Santariškių g. 2, 08661 Vilnius
tel. (+370) 5 236 5000
faks. (+370) 5 236 5111
info@santa.lt

      

SANTAROS KLINIKOS

VILNIAUS UNIVERSITETO LIGONINĖ

Achievements

Spausdinti

PROSTATE CANCER. Vilnius University Hospital Santaros Klinikos Urology Centre coordinates the National Early Prostate Cancer Detection Programme. According to this program men with elevated PSA receive professional urological consultation and prostate biopsies are performed using modern technologies if needed.

Radical surgical prostate cancer treatment and nerve-sparing radical prostatectomy is performed for prostate cancer patients preserving their sexual function. About 200 radical prostatectomy cases are performed per year. Moreover minimal invasive radiotherapy – low dose brachitherapy with low dose I125 radioactive “seeds” is offered for well selected patients (our experience is over 100 cases). This method provides local treatment of the prostate sparing surrounding organs.

For patients with advanced disease all forms of hormonal therapy, modern systemic chemotherapy and pain therapy are offered in the outpatient department of the Centre. Biological therapy using new androgen receptor blocking agents is now available. Patients suffering from severe pain are being referred to the Pain Clinic and Radiology department for radionuclide therapy.

RENAL TUMOURS are operated laparoscopically or by open nephron-sparing partial nephrectomy. Tumours with intravascular extension may be operated with extracorporeal circulation system. Collaborating with Nephrology Centre providing kidney replacement therapy, Centre of Urology has gathered the most profound experience in the field of solitary kidney surgery. Per year 100 nephrectomies and 40 kidney resections are performed. Patients with advanced disease are provided with immunotherapy with IFN-alpha or with a new class of treatment: targeted therapies, that blocks specific abnormal signals present in kidney cancer cells preventing them from growing or progressing. Differential diagnostics of complex renal cysts may be performed using contrast ultrasound.

BLADDER TUMOURS are removed with the most modern bipolar resectoscope and photodynamic diagnostic is employed to improve the quality of endoscopic resection. Bi-polar, saline-based plasma technology provides both improved performance of the resection for the urologist and increased safety for the patient. In order to obtain better results of endoscopic operations photodynamic diagnostic and green laser are used. For the prevention of cancer recurrence all types of endovesical chemotherapy and immunotherapy with BCG are provided.

In case of locally advanced muscle-invading bladder cancer the radical removal of the entire bladder is offered with a simultaneous creation of all kinds of new urinary reservoirs from the different parts of the patient’s bowel. In case of metastatic bladder cancer modern chemotherapy is administered.

TESTICULAR CANCER. More than 90 % of testicular cancer cases can be cured, especially if it is found early. Close cooperation with chemotherapists offers comprehensive treatment of the disease. Urologists perform the primary removal of the testicle with a subsequent histopathological examination of the tumour. In case of disease progression to retroperitoneal lymph nodes or lungs patients are treated in oncology department where systemic chemotherapy is performed. In case of disease progression to other organs or in case of disease relapse high-dose chemotherapy with bone marrow transplantation can be offered. This is a unique experience in the whole Baltic region. Systemic chemotherapy is usually followed by surgery to remove any remaining tumour. After removal of the testis testicular implants may be offered.

BENIGN PROSTATE HYPERPLASIA (BPH). Our centre offers wide spectrum of BPH treatment options including medications, minimal invasive procedures, endoscopic and open operations.

For medical BPH treatment alpha-blockers, the 5-alpha-reductase inhibitors or combination of these medications can be used. Urologists at our centre currently participate in clinical trials checking the long-term efficacy and safety of these drugs.

Transurethral Resection of the Prostate (TUR-P). TUR-P is the minimal invasive surgery most commonly used to treat BPH. This endoscopic procedure is performed under spinal or general anaesthesia trough natural urethra. Prostate tissue is removed using a wire loop, which has been charged with an electrical current and the view of the procedure may be observed on the big screen monitor. Using Olympus bi-polar, saline-based plasma technology operation procedure becomes safer for the patient and may be performed for the pacemaker carrying patients.

HoLEP. Holmium laser enucleation of the prostate (HoLEP) is suitable for the patients with large prostates (>100 cm3) and produces results that are similar to TUR-P with fewer complications (e.g., less intraoperative bleeding). In this procedure, a holmium laser is used to remove obstructive prostatic tissue and seal blood vessels. HoLEP is usually performed as a day care procedure in the hospital. In comparison with open prostatectomy HoLEP operations have lower risk of bleeding, shorter hospitalisation and recovery time.

PROSTATECTOMY If the prostate is greatly enlarged and the bladder has been damaged, or transurethral surgery is contraindicated, open prostatectomy (removal of the obstructing prostate) may be necessary. In selected patients this procedure may be optimal and safest approach.

TREATMENT OF URINARY STONES. Our centre specializes in minimally invasive surgery for the removal of kidney stones. The need for open surgery is exceptionally rare. We use the latest fibre optic telescopes and lasers for the removal of kidney stones. In most cases operations may be performed with one-night hospital stay. The Urology Centre has access to the latest generation shock wave extracorporeal lithotripter to break up large stones without general anaesthesia. We are proud to offer following methods for urinary stone treatment:

Extracorporeal shock wave lithotripsy This powerful tool uses focused shock waves to disintegrate kidney stones. We are fortunate to have the latest generation lithotripter, which does not require submersion into a water bath, and can usually be performed with intravenous sedation, rather than general anaesthesia. Almost all patients leave the hospital shortly after treatment and return to work within a day or two.

Ureteroscopy and contact lithotripsy Stones of any part of urinary tract may be reached using rigid or flexible ureteroscopes. The stone is disintegrated and removed. Several methods of contact lithotripsy may be used:

Holmium laser – new and the most effective method of endoscopic disintegration of urinary stones. Fine up to 200 micrometers diameter fibres may be used in order to reach and fragment even very hard stones of any urinary tract localization. Highly effective lithotripsy of big and impacted stones.

Swiss Lithoclast Ultrasound device. Two different endoscopic lithotripsy methods are applied simultaneously: pneumatic and ultrasonic. Complete disintegration of calculi, efficient suction and complete removal of residual calculi has become a standard of renal, ureteral and bladder stones treatment making open surgery unnecessary.

Percutaneous stone extraction Using this technique, the surgeon makes a one-inch incision in the flank, and uses a telescope to fragment and remove large kidney stones. Hospital stay for the most of these patients is limited to a few days and the patient is able to return to work shortly thereafter. It is an excellent technique for large stones or those in the lower pole of the kidney. In case of multiple stones combined percutaneous nephrolithotripsy is used: flexible and rigid instruments are used simultaneously.

Stone chemical analysis. All stones that are removed are sent for infrared spectroscopy analysis. All patients are offered the opportunity to undergo a comprehensive metabolic evaluation to help prevent further stone development.

Over 1000 operations are performed annually in our centre.

URINARY INCONTINENCE. Newly established modern office of urodynamics offers cystometry, bladder capacity, residual urine, urodynamic profile and uroflowmetry testing. Theses tests have prognostic value for upcoming surgical treatment and help to evaluate surgical results. Initially we offer conservative treatment options like pelvic floor exercises, functional electrical stimulation, kinesitherapy and medical treatment.

In cases of ineffective conservative treatment minimally invasive treatment options are offered: TVT and TOT operations, where special sling is placed under urethra using two small 1 cm incisions in order to strengthen pelvic support. Our centre has good experience (more than 100 cases) and very good outcome results. In case of male urinary incontinence our Centre is performing urethral and sphincter reconstructive surgeries (dilatation, urethrotomy and TUR of urinary bladder). In case of urinary incontinence after radical prostatectomies we perform sling placement for urethral support. In case of female and male urinary incontinence other minimal invasive methods like paraurethral injections (injection of special substance like collagen jell under urethral mucosa) are used. In case of hyperactive (overactive) bladder most promising minimal invasive method of botilinum toxin bladder mucosa injections are used.

ERECTILE DYSFUNCTION AND INFERTILITY. Our centre has long reaching experience in andrology. Patients with a help of our urologists are able to select an appropriate treatment option for erectile dysfunction and premature ejaculation. Treatment is offered also in theses cases when medical treatment is ineffective. Vilnius University Hospital Santaros Klinikos is the only medical institution in the country where penal implants are offered as treatment option. Erectile dysfunction is related to cardiovascular diseases, therefore urologists closely cooperate with internal medicine specialists and cardiologists.

In case of congenital penile anomalies and Peyronie’s disease plastic reconstructive operations are performed. In complicated cases autografting operations using other tissues of the patients may be performed.

Moreover in our centre various laboratory tests and invasive diagnostic procedures for male fertility disorder may be performed. In our day care centre we perform testicular biopsies and different types of varicocele operations. In case of male infertility we perform reconstructive operations of genital tract.

KIDNEY TRANSPLANTATION. At the moment this is the best known method for end stage renal disease treatment. Kidney transplantation program with professional team provides individual treatment for recipients and donors. The team of nephrologists, urologists, anaesthesiologists, radiologists and Laboratory diagnostic centre personnel work together. Laboratory of molecular biology provides HLA typing, identification of sensitised patients and crossmach reactions for all recipients and donors. Life donors undergo CT or MRT scan. In resolution of complex problems of transplanted patients pathology experts, microbiologists and infectious diseases specialists are involved. We have the biggest experience in Lithuania on kidney transplantation and this is the only centre performing live donor kidney transplantations.

About 50 kidney transplantations are performed in our centre each year. About 300 patients are on the kidney transplant waiting list at the moment.

Atnaujinta 2017-07-19
Straipsnis parodytas: 12618 kartų(kartus)
 
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