offered good three meals a day with a large selection of dishes. The patients inform about their wishes to the menu in advance, and this information is transmitted to the kitchen. Throughout the day, patients may drink mineral water and tea, which can be found in the department on special tables. The bedridden patients receive drinks from the nursing staff. Other drinks may be purchased at the hospital’s cafeterias and bistro, where patients can come along with visitors.

If you do not eat some products due to intolerance or other personal reasons, please notify the nursing staff in advance, so that all your wishes to be taken into account when preparing the menu.

Further details

Standard rooms include:

Shower
Toilet
TV
Wi-Fi

Television

All patient rooms have a free radio and TV. The patients can also watch the hospital’s own 24-hour channel with a varied program and interesting information.

Accompanying person

At the availability of free beds, the accompanying person may be accommodated in the same room with the patient, at an additional cost. In addition, the hospital offers special accommodation conditions for patients requiring long-term hospitalization. Parents have at their disposal special apartments in the children's hospital.