Representatives of the stronger sex admit to their weaknesses reluctantly, especially when it comes to their manhood and sexual health. They tolerate discomfort and pain because they fear long-term treatment and discomfort. Professor Alexander Bachmann is the Chairman of the Lower Urinary Tract section of the European Society of UroTechnology (ESUT) of the European Association of Urology (EAU).
Besides this, he is one of the leading urologists in Switzerland and specializes in minimally invasive surgical techniques and men’s health issues. His company – alta-uro AG, Basel – is «armed» with a powerful and precise minimally-invasive laser, which allows them to solve delicate problems quickly and efficiently.
Usually, after minimally invasive surgery, patients can return to their normal life within 2 or 3 days. The Greenlight laser in action in the operating theater is fascinating to watch, and looks like a blockbuster movie, with glowing green laser rays and uniformed surgeons. The outcome is usually highly satisfying for patients.
– Professor Bachmann, at what age should a man start seeing a doctor regularly?
– Urologists advise us to get a check-up at least once a year after you turn 40 or 50 years old. I would recommend an annual check-up until you turn 70, and thereafter, have one once every 1.5 years. In our clinic you can undergo a complete check-up of male health issues with absolute discretion. Each and every indicator is checked during the check-up, even genetic ones if requested. These additional diagnostic tools help to identify potential risks to the patient in the future. For example, if requested, the concept of so called «long-life levity» might include certain blood tests, which are done on a regular basis, e.g. every three months, includes fitness programs and a weight and mental stabilization program, which will finally end with recommendations for lifestyle changes to keep you healthy in the future.
– What are the symptoms of voiding disorders, which finally drive you to see a urologist?
– One of the first signs of a serious problem are hesitancy, nocturia (a weak voiding stream which can potentially lead to urinary retention) and frequent visits to the bathroom. For example, two times per night is normal, but three times is only marginally acceptable. If this occurs every two hours, in 99 percent of cases that means there is a problem. One should also pay attention to the weakness of the urine stream, the feeling of incomplete emptying of the bladder, infections and blood in the urine. All these are signs of urinary tract diseases associated with prostate growth or, simply, an inflammation of the prostate.
– Is it possible to identify the main causes of prostatitis?
– Acute inflammation of the prostate tissue usually occurs as a result of bacterial infection. Infection usually occurs as a result of obstruction of the prostate. Age is another risk factor. A man’s body has different concentrations of male and female sex hormones, testosterone and estrogen. Starting at the age of 30, testosterone levels fall gradually and the relative growth of estrogen in elderly men appears to be the cause of such problems. Many treatment options are available for chronic prostatitis. Often, a multimodal long-lasting treatment, including pharmacological treatment or minimally-invasive surgical techniques, is available. We offer our patients the entire spectrum of safe and efficient treatment options, but recommend only those offering the optimal effect for the individual patient.
– Are any preliminary examinations necessary, or can one just have a check-up at your clinic?
– If you have any results from previous examinations, you can certainly take them with you, but an outpatient consultation is usually enough before surgery. It is necessary to check the urine stream and post-void residual volume, and perform an ultrasound check of the kidneys and an ultrasound of the prostate to check its size. Additionally, a blood test for PSA (prostate specific antigen), and a prostate-specific marker for inflammation, lower urinary tract symptoms or even prostate cancer will be done. And if there are no discrepancies with the patient’s complaints, we decide on which treatment to offer. Our expertise encompasses the entire spectrum of safe, minimally-invasive treatment options for benign and malignant prostate diseases.
– What is the principle of Greenlight laser prostate surgery in BPH and how difficult is it?
– With the standard TURP procedure, the obstructed tissue is removed by cutting. With the safe XPS Greenlight laser procedure, the prostatic tissue is vaporized, usually with less blood loss than TURP. With one of the most experienced surgeons worldwide, this modern endoscopic technique can safely be used on elderly patients, patients with large prostates, patients with major comorbidities or patients with ongoing blood thinners. These men usually can’t be operated on using standard techniques. However, the individual’s preferred techniques will always be discussed with the patient prior to surgery.
– What is the most significant risk group?
– Older patients tend to suffer from cardiovascular diseases. For example, if they have a cardiac stent, they cannot stop taking drugs like Plavix for 12 months. Treatment of these patients should usually only be performed by experienced surgeons. As one of the first Greenlight laser users worldwide since 2002, and having experience of thousands of Greenlight laser prostatectomies, we can treat these men safely at our clinic.
– Is the surgery performed under general or local anesthesia?
– It depends. Usually spinal anesthesia for an hour works out well. But if the patient is taking blood thinners, he needs to sleep, meaning he needs to have general anesthesia. Additionally, patients with large prostates should choose general anesthesia as well.
– How long do you have to stay at the hospital after the surgery?
– Not long: two or three days following surgery. The surgery can also be done as outpatient surgery if the patient wishes. Usually, on the first day, for example on Friday, the surgery is performed and a transurethral catheter is placed for irrigation. On Sunday, early in the morning, the catheter is removed and, after successfully voiding, patients can go home. In the case of an outpatient procedure, you can go home in the afternoon following the surgery and come back the next day to get the catheter removed.
– Your company, alta-uro AG Basel, which is a partner of the Merian Iselin Clinic Basel, is growing, and you are building a new complex. What motivated you to start another project?
– Our priority is our patients’ wishes. In addition to the professionalism of our doctors, we offer a private and discrete atmosphere. Often, men want to keep their visit to the urologist a secret. Men’s health issues are very delicate and patients do not want to expose them to the public, especially if we are talking about well-known people. Driven by the desire of our clients, we have built a new branch of alta-uro which offers all the benefits of a medical center, such as day-surgery or even complex surgery in an optimized, professional and exclusive setting. This treatment facility enjoys one of the best locations in Basel, directly in the center near the main railway station of Basel. The project will be completed in December, 2016 and will open in January, 2017.
It will be a medical institution of the highest international standard. Only a few European clinics combine high-quality medical services with an exclusive ambience, including excellent hotel service. Based on the academic experience of the members of alta-uro Basel over the last decade, the existing worldwide network of experts and our chairman’s positions in the European Association of Urology (EAU), alta-uro Basel offers a uniquely Swiss blend of expertise and exclusiveness, as well as the entire spectrum of medical and surgical options in urology.
In my opinion, urology globally has some drawbacks, particularly with respect to the provision of exclusive services. The provision of VIP services requires, besides a proficiency in urology, a special understanding and approach to providing the best service possible. The requests from our patients are our motivation to deliver. Based on our activities over the last decade, alta-uro AG Basel has warm relationships with partners in many countries in Europe, and also in China, Russia, South Africa and UAE as well.
– Please tell us about any other diseases that your clinic specializes in.
– As mentioned above, based on my experience of over a decade as the former Urology Chairman of University Hospital Basel, the team of alta-uro Basel builds on tremendous experience on an international level, and provides the entire spectrum of surgical and medical procedures, just like an academic center. This includes minimally invasive surgical techniques for prostate and kidney surgery, laparoscopy, the full range of urethral reconstruction in strictures, penile prosthesis for erectile dysfunction, male slings or urinary sphincters for urinary incontinence, the entire spectrum of female incontinence treatments and, of course, the treatment of benign prostatic hyperplasia, especially with the XPS-Greenlight laser prostatectomy. Additionally, our patients have access to emerging techniques, if requested. For patients with prostate cancer or kidney cancer, the new XI-DaVinci-Robot is usually used for surgery.
– Do all these technologies allow for the treatment of male diseases only, or female diseases as well?
– Urology is not only a male issue. About 30% of our patients are women. Typically, female incontinence, voiding problems, kidney stones, chronic urinary tract infection, fistulas, or bladder and kidney tumors are treated.
In this context, we are also experienced in fertility problems. After check-ups, we provide «re-canalization» of the semen ducts microscopically, if necessary.
– What other innovative treatment methods do you use in BPH?
– In addition to the lasers, there are a number of other methods for the treatment ofbenign prostatic hyperplasia. One of the problems of standard prostate surgery by many urologists is that they treat every condition in the same way.
Based on my experience and expertise, this is fundamentally wrong. Small prostates must be treated different to large prostates due to the different pathophysiology (the cause of problems). For such cases, we usually use minimally invasive techniques, such as lifting the urethra (Urolift), vaporizing only localized tissue (Rezum) or incising the bladder neck, if necessary.
– In the leaflet for your clinic I found more than a dozen such techniques…
– Yes, all of them are available to our patients and most of them come with the highest level of experience. Based on this, we always look for the most appropriate method of treatment. Minimally invasive treatment options for prostate and kidney surgery are my speciality. As the current Chair of the lower urinary tract at ESUT, as a former member of the European guideline panel «BPH», and as the author of more than 200 scientific publications, I would argue that I have a certain overview of the levels of safety, efficiency and importance of these kind of techniques. Our company provides all the available standard and emerging techniques in this field.
– What is the meaning of the minimally invasive treatment option, or the so-called «minor surgery»? In a week, the patient can forget about what happened?
–Everyone understands that the minimally invasive technique means a fast recovery. People are usually not very happy with the idea of a prolonged stay at the hospital. Minimally invasive treatment usually means safety, efficiency and only a short period of the inconvenience of a hospital stay. Patients look always to the safest treatment first, and after this the most efficient treatment option is chosen. With these criteria, I would recommend any treatment even to my family.
– But the clinic’s level is determined not only by its equipment. the team of specialists is paramount.
– Only highly qualified and well-trained professionals work at alta-uro. they all have long-standing clinical experience and are doing tremendous scientific work of global significance. For example, my colleague, Ass-Prof. Dr. Gernot Bonkat, is one of the leading European experts in the area of urinary tract infections. He leads the European Guideline Committee on urological infections and is experienced in the entire field of endourology and andrological surgery. Dr. Muller was trained in daVinci robotic kidney surgery in London, and he was one of the faculty members at the University Hospital of Basel, where I held my previous position of Chairman of Urology.
– What are the additional services provided by your clinic?
– We provide the entire spectrum of services necessary to treat our patient safely and efficiently. Having that said, we offer services ranging from «Premium» up to so called «VIP». We are working closely together with Swiss companies that take care of our patients in terms of administrative work, visas, and the booking of private aircrafts and guided tours, if requested. But the main thing, of course, is the around-the-clock medical service. At Merian Iselin Clinic Basel we provide virtually all services in the field of urology, except for ultra-complex surgical procedures which require special rehabilitation. We ensure complete privacy and confidentiality, and in doing this, alta-uro Basel is probably unique in the region. In contrast to mainstream or large hospitals, the same level of professionalism from alta-uro is guaranteed during your stay. We ensure individualized support on all kind of problems, which includes avoiding waiting for consultations or diagnostics, organizing additional treatments on request or advice on social events during your stay in Basel, if requested. Our patients will always have a complete agenda prior to their stay.
– You are targeting mainly foreign customers?
– Our clinic is open to every patient from Switzerland or abroad. Our patients are mainly self-referrals following recommendations.
It is our absolute priority to provide our customers with not only the best available expertise in the field of urology, but also with a special alta-uro Basel experience. For example, the majority of our patients wish to have a lifelong connection with us, if necessary, regardless of where they are. The intention to combine our professional expertise and internationality with strong local partners and exclusive hospitality with first-class service was one of the basics for me in founding a company dedicated to these challenges. This kind of service will only be available at «alta-uro Basel, Switzerland – the choice in urology».
Professor, Doctor of Medical Sciences, is one of the leading urologists in Europe specializing in diagnostics and treatment of prostate diseases. He studied medicine at the Universities of Greifswald and Leipzig. He received a post-graduate education at the medical institutions of St. Gallen, Cologne, Monchengladbach and Leverkusen. From 2002 he worked as a senior physician and from 2002 till 2016 he was the Chief Doctor at the Urology Clinic of the University Hospital in Basel. Since 1999, he has taken part in the development of new minimally invasive surgical methods for the treatment of renal and prostate diseases (laparoscopy, daVinci robot). He became one of the first professionals in Europe to carry out a prostate laser vaporization, and the youngest (at the age of 37) head of a urology clinic in Switzerland. He is a member of many international professional associations and communities, as well as the author and co-author of over 200 scientific articles and publications.