March 2023

UROLOGY

LEADING THE WAY IN DELIVERING EXCEPTIONAL CLINICAL CARE


​At Northwestern Medicine Urology, our experience conducting breakthrough research allows us to offer leading-edge care for a wide array of medical concerns, from benign urologic conditions to advanced urologic cancers.

Our clinical teams strive for higher standards of care with every treatment or procedure they pioneer. Innovation allows us to provide state-of-the-art diagnosis and treatment with the ultimate goal of achieving better life-changing and life-saving clinical outcomes.
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Northwestern Medicine Urology’s clinical expertise covers almost every area of urological care, including:

Transforming Surgical Treatment for BPH

A frequent problem as men age, an enlarged prostate (otherwise known as benign prostatic hyperplasia or BPH) can block the flow of urine from the bladder and lead to uncomfortable urinary tract symptoms. Traditional surgery for BPH typically calls for an overnight hospital stay and weeks of catherization. Enter HoLEP, an incision-less treatment that eliminates urinary obstructions and allows patients to go home the same day after the procedure. The first to perform HoLEP (holmium laser enucleation of the prostate) in Chicago, Amy E. Krambeck, MD, of Northwestern Medicine Urology, led the way in standardizing this revolutionary treatment. Dr. Krambeck and her team are also training more urologists so that the unique procedure becomes more accessible to patients in the U.S. and around the world. In February 2023, Northwestern Medicine’s team performed its 1,000th HoLEP procedure.

Delivering a Holistic Approach to Kidney Stone Care

Kidney stones are common. Some 11% of men and 6% of women in the United States develop a kidney stone at least once in their lives. We offer the latest surgical stone removal techniques, including an advanced procedure known as a tubeless minimally invasive percutaneous nephrolithotomy (mini PCNL) for removing large kidney stones. Mini PCNL involves small instruments inserted through tiny incisions into the kidney. An outpatient procedure, it leads to less pain and quicker recovery. Uniquely focused on prevention as well, our multidisciplinary metabolic stone team includes nephrologists, geneticists and nutritionists who use strategies such as diet, medications and genetic testing to prevent stones before they start.

Pioneering Robotic Reconstructive Surgery

Open urethral reconstructive surgery remains a standard approach for repairing damage to the urethra due to injury, infection or inflammation. Northwestern Medicine Urology offers unparalleled expertise in performing complex urinary tract reconstruction robotically. Only a handful of medical academic medical centers in the U.S. offer this next-level surgical expertise for benign disease, as well as genitourinary reconstruction after prostate cancer treatment. Advancing new techniques in urinary tract repair and reconstruction, Ziho Lee, MD, is pioneering the use of tissue taken from inside the mouth. Known as buccal mucosa grafts, this novel alternative to currently used urinary tissue may promote better wound healing and vastly improve surgical outcomes.

Innovating Novel Cancer Tools and Therapies

At any given time, innovative cancer care abounds at the Polsky Urologic Cancer Institute of Robert H. Lurie Cancer Center at Northwestern Medicine. For example, we have developed an online individualized risk assessment algorithm for men considering prostate biopsy to help clinicians efficiently risk-stratify their patients. Using novel imaging such as 99m sestamibi SPECT/CT scans for more accurate kidney tumor classification, we are sparing patients with benign kidney tumors from unnecessary surgeries. By performing advanced minimally-invasive robotic surgery, we are reducing recovery times for patients after bladder removal.

Of the approximately one million prostate biopsies performed annually in the United States, some 30,000 men require hospitalization due to infection caused by the current standard of care: transrectal biopsy. We are recruiting patients for a first-time prostate cancer clinical trial investigating an alternative image-guided approach. Called transperineal biopsy, the procedure involves passing the biopsy needle through perineal skin and into the prostate rather than through the rectum. This option offers the potential to significantly reduce infection while improving cancer detection.

For men at increased risk of genitourinary cancers due to personal or family history, Northwestern Medicine Urology offers comprehensive genetic counseling and testing services. Men with BRAC1 or BRAC2 mutations face a 30% to 60% chance of developing prostate cancer. Providing urologic expertise as part of the Northwestern Medicine EDGe (Early Detection in Genetics) BRCA+ Men’s Clinic, we strive to screen, detect and prevent cancer in high-risk patients. Our dedicated genetic counselor connects eligible patients to specially trained experts in prostate cancer screening, breast cancer screening, skin cancer screening and pancreatic cancer screening.

Enhancing Adult Congenital Genitourinary Care
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Thanks to medical advances, today many more children born with genitourinary issues, from urinary tract to genital anomalies, successfully grow up to be healthy adults. Yet the transition from pediatric to adult urological care has been slow due, in part, to scarce clinical services tailored to this patient population. Northwestern Medicine Urology has long been at the forefront of helping these patients “graduate” to specialized multidisciplinary adult care. These efforts have been led by led by Diana K. Bowen, MD, and Stephanie J. Kielb, MD, of Northwestern Medicine Urology. We offer one of the few age-appropriate transitional adult Congenital genitourinary (TRAC) clinics in the country. With the recent launch of our adult Spina Bifida Clinic, we are connecting many more people with the specialists who will best meet their specific health needs as they mature.

Offering Emerging New Therapy for ED

Low-intensity shockwave technology has become a useful tool for improving blood flow and reducing pain and inflammation. Routinely used in orthopaedics and physical medicine, shock wave therapy has recently emerged as a potential medical treatment for erectile dysfunction (ED). This evolving therapy works by enhancing penile arterial blood flow and remodeling penile tissue to improve function, especially for men with blood flow issues or vasculogenic ED. Typically performed during a series of  office visits, this painless noninvasive therapy offers a viable option to surgery, oral medications and/or injections. Always seeking new ways to improve care, we are among a handful of medical centers now evaluating this promising treatment.

Investigating Hormone Treatment for Male Fertility

Hormones play a significant role in fertility for both female and male patients. Follicle-stimulating hormone (FSH) helps control menstrual cycles as well as stimulates the growth of eggs in the ovaries. FSH also promotes the testicular production of sperm and has recently become a novel strategy for treating low sperm count to improve the chances of pregnancy. Joining a select group of academic centers, Northwestern Medicine Urology is participating in a new multi-center, randomized placebo-controlled clinical trial looking at the efficacy and safety of using FSH to treat men with unexplained reduction of semen quality. In the study led by Joshua A. Halpern, MD, of Northwestern Medicine Urology, participants will be treated with a daily dose of the hormone or placebo for six months to see if the female partners of these men become pregnant within nine months after randomization.

Advancing Health Equity in Urology

Conversations about sexual and urologic health can be challenging between physicians and patients of any gender and sexual orientation. A true understanding of a patient’s physical, as well as emotional needs, is needed to provide the best possible urologic treatment — especially for prostate cancer. Recognizing a glaring gap in care, Northwestern Medicine Urology developed the nation’s first-of-its-kind Gay and Bisexual Men’s Urology Program to deliver better care to people who were assigned male at birth and identify as gay or bisexual. Channa A. Amarasekera, MD, of Northwestern Medicine Urology, leads the program.

By providing a welcoming environment that includes and affirms all patients, we hope to meet the specific needs of this population with compassion and understanding. Collecting data and identifying how certain urologic conditions and therapies affect gay and bisexual men advances knowledge, which in turn empowers physicians and patients to make the most informed treatment decisions. We also serve transgender and gender-diverse individuals by providing urologic care through the Northwestern Medicine Gender Pathways Program. Our experts support complex reconstructive and transition surgeries, and provide andrology and fertility care. They work closely with colleagues at Ann & Robert H. Lurie Children’s Hospital of Chicago to ensure patients have the gender-affirming and urology services they need throughout their lives.

Our patients deserve the best diagnosis and urological treatments we can offer today and discover tomorrow. Every day, we safely and effectively introduce the latest and most promising advancements into the clinical setting. No matter how common or complex their urologic problem, patients can be assured they are receiving state-of-the-art care from experienced and innovating specialists at Northwestern Medicine Urology.
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