Urological and Andrological Surgery

MediClinic’s Urological and Andrological Surgery service provides the most modern and advanced surgical options for the treatment of urological and andrological conditions. The proposed treatments are chosen according to the guidelines established by the most authoritative international scientific societies. All procedures are performed in modern operating rooms by qualified professionals with many years of experience.

In particular, the MediClinic Urological and Andrological Surgery team provides health services such as:

• non-invasive urological and andrological diagnostics
• minimally invasive urological diagnostics
• urological and andrological surgery
• treatment and prevention of kidney, bladder, prostate, erectile dysfunction and male infertility diseases.

Who could benefit from this service?

MediClinic’s Urological and Andrological Surgery is aimed at patients complaining of irritative or obstructive symptomatology of the upper and lower urinary tract, couple infertility and erectile dysfunction. These patients are advised to undergo a urological and andrological check-up, in particular, the most frequent symptoms and signs that are subjected to the examination by the urologist and andrologist are summarized in the list below:

Painful urination
Difficulty urinating
Night urination (Nocturia)
Blood in the urine
Renal colic
Incontinence
Sexual dysfunction
Infertility
Testicular pain
Inflammation of the external genitalia.

The diagnosis is obtained with the top-notch diagnostic imaging systems and minimally invasive endoscopic examinations performed by the specialist.

In the diagnostic field, MediClinic urology and andrology specialists perform the following tests:

• 3D ultrasound
• Uroflowmetry (non-invasive examination performed to determine the degree of obstruction of urinary flow through the lower urinary tract)
• Color Doppler Ultrasound for the diagnosis of varicocele or erectile function
• Dynamic Color Doppler Ultrasound for the diagnosis of erectile function
• Prostate ultrasound with endocavitary probe
• Cystoscopy with flexible and integrated Full HD camera Spice system. This innovative cystoscopy system allows the specialist to explore the bladder in detail and to highlight areas suspected of neoplasm with greater certainty compared to the traditional systems.

Treatments

All MediClinic treatments are minimally invasive and undergo a continuous improvement thanks to the ongoing scientific research, a peculiar characteristic of the clinic.

Laser therapy

Laser therapy is a cutting-edge treatment in the urological field. This technique uses a safe laser, which causes few postoperative irritations. Treatment with the contact laser technique is preferable to the traditional endoscopic techniques for the following reasons:

• Very low invasiveness
• prompt and rapid resumption of normal daily life in the postoperative period
• complete absence of bleeding during surgery
• maintenance of sexual functions.

The team has developed an “Ejaculation Sparing” technique that can maintain the ejaculation after surgery in about 80% of cases unlike traditional techniques or the Holmium Laser which almost never manages to preserve it.

The use of Laser in Urological Surgery is also applicable in the endoscopic treatment of urethral strictures with reduced risk of recurrence. Some conditions affecting the external genitalia successfully benefit from the use of the Laser, in particular:

• Condylomatosis from HPV
• Lichen Sclerosus
• Early stage penile cancers.

Varicelectomy with microsurgical technique

Varicocele, which most often affects the left testicle, but sometimes the right testicle or both, is a very frequent condition in young people and athletes. It causes male infertility in about 25% of cases and sometimes testicular pain. In both cases it is necessary to correct it. The traditional surgery consists of the ligation and section of the spermatic vein, with the incision of muscles and muscle fascia. The most frequent complication is hydrocele, caused by the ligation of the small lymphatic vessels that run adhering to the venous wall or in the peri-venous loose cellular tissue. This surgical procedure shows an incidence of complications that in some cases reaches 45% of cases. The microsurgical technique involves a sub-inguinal incision, which, not having to incise muscles and muscle fascia, allows a faster recovery. In practice, a few days after surgery, the patient can resume the normal physical activities. Furthermore, the microsurgery allows a fine dissection of all the elements of the spermatic cord, thus minimizing the complication of hydrocele to save the lymphatic vessels, and reducing the recurrence index to about 1%, since it allows to identify the binding and dissection of even the smallest venous vessels, which cannot result in a relapse.

Penis prosthesis implant on an outpatient basis

The penile prosthesis implant, for the treatment of erectile deficit unresponsive to any type of medical therapy, represents the only therapeutic possibility to definitively solve the problem. The technique is now codified both for the implantation of single-component prostheses (i.e. with the simple intracavernous cylinder) and for the more sophisticated three-component which in addition to the intracavernous cylinders are composed of a tank that must be inserted in the prevesical space, and an activator that is inserted in the scrotum.

Two essential elements for a successful implantation are a team of professionals with expertise in the implantology and a structure equipped with adequate operating rooms, both elements are available at MediClinic. The most fearsome complication for this type of surgery is represented by the rejection of the prosthesis due to infection. Today the complication rate does not represent more than 3% of cases.

The recovery time ranges between eight and 15 days.

Artificial sphincter implant on an outpatient basis

The MediClinic surgical group is able to perform the surgical implant of the most modern sphincters, less demanding both from the surgical point of view and also in regards to the functional recovery of a normal urination. The most feared complications, as in all prosthetic implants, are rejection (due to implant infection) and erosion.

Morphofunctional penile surgery for congenital or acquired recurvatum (La Peyronie’s disease)

La Peyronie’s disease can be addressed with minimally invasive techniques that allow for rapid recovery. The different techniques have strengths and weaknesses. The team is able to perform different types of surgery on an outpatient basis, evaluating the best solution for each case.

Why choose MediClinic?

In the urological and andrological field, MediClinic can benefit from a team with great experience and ultra-specialized skills. The patient’s care path begins with the provision of diagnostic services, performed by the same team who will eventually perform surgery using cutting-edge technological tools. At the end of the diagnostic phase, the urological patient has the possibility, if necessary, to access high-level outpatient or day surgery services. Surgeons have mainly performed minimally invasive procedures, ensuring maximum safety in the operating and post-operative phase, thanks to the state-of-the-art medical technology and the provided safety systems. The treatment path does not end with surgery, instead it can continue with the rehabilitation and follow-up phase directly managed by the clinic’s specialists.