Examples of modern technologies we offer in addition to conventional treatments. Of course, these treatments are only possible for certain specific pathologies and with well-defined criteria.
Prostate cancer :
- The radical prostatectomy (removal of the prostate) is a possible treatment for prostate cancer when potentially aggressive but not yet advanced (localized tumor in the prostate gland) A radical prostatectomy is not justified for beginners and non-aggressive micro-tumors that have more minimally invasive alternative treatments or even a simple monitoring. Radical prostatectomy can be performed by using standard laparoscopy or robot-assisted laparoscopy.
(Warning: some images may offend the sensibilities)
"Robot-assisted radical prostatectomy: vesicourethral anastomosis" film
- Brachytherapy is an alternative to prostatectomy for minimally invasive cancer. This procedure involves implanting radioactive seeds in the prostate, which will carry an "internal" radiation. It is less invasive than radical prostatectomy because it induces less sexual and urinary sequelae. We offer this technology in partnership with the European Georges Pompidou hospital, located in the15th arrondissement of Paris and our health care network is the first center of brachytherapy in Europe.
- In the context of clinical research, we can propose a focal treatment by laser or by microwaves in some very localized forms of prostatic cancer.This new procedure is to treat only a portion of the prostate, and not all of the gland. It is to induce necrosis exactly at cancer sites. This technique is being evaluated in selected European centers, including ours. It can only be achieved under a research protocol. Its advantage would be to induce a very limited or zero rates of urinary and sexual disorders.
Benign prostatic hyperplasia:
"Holmium laser enucleation of prostatic benign hyperplasia (HOLEP procedure)" film
Endoscopic treatment of BPH can be achieved by a conventional resection technique, by bipolar resection, vaporization or laser.
The use of Holmium laser enables us to treat endoscopically all patients with prostatic hyperplasia, even with large volume. In our department, we do not use open approach anymore to remove prostatic hyperplasia.
Some techniques have the advantage of reducing the bleeding, particularly in patients receiving anticoagulant therapy for cardiovascular diseases. Reducing the risk of bleeding limits the general complications and hospitalization time. All these techniques are available in our service. They are adapted to the patient's history, his preference and that of the surgeon.
"Laser Vaporization of the Prostate" film
We also suggest to patients that wish and that meet specific criteria, prostatic injections of botulinum toxin. This is injected into the prostatic lobes a product that will induce a reduction in volume of the adenoma. The objective is to further limit the risk of bleeding and accelerate the return to normal activity. This technique is being evaluated in a clinical research protocol.
Finally, in order to reduce complications of treatment of the adenoma, we began intra-prostatic implants Urolift®. This highly innovative process involves compressing endoscopically lobes of the prostate by implanting retractable wires. The light of the urethra is enlarged and thus allows better urine flow. This process is done as an outpatient (one day stay in hospital). It is the only surgical treatment of prostatic hyperplasia causing no sexual side effects.
"Laparoscopic total nephrectomy : vascular control and removal of the kidney using endobag extractor" film
"Laparoscopic partial nephrectomy : tumor dissection and renal hemostasis using biological glue" film
"Laparoscopic pyeloplasty for ureteropelvic junction obstruction" film
All modern treatments of urinary stones are available in our service. Depending on the size, location and composition of the kidney stones, we can use extracorporeal lithotripsy, the ureteroscopy, the flexible renoscopy with kidney stones laser destruction, or percutaneous surgery.
Similarly, we have all new techniques to treat urinary incontinence, whether for women or for men after prostate surgery. For women, urinary incontinence is often treated by sub-urethral sling. When leaks occur outside efforts with urge incontinence (overactive bladder), it is sometimes necessary to make intravesical injections of botulinum toxin or a sacred neuro-modulation. This last option is to set up an electrode in contact with the nerve that regulates contraction of bladder. For men, moderate incontinence can be treated by sub-urethral sling or peri-urethral balloons. Ultimately, severe incontinence requires the establishment of an artificial urinary sphincter. All these devices are used in our service.