Urology
Urology at Karolinska University Hospital includes a major academic unit for urological diseases and conducts specialized and highly specialized urology with a focus on surgery. Our team of exceptional experts offers customized treatments to ensure the best possible outcomes for every patient.
The unit has been a pioneer in Robotic surgery, and the technique was initiated at the department already 2002. Today we are one of the world’s leading clinics in urological surgery, with a very high volume of robot-assisted surgeries. Highly specialized surgeons perform more than 600 prostatectomies and about 100 cystectomies a year, always at the cutting edge to increase precision and minimize side effects. The clinic is in the research frontline of prostate and bladder cancer and collaborates with major international urological centers.
In addition to the surgeons, our team includes oncologists, pathologists, and radiologists, as well as specially trained support staff. They all cooperate closely to provide comprehensive and personalized care, from counseling and treatment to the end of recovery, even after leaving the hospital.
Robot-assisted radical prostatectomy
The skills and experience of the surgeons are the most important factors when considering surgery for prostate cancer. Both oncological and functional outcomes following radical prostatectomy are related to surgical experience.
Karolinska University Hospital has pioneered robotic-assisted radical prostatectomy and robotic-assisted radical cystectomy and is one of the highest-volume robotic surgery providers in Europe. Our urology clinic performs about 600 prostatectomies every year.
With the radical prostatectomy or nerve-sparing surgery performed at the urology clinic at Karolinska University Hospital, many patients retain their potency and continence. Surgeons worldwide regularly visit Karolinska to learn more about robotic surgery. Karolinska is also leading research in the potential benefits of robotic-assisted radical prostatectomy in patients previously not considered for surgery, such as:
- Patients with limited metastatic disease
- Patients with a history of failed treatment from radiotherapy or other treatment modalities
- Patients with significant co-morbidities.
Robot-assisted radical cystectomy
Cystectomy is a surgical procedure to remove the bladder completely or partially. Cystectomy is usually used to treat bladder cancer. It is a complex procedure, and surgeons may use different surgical techniques, such as:
- Open surgery, which requires one long incision to access the bladder.
- Robot-assisted minimally invasive surgery, which involves several small incisions where special surgical tools are inserted to access the bladder. The surgeon sits in a console and remotely operates the surgical tools. If the bladder is removed completely, surgeons work to reconstruct the urinary tract in order to ensure that the patient will be able to urinate in one way or another. Several options exist:
- Orthotopic continent urinary diversion (neobladder). During this procedure, the surgeon uses a piece of the intestine to create a tube that runs from the kidneys to a small reservoir allowing the patient to urinate through the urethra relatively normally.
- Urinary conduit (ileal conduit or urostomy). During this procedure, the surgeon uses a piece of the intestine to create a tube that runs from the kidneys to the abdominal wall. A bag is worn on the abdomen to collect the urine.
Our unit has been pioneers in developing a method of a totally minimal invasive approach for cystectomies where the whole procedure is done inside the body, intracorporeal.
We have a long experience in performing Robot-assisted radical cystectomies (RARC), and are the leading clinic today when it comes to this minimally invasive method with totally intracorporeal urinary reconstruction for patients with clinically high-risk or muscle-invasive bladder cancer.
The potential advantages of a complete intracorporeal procedure are:
- Less intraoperative blood loss
- Decreased bowel manipulation and exposure
- Reduced insensible losses
- Decreased morbidity from smaller incisions
- Reduced postoperative analgesic requirements
- Shorter hospital stay
- Earlier return to normal activities
The procedure has demonstrated good oncological outcomes and has encouraging long-term cancer-specific survival rates. The procedure has also shown good functional outcomes with intracorporeal continent diversion and high levels of quality of life after surgery.
The type of cystectomy and reconstruction a patient undergo depends on several factors, such as the reason for the surgery, the patient’s overall health, and preferences.
In order to give our patients the best possible recovery, we have developed an enhanced recovery program that starts directly after the surgical treatment. Once the patient returns home, our staff will continue the support throughout the recovery process.
