Department of Adult and Pediatric Urology, Andrology - University Hospital Hamburg-Eppendorf

About the Department of Adult and Pediatric Urology, Andrology at University Hospital Hamburg-Eppendorf

According to the Focus magazine, the Department of Adult and Pediatric Urology, Andrology at the University Hospital Hamburg-Eppendorf is one of the best medical facilities in Germany for prostate cancer treatment! 

The department provides effective treatment for the entire spectrum of diseases of the urinary tract and male reproductive system in accordance with the highest medical standards. Patients of all ages, from newborns to the elderly, can receive medical care. The department's primary specialty is reconstructive urology: surgeons perform reconstructive urethral plastic surgery, artificial sphincter and synthetic tape (sling) implantation surgery to treat urinary incontinence, reconstructive penile plastic surgery to correct congenital and acquired defects, and penile prosthetics for erectile dysfunction. An equally important focus of the urology team is the surgical treatment of oncologic diseases such as bladder, kidney, adrenal, prostate, testicular, and penile cancer. Almost all surgical procedures to treat cancer are performed using minimally traumatic microsurgical and robot-assisted techniques – the department's urologists have the innovative da Vinci system at their disposal. Tumor drug therapy is provided in cooperation with specialists at the Cancer Center Hamburg. The department is a certified Urologic Oncology Center of the German Cancer Society (DKG). It is also one of the leading centers for pediatric urology in Germany and has the status of a certified training center for physicians of the European Society for Pediatric Urology (ESUP). The Head Physician of the department is Prof. Dr. med. Margit Fisch.

Reconstructive urology occupies a central place in the clinical practice of the department. The therapeutic offer in this area includes operations for strictures of the urethra, ureters, and ureteropelvic junction, surgery to create alternative urinary outflow pathways, interventions to implant an artificial sphincter, sling procedures, reconstructive plastic surgery, and penile prosthetics. The department performs more than 220 operations for urethral stricture each year. It should be noted that the medical facility has the status of a Reference Center for Urethral Reconstructive Surgery that uses progressive methods for the treatment of urethral conditions. Urethral stricture is a pathological narrowing of the anterior segment of the urethra. The disease is most common in men. The main symptoms are difficult and painful urination, a feeling of incomplete emptying of the bladder, and frequent urinary tract infections. The department's team of urologists successfully performs urethral reconstructive surgery using endoscopic and classical open techniques. Whenever possible, internal optical urethrotomy is performed. This is the least invasive procedure in which doctors use endoscopic equipment in combination with a laser or other energy source. The hospital stay after optical internal urethrotomy is only 2 days. In complex clinical cases, open urethroplasty is performed using autografts of the oral mucosa or a skin graft from the lateral thigh to replace the removed tissue of the urethra. Another option for open surgery to treat urethral stricture is urethroplasty with an end-to-end anastomosis, which does not require the use of autografts. These surgeries require the patient to stay in the hospital for at least 5 days. The optimal type of reconstructive urethral plastic surgery for the patient is determined after a thorough study of the medical history and diagnostic results.

The department's team of urologists also has excellent qualifications in the treatment of oncological diseases of the urinary system and male genital organs, in particular, bladder, kidney, prostate, testicular, and penile cancers. Prostate cancer is the most common oncopathology in men, in most cases developing after the age of over 60. In the early stages, there are usually no symptoms, so the department's specialists recommend regular preventive examinations, because there is a high chance of recovery with early detection of prostate cancer. The first stage of the diagnostic process includes the PSA (prostate-specific antigen) test, digital rectal examination, and transrectal ultrasound. If the results are unsatisfactory, a prostate biopsy, MRI, CT, PET/CT with PSMA, and skeletal scintigraphy may be performed. Treatment tactics are determined on an individual basis by an interdisciplinary tumor board. The first-line treatment is usually prostatectomy. For localized prostate cancer, it is also possible to destroy the tumor with cryotherapy or high-intensity focused ultrasound (HIFU). However, surgery is often not enough to completely defeat prostate cancer: in cooperation with oncologists, patients are prescribed chemotherapy, hormone therapy, and radiation therapy (external and/or internal). It is noteworthy that the doctors of the department work closely with the Martini Urology Clinic in Hamburg, where more than 2,600 prostate cancer operations are performed every year – this is the largest and leading center for prostate cancer treatment in the international medical arena.

In the field of pediatric urology, the treatment of congenital and acquired diseases of the genitourinary tract in children is of special interest to the specialists of the medical facility. The department provides qualified medical care to young patients with renal pelvis stenosis, vesicoureteral reflux, megaureter, urethral malformations, hypospadias, cryptorchidism, urinary tract infections, enuresis, and other conditions. Doctors of the department have at their disposal all modern conservative and surgical methods for the effective treatment of urological diseases in children.

The department also provides a wide range of andrological services. The healthcare facility offers modern methods of treatment of erectile dysfunction, ejaculation disorders, orgasm disorders, male hormonal disorders, Peyronie's disease, congenital penile curvature, and male infertility. Almost all of the above conditions respond well to conservative therapy. However, cooperation with a psychologist is often necessary, for example, in the case of erectile dysfunction. The department has extensive experience in performing MESA (microsurgical epididymal sperm aspiration) and TESE (testicular sperm extraction) procedures to treat female infertility.

The main areas of the clinical practice of the department are as follows:

• Urology
  • Diagnostics and treatment of general urological diseases
    • Diagnostics and treatment of urethral, ureteral, and ureteropelvic junction strictures
    • Diagnostics and treatment of urinary incontinence
    • Diagnostics and treatment of urolithiasis
    • Diagnostics and treatment of benign prostatic hyperplasia
    • Diagnostics and treatment of urological diseases in children
      • Diagnostics and treatment of renal pelvis stenosis
      • Diagnostics and treatment of vesicoureteral reflux
      • Diagnostics and treatment of megaureter
      • Diagnostics and treatment of urethral malformations
      • Diagnostics and treatment of hypospadias
      • Diagnostics and treatment of cryptorchidism
      • Diagnostics and treatment of urinary tract infections
      • Diagnostics and treatment of enuresis
  • Diagnostics and treatment of urological cancers
    • Diagnostics and treatment of bladder cancer
    • Diagnostics and treatment of kidney cancer
    • Diagnostics and treatment of prostate cancer
    • Diagnostics and treatment of testicular cancer
    • Diagnostics and treatment of penile cancer
• Andrology
  • Diagnostics and treatment of erectile dysfunction
  • Diagnostics and treatment of ejaculation problems
  • Diagnostics and treatment of orgasm disorders
  • Diagnostics and treatment of hormonal imbalances in men
  • Diagnostics and treatment of Peyronie's disease
  • Diagnostics and treatment of congenital penile curvature
  • Diagnostics and treatment of male infertility
• Other medical services

The department's therapeutic services include the following:

• Conservative treatment
  • Drug therapy for general urological diseases
  • Conservative therapy for malignant urological diseases
    • Chemotherapy
    • Hormone therapy
    • Radiation therapy (external and internal)
• Surgical treatment
  • Minimally invasive surgery
  • Endoscopic surgery
  • da Vinci robot-assisted surgery
  • Removal of prostate malignancies using cryotherapy or high-intensity focused ultrasound (HIFU)
  • Holmium laser enucleation of the prostate (HoLEP) for prostate adenoma
  • Rezum steam ablation for prostate adenoma
  • Ureterorenoscopy and percutaneous nephrolithotripsy for urolithiasis
• Other treatment methods