Northwestern University Feinberg School of Medicine

Department of Urology

Endourology (Stone Disease)/Minimally Invasive Surgery

Endourology is the minimally invasive discipline in which small telescopes and lasers are used to treat tumors, strictures, or congenital anomalies of the bladder, ureter, and kidney. Members of the Department of Urology are actively pursuing the etiology and treatment of transitional cell cancer of the upper urinary tract, scar tissue formation (strictures), and the treatment of ureter pelvic junction obstruction. The Department of Urology is active in minimally invasive therapy of both benign and malignant disease. Robert B. Nadler, MD, heads the Section of Endourology, Laparoscopy, and Stone Disease. Drs. Robert Nadler and Steven Campbell at Northwestern performed the first laparoscopic prostatectomy in the state of Illinois in the fall of 2000. This minimally invasive technique allows for faster recovery, less blood loss, and better continence and potency in men with prostate cancer.

Education

The clerkship and fellowship programs in endourology and minimally invasive surgery offer training in both advanced endourologic and laparoscopic procedures, including prostatectomy, pyeloplasty, nephrectomy, partial nephrectomy and cryoablation. Training in the treatment of medical stone disease in an outpatient clinical setting is also provided. The outpatient clinical experience is heavily weighted toward endourology/laparoscopy patients; however, some general urology patients are also seen. Clinical research is stressed, although basic research (primarily in nanotechnology) is also available.

Research

Research is being pursued on treating tumors not only laparoscopically but also in an even less invasive manner - via radio frequency ablation and cryosurgery delivered percutaneously into small tumors. Ongoing research studies are also underway to evaluate the role, cost, and efficacy of various laparoscopy techniques. Studies to evaluate the exciting new minimally invasive technique of cryosurgery are ongoing under the direction of Dr. Nadler. Cancers in various organs in the body can be eradicated by freezing to very low temperatures (cryosurgery) and experimental studies have demonstrated that cryosurgery can be safely applied to the kidneys. Under the direction of Robert B. Nadler, MD, clinical trials on the optimal treatment for ureteropelvic junction obstructions using the Acusize cutting balloon, holmium laser, or the technique of antegrade endopyelotomy are ongoing. A similar study for ureteral strictures and a long-term analysis of patients with small upper tract transitional cell cancer treated endoscopically are also underway.

Patient Care

The Department of Urology faculty members treat patients through our affiliated clinical sites. We are dedicated to the thorough evaluation and minimally invasive treatment of stones, tumors, and congenital anomalies of the kidney, ureter, and bladder. The latest minimally invasive techniques are used to treat stones in the upper and lower urinary tract; these techniques include extracorporeal shock wave lithotripsy (ESWL) using two state of the art lithotripters.

Selected Research Publications

Pierorazio PM, Mullins JK, Eifler JB, Voth K, Hyams ES, Han M, Pavlovich CP, Bivalacqua TJ, Partin AW, Allaf ME, Schaeffer EMContemporaneous Comparison of Open vs Minimally-Invasive Radical Prostatectomy for High-Risk Prostate Cancer. A study analyzing pathological and short-term oncological outcomes in men undergoing open and minimally-invasive radical prostatectomy (MIRP) for high-risk prostate cancer.

Chi AC, McGuire BB, Nadler RBModern Guidelines for Bowel Preparation and Antimicrobial Prophylaxis for Open and Laparoscopic Urologic Surgery. A review of the history of mechanical and oral antibiotic bowel preparation, evolution of the practice trends in colorectal surgery and urology, and contemporary guidelines in skin preparation and antimicrobial prophylaxis before surgery.

Sharma V, Aggarwal A, McGuire B, Rambachan A, Matulewicz RS, Kim J, Nadler RBOpen versus Minim

Lloyd G, Lim A, Hamoui N, Nakada SY, Kielb SJ. The Use of Medical Expulsive Therapy during Pregnancy: A Worldwide Perspective.  An examination of the worldwide usage of medical expulsive therapy in pregnant women with presumed ureteral stones.

Oberlin DT, Flum AS, Bachrach L, Matulewicz RS, Flury SC. Contemporary Surgical Trends in the Management of Upper Tract Calculi. An analysis of American Board of Urology case logs to examine trends in treatment of upper urinary tract stones.

McGuire BB, Matulewicz RS, Zuccarino-Crowe R, Nadler R, Perry KT. Contemporary Attitudes and Practice Patterns of North-American Urologists in Investigating Stone Forming Patients - A Survey of Endourological Society Members. An assessment of the attitudes and practice patterns of metabolic work up in North American endourologists.

Robert Nadler, MD

Robert B. Nadler, MD
Section Director

Faculty

Sarah Flury, MD

Stephanie J. Kielb, MD

Kent T. Perry, MD