University of Wisconsin Prostate and Genitourinary Cancer Program: Treatment Options

Tumor Specific Treatment Options for Patients

Prostate Cancer

Laparoscopic Prostatectomy
Nerve Sparing Radical Prostatectomy
Nerve Sparing Radical Prostatectomy with Sural Nerve Grafting
Prostate Brachytherapy & Tomotherapy
Management of Cancer Failure after Surgery, Radiation Therapy or Hormone Therapy
Robotic Assisted da Vinci® Radical Prostatectomy

Renal Cancer

Laparoscopic and Hand-Assisted Nephrectomy
Partial Nephrectomy
Cryoablation of Renal Tumors
Management of Metastatic or Advanced Disease

Bladder Cancer

Continent Urinary Diversion (Indiana Pouch and Neobladder)
Management of Progressive or Advanced Disease
Chemoprevention Strategies

Testicular Cancer

Retroperitoneal Lymph Node Dissection
Management of Advanced Disease

Complex Genitourinary Cancer Cases

Our fellowship-trained experts are willing to offer opinions regarding complex cancer cases involving the bladder, prostate, kidney, testes, urethra, and other sites. Within our multidisciplinary genitourinary oncology clinic, patients are exposed to multiple opinions at the same time. These options are clearly presented in depth and the goal is to allow patients to feel comfortable and to make informed decisions about their treatment choice.

Nerve Sparing Radical Prostatectomy

radical prostatectomy

sural nerve grafting
Kim et al., Urology 2001

Our program offers nerve sparing radical prostatectomy performed by surgeons that have had additional training in this specialized area. The cavernous nerves are important in the maintenance of erections after radical prostatectomy. In patients who have indications for removing one or both nerves, we offer sural nerve grafting. This new procedure harvests a piece of nerve from the lateral part of the ankle and ties it into the stump of the resected nerve in the pelvis. Recent studies suggest that this permits the maintenance of erections, although one or both nerves may be removed. For more information - view a few recent articles which highlighted the procedure.

Laparoscopic and Laparoscopic/Hand-Assist Nephrectomy

We developed the hand-assist nephrectomy and published the first articles about this procedure (Nakada et all, 1999). To date, we have one of the largest and most experienced facilities in the country for this procedure. Hand-assisted nephrectomy permits the kidney to be removed through a small incision. This allows decreased time back to work or full activity without compromising cancer control. As we have demonstrated, this is applicable to a large number of kidney operations that require removal of the whole kidney.

Partial Nephrectomy and Minimally Ablative Techniques

We offer removal of just the tumor leaving the rest of the normal kidney behind in some situations. This allows patients to maintain their normal renal function without having the entire kidney removed. In selected situations, we have utilized cryoablation for kidney lesions using a laparoscopic approach.

Continent Urinary Diversion

When the bladder must be removed as a result of cancer or other medical problems, an appliance-free urinary diversion may be performed. The patient can maintain an excellent quality of life without utilizing a bag to collect urine. This urinary diversion is made of bowel and is hooked up either to the urethra where the patient may void or to the skin, where it is catheterized through a small hole periodically.

Laparoscopic Radical Prostatectomy

We are currently utilizing laparoscopic prostatectomy as a way of removing the prostate in selected individuals. This procedure is still experimental, but it may offer some benefits with regard to recovery.