Urology

Policlinico San Donato

key figures 

CLINICAL SERVICES:

  • Referral centre for thulium laser endoscopic treatment of benign prostatic hyperplasia with an experience of more than 900 surgeries performed since 2012
  • Training centre for thulium laser surgery with regular courses for urologists from all over the world
  • Training centre for endoscopic treatment of urinary stones
  • Robotic surgery centre for treatment of prostate and kidney cancer
  • Centre for treatment of urinary tract cancers with endoscopic, laparoscopic and open approach
  • Referral centre for treatment of paediatric urinary stone diseases
  • Regional referral centre for long term follow-up of urinary malformations
  • Laser treatment of female low urinary tract symptoms with Youlaser MT (Quanta System)

PROCEDURES PERFORMED PER YEAR:

  • Laparoscopic Adrenalectomy
  • Partial Nephrectomy
  • Laparoscopic Nephrectomy
  • Nephrectomy open
  • Laparoscopic Nephroureterectomy
  • Robot assisted pieloplasty
  • Retrograde intrarenal surgery
  • Percutaneous nephrolitomy
  • Bladder lithotripsy
  • Ureterorenoscopy for upper tract carcinoma
  • ULL
  • Ureteral stenting
  • Cystectomy
  • Transurethral resection of bladder cancer
  • ThuVep
  • Robotic Radical Prostatectomy
  • Robotic Open Prostatectomy
  • Orchiectomy
  • Uretrotomy
  • Circumcision

The activity of urology department is focused on the treatment of malignant and benign diseases using endoscopic, laparoscopic, robotic or open approaches, tailoring every approach on the single patient.

Clinical activities include:

  • Specialist medical examinations (urological and andrological)
  • Diagnostic procedures (ultrasound exams of the urinary tract, cystoscopy, trans-rectal ultrasound of prostate, uroflowmetry, ultrasound and MRI-guided prostate biopsy)
  • One Stop Clinic Haematuria (for early diagnosis of bladder cancer)

The Policlinico San Donato Hospital is a centre for the Medicine Department of the University of Milan. The department is a residency training centre for young urologists from University of Milan.

 

treatmentS

Benign Prostatic Hyperplasia

Benign prostatic hyperplasia or Hypertrophy (BPH) is one of the most common diseases in men. It occurs in 30% of patients over the age of 60 with the onset of urinary disorders (weak urine stream, difficulty starting it, frequent, urgent and night-time urination, frequent infections); in severe cases, it is even necessary to adopt a bladder catheter in order to help the patient who cannot urinate. In the early stages, BPH is treated with medication (Tamsulosin, alfuzosin, silodosin, Dutasteride, etc.); however, when the drug therapy fails, surgery is recommended. Today many alternative techniques are available: one of the most safe and convenient, is the thulium laser transurethral prostatectomy (THULEP). Thulium laser enucleation of the prostate (THULEP) is an endoscopic technique: this means that it does not require incisions, because the surgical instrument is inserted through the penis. The aim of this procedure is to reduce the urinary and obstructive symptoms due to the enlargement of the prostate, which causes problems to the emptying of the bladder. It is an innovative technique that allows to reduce postoperative complications and to obtain an early discharge.

Kidney Stones

Kidney stones are deposits of minerals and salts along the urinary tract, especially the kidneys and the ureter. Passage of renal stones along the urinary tract is usually not perceived but if their diameter gets bigger their migration can be painful.

Kidney stones often have no single cause; although several factors may increase risk of developing the disease. Known risk factors are: family history, dehydration, diet, obesity, digestive diseases and surgery, particular medical conditions (renal tubular acidosis, cystinuria, hyperparathyroidism).

The most common symptoms that can be experienced are: severe waving pain on the sides and back, that usually radiates to the genitals, pain during urination, haematuria, vegetative symptoms (nausea and vomiting).

During acute symptoms, if not treated, renal stones can lead to loss of renal function or severe urinary tract infections.
The spectrum of therapy is very broad, depending on the single clinical stage, it includes pain killers and drinking lots of water to encourage the stone expulsion, but in some cases the treatment is surgical.

Main Pathologies Treated:

  • Renal lithiasis
  • Ureteral lithiasis
  • Bladder lithiasis

Top Procedures:

  • RIRS
  • ULL
  • PCNL
  • Bladder lithotripsy

Robotic Radical Prostatectomy

Robotic prostate surgery, or robotic prostatectomy, or Robot- Assisted laparoscopic radical prostatectomy (RARP or RALP), has become in recent years a possible option for patients who have to undergo surgery for prostate cancer. Scientific literature has now demonstrated that, in terms of healing, the results of open prostatectomy and robotic prostate surgery (RALP) are stackable. However, robotic surgery offers significant advantages since it preserves the functions of the prostate, shortens the time of hospitalisation and convalescence, limits blood loss and the size of the surgical wound. The new robotic technique allows performing the same actions of the surgeon's hand directly or through laparoscopic instruments. The view is, however, enlarged, close and three- dimensional, and the surgeon has 7 degrees of freedom of movement, that allow him to operate even in very confined spaces. This ensures greater accuracy in identifying the structures and permits to intervene on dissection planes that with other techniques are less visible. The surgeon can be very precise in the demolishing phase of the intervention, in order to preserve nerves and vessels, thereby reducing the intraoperative blood loss.

 

NOTABLE ADVANCED TECHNOLOGICAL EQUIPMENT

  • DaVinci Robotic Surgery System
  • Quanta System Thulium laser
  • Quanta System Holmium laser