For men

Kidney stones are formed by an imbalance of metabolic waste products in the urine. This imbalance causes substances normally dissolved in the urine to form crystals, which can then turn into stones. The most important risk factor for urinary stones is drinking too little.

A stone that is located in the kidney often causes no discomfort. However, if the stone migrates into the renal pelvis or ureter, it causes severe, wave-like pain, so-called colic. The pain is often accompanied by nausea, vomiting or a strong urge to urinate.What clarification for urinary stones does alta uro offer?

To find out whether a kidney or ureteral stone exists, a computer tomography scan is performed in addition to a urine examination and an ultrasound. This allows the number, size and location of the stones to be determined and thus a tailored treatment plan to be drawn up. After removal, the stones are examined for their composition. For patients with an increased risk profile, a special metabolic examination is performed. Based on this examination, we create an individual concept for our stone patients to prevent the formation of new stones.

alta uro offers a broad spectrum for the treatment of kidney and ureteral stones. In the case of very small stones, there is a high probability that they will be flushed out on their own. Therefore, waiting is possible in certain situations. In the case of stones in the ureter, a ureteroscopy (so-called ureterorenoscopy, URS) is performed under anesthesia and the stone is removed using the smallest instruments. In the case of kidney stones, depending on the size and location, we perform a reflection using flexible instruments (so-called flexible URS). In the case of large kidney stones, endoscopic removal from the outside through the skin, a so-called PCNL (percutaneous nephrolithotomy), may be necessary.

Kidney cancer is a disease in which the cells in the kidney change so that they grow unchecked. Today, most kidney tumors are discovered incidentally during imaging. Fortunately, the tumors are therefore often in an early stage, so that a cure is possible in the vast majority of cases with the correct therapy.

If kidney cancer is suspected, further imaging using computed tomography (CT) or magnetic resonance imaging (MRI) is required for more precise assessment. These procedures can be used to identify the tumor sites as well as the extension and possibly metastases in other organs. Imaging can usually reliably distinguish between benign changes in the kidney and kidney cancer. If the suspicion of kidney cancer is confirmed, surgery is required. In selected cases of small tumors, monitoring may also be performed in patients* with serious secondary diseases.

At alta uro, minimally invasive therapy of kidney tumors is one of our main focuses. In the vast majority of cases, surgery is performed using the Da Vinci surgical robot. This technique allows us to operate very precisely and to remove only the tumor-bearing part of the kidney, while sparing the healthy part of the kidney. This has the following advantages for our patients:

Bladder cancer is a disease in which the cells of the urinary bladder change so that they grow unchecked. Growths develop in the urinary bladder that can, for example, grow like coral. The tumors can range in size from a few millimeters to several centimeters. Blood in the urine is often the first warning sign that bladder cancer is present. The most important known risk factor for the development of bladder cancer is smoking.

In addition to diagnostics by means of outpatient cystoscopy, alta uro offers endoscopic removal of bladder tumors. Here we make use of the latest technologies, which can make it much easier for us to detect even the smallest tumors. If the tumor is limited to the mucous membrane but is more aggressive, further treatment with regular bladder irrigation (so-called BCG immunotherapy) is necessary after surgical removal. We perform this therapy on an outpatient basis in our practice. If the removal of the entire bladder is necessary, we will advise you comprehensively and perform the operation together with our colleagues at the University Hospital Basel.

Strictly speaking, the term "irritable bladder" refers only to situations of disturbingly frequent urination for which no other causes can be found. In irritable bladder, the function of the urinary bladder is disturbed. This means that those affected feel the need to urinate much more often than would be physically necessary. In addition, there may also be involuntary loss of urine.

A constant urge to urinate or incontinence can occur with many diseases. These include, for example, sexually transmitted diseases, neurological diseases, narrowing of the bladder outlet, tumor diseases, mental illnesses, or chronic bladder inflammation (interstitial cystitis).

The most important thing is first to have a detailed discussion with the people affected. We take a lot of time for this, as valuable information is gained here. Often, a so-called drinking and micturition protocol is also necessary. For this purpose, the patients document their drinking quantity as well as the quantity of urine by means of a measuring cup. This documentation allows the first conclusions to be drawn about the function of the urinary bladder. Furthermore, a physical examination, a urine test and an ultrasound are performed. Further clarifications depend on the type of symptoms and include, for example, a cystoscopy or a bladder pressure measurement (so-called urodynamics).What are the treatment options for an irritable bladder?

The type of treatment depends on the underlying disease. In the case of sexually transmitted diseases, antibiotic therapy is given. If tension or cramping of the muscles of the pelvic floor or increased stress is the cause, specific bladder training exercises and relaxation exercises using physiotherapy are very effective. Certain foods can also cause irritation of the bladder, so that adjustments are also very promising here.

When treating irritable bladder, the team of doctors at alta uro always applies a therapy concept that is tailored to the respective cause. With this concept, which is optimally adapted to the person affected, very pleasing therapeutic successes can be achieved.

Urinary incontinence is any involuntary or unwanted loss of urine. If incontinence occurs regularly, it is considered a medical condition. Women have a higher risk than men of developing urinary incontinence. Different forms of incontinence are distinguished, depending on the situation in which the loss of urine occurs:

Urinary incontinence can have a wide variety of causes. The most common causes include hormone deficiency, weak pelvic floor muscles or diseases of the nervous system. Furthermore, the following risk factors are known:

The most important thing is first to have a detailed discussion with the person concerned. We take a lot of time for this. This is followed by a physical examination, a urine test and an ultrasound. Further examinations depend on the nature of the symptoms and include, for example, an X-ray examination, a cystoscopy or a bladder pressure measurement (so-called urodynamics).

Depending on the type of incontinence as well as the severity, bladder training or pelvic floor training under professional guidance is very effective. In addition, various medications are available that can achieve a significant improvement, especially in the case of urge incontinence.

If these measures do not lead to success, surgical treatment is necessary. The choice of procedure here depends on the type and severity of the incontinence and the burden of the symptoms.

Chronic pelvic pain is said to occur when the symptoms have persisted for more than 3 months in the last six months. The cause of chronic pelvic pain is often unclear. Various causes are discussed, such as infections, a disturbed control of the bladder function or the muscles of the pelvic floor, chronic non-bacterial cystitis or pain caused by a permanent nerve irritation.

Various examinations are carried out to diagnose chronic pelvic pain. In addition to a detailed interview, these include special questionnaires that have been developed for diagnostic purposes. A palpation examination of the prostate, a urine examination, blood tests, an ultrasound examination of the bladder and prostate and, if necessary, further clarifications such as a cystoscopy are also necessary.

Therapy for chronic pelvic pain is based on the underlying cause. If the cause is bacterial, a single course of antibiotics for several weeks may be justified. If the cause is so-called interstitial cystitis, the protective layer of the bladder mucosa is rebuilt using drugs specially developed for this purpose. Furthermore, depending on the severity of the symptoms, anti-inflammatory drugs, drugs that improve urination, pain-relieving drugs, drugs that slow down the urge to urinate, drugs to relax the muscles, physiotherapy, herbal preparations or even psychotherapy are used.

Testicular cancer is a malignant growth in the testicle in which the cells of the testicle change so that they grow unchecked. Later, the testicular tumor can potentially metastasize to other organs through lymphatic channels or the blood. Testicular cancer is the most common malignant cancer in young men between the ages of 20 and 40. Each year, approximately 400 men in Switzerland are newly diagnosed with testicular cancer. Testicular cancer accounts for about 1% of all cancers in men. Risk factors for testicular cancer are, for example, undescended testis, a tumor in the opposite testis, infertility, and a first-degree relative already suffering from testicular cancer.

In addition to an examination of the testicles, an ultrasound examination is standard. With ultrasound, the testicles can be examined excellently and with high resolution and thus a testicular tumor can be excluded or confirmed. If an abnormality is confirmed in the ultrasound, a blood sample of the so-called testicular tumor markers is taken. In addition, a computer tomography of the abdominal cavity and the lungs is performed in order to clarify whether any reducers are present.

If a testicular tumor is suspected, the affected testicle must be surgically exposed and removed via an inguinal incision. This procedure is performed under anesthesia. Subsequently, the tumor is examined by the pathologist and the final diagnosis is confirmed. If the findings are unclear, the tissue can be examined directly by the pathologist during the operation (frozen section). If the suspected tumor is confirmed, the testicle must be removed. Depending on the final tumor findings in the tissue examination, chemotherapy must be administered in certain risk constellations. This will be determined in a tumor case discussion together with experts from other specialties and you will then be assigned to the experts.

Erectile dysfunction is not uncommon and is one of the most common sexual dysfunctions in men. Erectile dysfunction can be pronounced in different ways. Thus, one (s) must not always be able. However, if it is not possible to build up an erection over a longer period of time, further clarification should be made. Common causes of erectile dysfunction are cardiac or vascular disease, diabetes mellitus, pelvic surgery, neurological diseases or a lowered testosterone level.

First of all, a detailed conversation is the basis of a diagnosis. We go into detail about the patient's medical and sexual history. This serves to accurately assess the severity of erectile dysfunction and to identify risk factors. In addition, a physical examination and blood analysis are performed. A more advanced examination is the erectile tissue injection test, which determines the flow rate of blood in the penis after artificially triggered erection.

When treating erectile dysfunction, it is important to understand the causes and consequences of the condition. We include physical and psychological aspects of erectile dysfunction in the treatment. When it comes to treatment options, recommendations for improved lifestyle are at the top of the list. For example, stopping smoking or exercising regularly can already lead to a significant improvement in erection.

The so-called phosphodiesterase-5 inhibitors (PDE-5 inhibitors) play an important role in drug therapy. This group of drugs leads to improved blood flow to the penis and an easier erection. Various active ingredients are available for this purpose, which differ in particular with regard to the onset of the effect and the duration of action. Both on-demand and daily use of preparations are available.

As an alternative to drug therapies, alta uro offers extracorporeal shock wave therapy (ESWT) to improve erectile dysfunction. This involves delivering shock waves to different areas in the penis. The therapy can cause constricted or damaged blood vessels to recover permanently. The formation of new blood vessels in the corpus cavernosum can lead to better blood flow to the penis and improved erection. One treatment lasts about 15-20 minutes. Depending on the severity, between 6 and 10 therapy sessions are required. The therapy does not cause any pain and is performed on an outpatient basis in our practice.

Another form of therapy is the so-called MUSE therapy. Here, an applicator is used to apply a pellet of active substance into the urethra, which leads to an erection. In addition, there is the possibility of a corpus cavernosum injection therapy (SKAT). In this form of therapy, a vasodilator is injected directly into the corpus cavernosum using a very fine syringe.

Premature ejaculation (ejaculatio praecox) is when a man permanently "comes too soon". In extreme cases, affected men find it impossible to penetrate their partner at all, or the mere thought of a sexually arousing situation is enough to cause them to have an orgasm.

A distinction is made between a lifelong (primary) form, for which, among other things, genetic, hormonal changes are possible. Premature ejaculation usually occurs at a young age. The acquired (secondary) form is usually due to diseases or risk factors, such as hyperthyroidism, postata inflammation, emotional problems and stress.What treatment for premature ejaculation offers alta uro?

Previously, analogous to the assumption that premature ejaculation is mostly psychological, the main focus was on behavioral therapy approaches. Here, the couple jointly interrupts sexual activity when the man feels climax or a painful stimulus is applied to the glans (squeeze), thus suppressing ejaculation. Since behavioral treatment approaches usually show no or only short-term success, drug therapy has become the focus in recent years.
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A treatment concept that has been tried and tested for some time is the local application of numbing drugs in the form of ointments, creams or sprays. These are applied to the glans and the foreskin frenulum about 15-20 min before sexual intercourse. The active ingredient dapoxetine (trade name: Priligy) is the only medication in tablet form approved by the drug authorities for the treatment of premature ejaculation. In addition, alta uro works with experienced sex and couples therapists, so that in the vast majority of cases a satisfactory result can be achieved for all concerned through a multimodal treatment concept.