Outpatient care and consultation

What is Focal Therapy for Prostate Cancer?

Focal therapy presents an opportunity for targeted tumor control in patients with localized (early) prostate cancer.Using precise physical methods, only the tumor-containing tissue is selectively destroyed, resulting in reduced side effects compared to current standard therapies like complete surgical removal of the prostate (radical prostatectomy) or radiation therapy. High-Intensity focused Ultrasound (HIFU) is one of the most established focal therapy. Before commencing the therapy, the tumor must be precisely localized, which is achieved through MRI of the prostate and MRI-targeted prostate biopsy.

What is High Intensity Focused Ultrasound (HIFU)?

During HIFU therapy, an ultrasound probe is inserted into the rectum at the level of the prostate. This probe delivers highly focused ultrasound waves precisely to the region of the prostate requiring treatment. This process heats and destroys the targeted tissue, effectively leading to the destruction of the prostate cancer tissue.Utilizing MRI and incorporating biopsy findings during the therapy ensures precise treatment. The procedure is performed under general anesthesia and typically lasts between 1 to 2.5 hours, depending on the size of the treatment area. The hospital stay is usually 3 days.

Since the rest of the prostate remains untreated, it is essential to conduct regular follow-up checks. These include PSA testing, repeat MRI, and control biopsies.

Focal One device by the company edap for the treatment of prostate carcinoma using focal HIFU therapy © Company Edap (with kind permission)

What are the possible side effects?

Potential side effects following HIFU treatment may include short- or long-term bladder emptying disorders, which can often be managed with medical therapy. Additionally, patients may experience bladder irritation with frequent urination for several weeks. Notably, in untreated areas, further tumor growth may occur, even if initially undetected. Hence, close follow-up with PSA testing, MRI, and control biopsies is necessary. In case of tumor recurrence and the need for salvage therapy, e.g. radical prostatectomy or radiation therapy, the treatment outcome may be less favorable.

Which patients are suitable for HIFU?

I      Prostate cancer with a maximum Gleason Score 3+4=7

I      PSA ≤ 15ng/ml

I      Unliteral tumor involvement in the area of the posterior prostate

I      the tumor os localized within the prostate

I      Existing MRI of the prostate and detection of a suspicious lesion in the MRI

I      Prostate volume < 80ml

I      No latex allergies

Please note that these are the main criteria to perform HIFU for prostate cancer. However, additional factors may impede HIFU treatment.

Interested in HIFU consultation?

If you have been diagnosed with localized prostate cancer and are interested in undergoing therapy using the HIFU procedure, we encourage you to contact us. We kindly ask you to send us all your medical findings (PSA, pathologist's report, biopsy results, and MRI including the CD with images). We will then schedule an appointment with you in our Focal Therapy Consultation to assess whether we can perform HIFU in your case. During the appointment, we will also provide you with detailed explanations of the procedure.

Contact:

Klinik und Poliklinik für Urologie/Department of Urology

Fokale Therapie Sprechstunde/Focal therapy consultation

Universitätsklinikum Dresden/University Hospital Dresden

Haus 27 - DINZ
Fetscherstraße 74
01307 Dresden

Tel. +49 3 51/4 58 44 47

Email 

In the kidney stones consultation-hour, we counsel and treat patients who suffer from recurring stones in the upper urinary tract. For this purpose, we have high-resolution ultrasound equipment and state-of-the-art radiological examination techniques at our disposal. If indicated, an intensive metabolic workup by blood and urine analyses is possible.

Please send your documents and findings, if available, in advance to the following address:

Universitätsklinikum Carl Gustav Carus
Klinik und Poliklinik für Urologie
Fetscherstraße 74
01307 Dresden

Parents with children who suffer from congenital or acquired dysfunctions of the kidneys, urinary tract or genitals can come to the pediatric urology consultation. In addition to narrowing of the foreskin (phimosis), undescended testicles and abnormal opening of the urethra (hypospadias), these also include urinary incontinence, bladder emptying disorders and kidney drainage disorders. In addition to state-of-the-art ultrasound devices, a uroflowmetry and bladder pressure measurement (urodynamics) are available as diagnostic modalities.

Depending on your child's symptoms, it may be advised to prepare a so called "drinking-micturition log" or a "testicle position log" in preparation for the consultation. Please inquire about this by telephone. The relevant protocols can be found here..

• Drinking-micturition log (in German)
• Testicle position log (in German)
  
  

Please send your documents and findings, if available, in advance to the following address:

Universitätsklinikum Carl Gustav Carus/University Hospital Carl Gustav Carus
Klinik und Poliklinik für Urologie/Department of Urology
Fetscherstraße 74
01307 Dresden

Patients who suffer from bladder emptying disorders or uncontrolled urine loss can present themselves at the continence consultation. In order to determine the causes of the given symptoms more precisely, we offer various special examinations. In addition to cystoscopy, this includes measurement of the urine flow (uroflowmetry) and bladder pressure measurement (urodynamics). Depending on the type and cause of the symptoms, both conservative and surgical treatment methods can be considered. For male urinary incontinence, we have various sphincter replacement systems (artificial urinary sphincter) available. To correct female incontinence, depending on the cause, surgical correction of the pelvic floor or the insertion of tension-free slings can be performed. We will work with you to find the right treatment for you. We ask that you bring all of your medical findings and treatment reports with you to your appointment.

In preparation for your appointment in our special consultation, please fill out a so-called “drinking-micturition protocol”. You can find it here as a download in German (drinking-micturition protocol). Please bring the completed protocol with you to your appointment.

Please send your documents and findings, if available, in advance to the following address:

Universitätsklinikum Carl Gustav Carus/University Hospital Carl Gustav Carus
Klinik und Poliklinik für Urologie/Department of Urology
Fetscherstraße 74
01307 Dresden

PD Dr. med. Martin Baunacke is a member of the German Society of Continence and expert in the field of continence.

Here, patients are evaluated for inclusion on the waiting list, i.e. their suitability for transplantation is checked from a surgical point of view, preliminary discussions on transplantation are held in the event of special questions or previous illnesses and a large proportion of patients who have already successfully undergone transplantation at our center receive urological follow-up care. In special cases, externally transplanted patients are also welcome to come to us for urological pre- or post-transplant care. Preparations and discussions regarding a possible living kidney donation also take place here. Our transplant office is always available to answer any questions you may have about a kidney transplant or to schedule a specific appointment in the urology consultation (contact).

Men who suffer from symptoms of benign prostate enlargement and would like advice on treatment options can come to this consultation. We will discuss whether surgical treatment is appropriate to improve the symptoms or whether drug therapy is more likely to alleviate the symptoms. If surgical treatment is indicated, we will advise you on the most suitable surgical procedure (link). This depends on various factors in addition to the patient's wishes. Patients who are at risk of anesthesia due to various concomitant diseases will be given detailed advice on alternative treatment methods.

Andrology is a special field of medicine that deals with the function of the reproductice organs and their disorders in men. In our andrology consultation, we treat patients who have an unfulfilled wish to have children, suffer from erectile dysfunction, penilecurvature (Peyronie’s disease or Induratio penis plastica) or men who suffer from hormonal imbalances. During the consultation, we diagnose and treat the above mentioned conditions. Since andrology is an interdisciplinary field, we work closely with other departments, such as the Department of Endocrinology and Metabolism, the Institute of Clinical Genetics, and the Fertility Center and Hormone Clinic.

Please send your documents and findings, if available, in advance to the following address:

Universitätsklinikum Carl Gustav Carus/University Hospital Carl Gustav Carus
Klinik und Poliklinik für Urologie/Department of Urology
Fetscherstraße 74
01307 Dresden

Sperm analysis

Sperm analysis are performed by our urological laboratory according to WHO criteria (including bacteriological and chemical analyses of the ejaculate).

To make an appointment, please contact our urological laboratory:

Monday - Thursday,  8 a.m. - 4 p.m.
Friday, 8 a.m. - 2 p.m.
+49- 351 458-3726

Cryopreservation of sperm (Sperm banking)

Our urological laboratory offers cryopreservation of sperm (sperm banking) of ejaculate (seminal fluid).

If you are interested in cryopreservation of sperm, please contact the outpatient clinic or the urological laboratory.

You can find more information here:

Monday - Thursday,  8 a.m. - 4 p.m.
Friday, 8 a.m. - 2 p.m.
+49- 351 458-2249 (outpatient clinic)
+49- 351 458-3726 (urological laboratory)

The development of new potential drugs is tedious and time consuming. Clinical trials are essential to verify the efficacy and safety of a therapy before market approval is possible. This process is subject to strict regulations to ensure patient safety and is monitored by an ethics committee, task force and the sponsoring pharmaceutical company.

In our clinical trials center, we conduct studies in every development phase. Specifically, we investigate new surgical, medical and diagnostic concepts.

Novel promising therapies within clinical studies offer attractive alternatives to established standard treatments. Moreover, study inclusion is a good option in cases with no approved treatment options or if a significant benefit over the standard of care is expected. Clinical trials thus contribute to medical progress and benefit patients due to intense therapeutic monitoring.

Please contact our clinical trials center for further consultation or evaluation of eligibility.

A summary of all actively recruiting studies and the contact details to our clinical trials center can be found here (link).

Please send us your diagnostic findings and reports in advance to:

Universitätsklinikum Carl Gustav Carus
Poliklinik für Urologie
Fetscherstraße 74
01307 Dresden