Surgical ureteral cancer treatment with transurethral tumor excision in University Hospital Greifswald

About the department

The Department of Urology and Andrology at the University Hospital Greifswald offers the full range of medical services for the treatment of diseases of the organs of the reproductive system in men as well as urinary system pathologies in men and women. In addition, men with erectile dysfunction, infertility, and hormonal imbalances are treated here. The key focus of the work of the department's doctors is the treatment of prostate, testicular, penile, kidney, and bladder cancers. The medical facility is certified as a Urologic Oncology Center in accordance with the standards of the German Cancer Society (DKG), which indicates the excellent quality of treatment and its high success rates. The department's specialists have a perfect command of modern laparoscopic techniques and laser technologies, which allow them to perform treatment with minimal tissue trauma. The team of doctors at the medical facility devotes enough time to personal communication with the patient and always strives to carry out treatment in the most comfortable conditions for the patient. Many minor interventions and therapeutic procedures are performed on an outpatient basis without the need for hospitalization, which is an additional advantage.

The Head Physician of the department is Prof. Dr. med. Martin Burchardt, who has proven himself as a top-class expert at the national and international levels. He is the co-author of the current S3 guideline for prostate cancer treatment of the German Society of Urology. The specialist actively participates in the work of professional urology societies.

The department's particular specialty is prostate cancer treatment. This type of cancer is one of the most common in men. A complete cure for prostate cancer can be achieved in the early stages, when the tumor is localized and does not spread beyond the organ capsule. When metastases spread, the therapeutic process becomes complex, and in most cases, doctors manage to achieve a long-term remission but not a complete cure. Since the oncological disease is asymptomatic in its early stages, the department's doctors strongly recommend patients over 45 undergo an annual PSA test, which is the first-line screening for prostate cancer. If the test results are abnormal and cause concern for the doctor, the man may be advised to undergo a prostate biopsy. The procedure is performed on an outpatient basis under local anesthesia. Since 2019, the department has also been performing modern MRI fusion biopsies. For localized prostate cancer, the main treatment is surgery or external beam radiation therapy. It is possible to undergo a surgical resection of a prostate tumor using robot-assisted techniques in the department. In the advanced stages of the oncological process, drug therapy methods come to the fore, including hormone therapy, chemotherapy, immunotherapy, radionuclide therapy, etc.

Since 2012, the department has had the status of a certified Prostate Cancer Center with a certificate from the German Cancer Society. The certified medical facilities of this kind in Germany are considered the best choice for patients with cancer, as highly qualified specialists and advanced treatment methods are available here and excellent therapeutic results are regularly achieved.

The department also admits patients with kidney cancer. Like most cancers, kidney cancer does not cause any symptoms in the early stages, so it is often detected during an ultrasound scan for another problem. After that, CT or MRI scans and scintigraphy scans may be required. A complete blood count and a urinalysis are also performed. The first-line treatment for localized kidney tumors is a partial or total resection of the organ, depending on the size of the neoplasm. The department's doctors perform both interventions using minimally invasive techniques, thanks to which patients recover in the shortest possible time and have a low risk of surgical complications. Patients with metastatic kidney cancer are usually recommended for immunotherapy or targeted therapy with angiogenesis inhibitors.

Another focus of the department's clinical practice is medical care for patients with bladder cancer. If this pathology is suspected, the diagnostics include ultrasound scans, cystoscopy, contrast-enhanced X-ray scans, and laboratory tests. Transurethral resection is the main treatment for superficial bladder tumors. Nevertheless, patients with advanced tumors that have invaded the muscular layer of the bladder require total removal of the organ. If the bladder is completely removed, an orthotopic neobladder will be formed after surgery, or urine will be diverted through the ileal conduit. Surgery may be supplemented with chemotherapy, immunotherapy, radiation therapy, and other methods.

The department's medical team successfully treats benign urologic diseases. Benign prostatic hyperplasia is one of the most common among them. The pathology is manifested by the overgrowth of prostate tissue and its significant increase in size. The main manifestation of the disease is a urinary disorder. In some cases, acute urinary retention may develop, requiring emergency treatment. In the early stages of prostate adenoma, the department's doctors use only drug therapy, and in the advanced stages, it is often impossible to do without surgery. The department's specialists perform transurethral resection of the prostate or thulium laser enucleation of the prostate (ThuLEP). The optimal type of intervention is selected depending on the patient's clinical case. The department's urologists perform operations for benign prostatic hyperplasia using minimally invasive techniques.

The department's specialists in andrology provide consultations for men with erectile dysfunction, infertility, hormonal imbalances caused by age-related changes, and other pathologies in this spectrum. As a rule, patients with such disorders receive individually selected drug therapy.

The department's main clinical activities include:

• Diagnostics and treatment of malignant urologic diseases
  • Prostate cancer
  • Testicular cancer
  • Penile cancer
  • Kidney cancer
  • Bladder cancer
• Diagnostics and treatment of benign urologic diseases
  • Benign prostatic hyperplasia
  • Kidney stone disease
  • Urethral stricture
  • Phimosis
  • Hydrocele
  • Urinary incontinence
• Diagnostics and treatment of andrologic pathologies
  • Erectile dysfunction
  • Male infertility
  • Hormonal imbalances due to age-related changes in men
  • Sexual disorders due to diseases of the reproductive system and their treatment
• Diagnostics and treatment of other diseases

The department's range of surgical services includes:

• Endourological interventions
  • Transurethral resection, including laser therapies
    • Transurethral resection of the prostate (TURP), including laser one
    • Bladder neck resection using Turner Warwick procedure
    • Transvesical enucleation of prostate adenoma
    • Transurethral resection of the bladder
  • Endoscopic procedures for urinary system diseases
    • Extracorporeal shock wave lithotripsy
    • Ureterorenoscopy (semi-rigid and flexible)
    • Percutaneous nephrolitholapaxy
    • Lithotripsy for bladder stones
    • Ureteral splinting (for example, a double J stent)
    • Percutaneous nephrostomy
• Laparoscopic interventions
  • Laparoscopic removal of the prostate gland
  • Laparoscopic removal of the kidney (nephrectomy): total and partial
  • Laparoscopic plastic repair of the kidney pelvis
  • Laparoscopic nephropexy
  • Laparoscopic removal of a kidney cyst
  • Ureteral intraperitonealization (for Ormond's disease)
  • Laparoscopic removal of the kidneys and ureters (nephroureterectomy)
  • Laparoscopic removal of the adrenal glands (adrenalectomy)
• Classic open interventions
  • Abdominal operations
    • Open nerve-sparing radical prostatectomy
    • Cystectomy using modern types of urinary diversion
    • Open nephrectomy
    • Open surgery to remove retroperitoneal lymph nodes
  • Operations on the external male genitalia
    • Open orchiectomy
    • Open penectomy: total and partial
    • Open testicular prosthetic repair
    • Open surgery for hydrocele
    • Open surgery for spermatocele
    • Open surgery for varicocele
    • Open plastic repair of the frenulum of the foreskin
    • Vasectomy
    • Vasovasostomy
    • Circumcision
• Reconstructive interventions
  • Urethroplasty: open and endoscopic techniques
  • Implantation of an artificial urethral sphincter (Scott-Sphincter®, Flow Secure®)
  • Ligament implantation for urinary incontinence (TOT, Advance®)
  • Ureter formation (Boari flap procedure, Psoas Hitch procedure)
  • Penile curvature repair in patients with Peyronie's disease
• Other surgical options