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Urology


Urinology is a sphere of clinical medicine dealing with diseases of urinary organs, male reproductive system, and developing their treatment modes and preventive measures.

Diagnostics.

GHCA urological clinics propose all up-to-date urological diagnostic techniques.

Nuclear Magnetic Resonance Imaging (NMRI).

Distinguishing and diagnostics of extension of prostate gland carcinoma at the early stages is performed in GHCA clinics by means of nuclear magnetic resonance imaging and prostate gland biopsy carried out under control of NMRI. Moreover, for diagnostics of extension of muscle-invasive carcinoma of urinary bladder or prostate gland carcinoma one uses high-strung FDG-positron emission tomography (PET/CT) as well as PET/CT with choline.

Transrectal Histoscanning Ultrasonography.

Transrectal Histoscanning Ultrasonography is one of gentle methods of diagnostics. By means of this newest based on the application of ultrasound method can exactly determine a position and sizes of prostate gland tumoral areals (solid organs). With the help of special software support through which one can acquire access to the data according to the findings of investigation of over 10 thousand tumors; suspicious areals existing in prostate gland are distinguished and marked with color.

Incontinence of Urine Diagnostics.

When diagnosing incontinence of urine in GHCA clinics one uses such standard methods as pressure measurement in urinary bladder (urodynamics), including analysis of pressure zones, pharmacological testing, X-ray analysis of the lower part of urinary system (urinary bladder and urethra) using contrast agent (for example, cystoradiogram, voiding cystography, urethogram), ultrasonography of upper and lower parts of urinary system, urethra measurement, urinary bladder and vagina endoscopy.

Therapeutic Methods.

A range of services of GHCA urological clinics along with up-to-date methods of treatment of benign diseases of prostate gland include laser surgery, cover minimally aggressive treatments of kidney and ureter stones as well as chemotherapy in case of urological tumors. Specialists of GCA clinics have sufficient experience in the field of replacement of urinary bladder with parts of intestine of own body (neo-bladder), if it is necessary to excise it because of cancerous diseases.

Treatment of carcinoma of the prostate.

A significant place is taken by the treatment of carcinoma of the prostate. The most frequently used therapeutic method when treating carcinoma of the prostate is its radical operational intervention. The second important therapeutic method having chances of successful treatment is considered to be radiation exposure. In this case high energy radioactive emission is directed immediately at the tumorous tissues. As a consequence cell nucleuses are damaged in such a way that the cancer cells cannot reproduce anymore and die away. The radiation has the same influence with the healthy cells as with the cancerous cells. However, today the radioactive rays can direct exactly towards the target, thereby, predominantly, the cancerous cells are destroyed. and surgery give comparable chances for recovery and side effects.

Usually, there are two kinds of radiation exposure:
  • Radiation exposure from outside through the skin ("subdermal radiation treatment").
  • Radiation exposure from inside ("brachytherapy").
The radiation exposure from inside is possible in case of very high dose of radiation (high-dose brachytherapy). The sources of radiation can be injected also in the prostate gland where they during a long period of time deliver a dose of radiation of low intensity (Low dose, "Low-Dose-Rate", therefore, low-dose brachytherapy).

Another alternative method is so caked HIFU-method (high-intensity focused ultrasound ablation) according to the method of Sonablate 500 system, where HIFU maintains high-intensity focused ultrasound. This method allows individually for every patient to match a scheme of treatment and intentionally provide treatment of infected tissues. Together with sophisticated methods of treatment of all prostate gland it is possible also a partial organ preservation treatment.

Kidney and ureter stones.

In case of kidney and ureter stones one uses gentle shock-wave therapy, due to which the kidney stones are destroyed and eliminated "naturally". So called ESWT (extracorporal shock-wave therapy) is controlled by the radio or ultrasonic waves. Where it is possible ESWT is limited, up-to-date endoscopic methods of maximum reliable removal of deposits of calculus come to help. Due to the combination of moving devices and laser probes the stones treatment can be performed in place in the pelvis of kidney that was almost impossible until quite recently. In case of big kidney stones one performs minimal invasive surgery of kidney (percutaneous nephrolithotomy). Meanwhile, kidney stones can be removed through a small side cut (about 1 cm).
  • Professor Dr. Thomas-Alexander Voegeli, MD.
  • Alfried Krupp Hospital.
  • Duisburg Clinic.
  • St. Maria Hospital (D).
  • St. Maria Hospital (G).
  • Aachen Region Medical Center.