CLINIC AND OUTPATIENT CLINIC FOR UROLOGY

CLIN IC AN D O U TPATIE NT CLIN IC
FO R U R O LO G Y
CLIN IC A ND O U TPA TIE N T CLIN IC FO R U R O LO GY
FACTS AND FIGU R E S
Clinic and Outpatie nt Clinic for Urology
Fleis ch m anns traße 42- 44
17475 Gre ifs w ald
Te leph one :
03834- 8659 79
Te lefax:
03834- 8659 78
E- m ail:
Sim one .Le m m @ uni- gre ifs w ald.de
H om e page :
w w w .k linik um .uni- gre ifs w ald.de /patie nte ninfo/k linik e n/urologie
H e ad of de partm e nt:
Univ.- Prof. D r. m e d. K.- J. Klebingat
Se nior ph ys icians :
OA D r. m e d. U. Z im m e rm ann
OA D r. m e d. D . Pie h ler
OA D r. m e d. D . Rös ing
OA D r. m e d. M . Pe ch oe l
H e ad of nurs ing s taff:
Frau M . H e nk e
QM re pre s e ntative :
OA D r. m e d. M . Pe ch oe l
Th e de partm e nt h as 28 be ds . In 2006 1665 patie nts re ce ive d inpatie nt tre atm e nt and
3545 patie nts re ce ive d outpatie nt tre atm e nt.
QU ALITY R E PO R T FO R PATIE NTS
2006
U NIVE R S ITY CLINIC GR E IFS W ALD
CLINIC AND O U TPATIE NT CLIN IC FO R U R O LO GY
M E D ICAL CAR E S E R VICE S
M
e dicalcare s e rvice s of th e Clinic and Outpatie nt Clinic of Urology include th e
diagnos is and tre atm e nt of m alform ations and dis e as e s of th e m ale and fe m ale
urinary tract and of th e m ale ge nitals. Th us , th e de partm e nt is s pe cialis e d in th e e arly
de te ction, diagnos is and th e rapy of dis e as e s of th e k idne ys , th e urinary bladde r, th e
pros tate , of th e te s ticles and th e s crotum and of th e pe nis .
Th e s e are pre dom inantly inflam m ations , dis orde rs of th e urinary trans port and
outflow , urolith s , tum ours and s e xualdis orde rs . Urologicaldis e as e s are tre ate d
according to nationaland inte rnationalguide line s w h ich corre s pond to th e curre nt
leve lof s cie ntific k now ledge . Th e de partm e nt is auth orize d to com pre h e ns ive ly train
s taff and cove rs th e w h ole fie ld of urology e xce pt for k idne y trans plantations .
U NIVE R S ITY CLINIC GR E IFS W ALD
QU ALITY R E PO R T FO R PATIE NTS
2006
CLIN IC A ND O U TPA TIE N T CLIN IC FO R U R O LO GY
S PE CIAL AR E AS O F M E D ICAL CAR E
T
h e de partm e nt is s pe cialis e d in urologic oncology (carcinom as of te s ticles ,
pros tate , k idne ys and of th e bladde r), in ne urourology and urinary incontine nce ,
in s e xualm e dicine and in pros th e tics of th e urinary and ge nitaltract.
Furth e r th e de partm e nt offe rs outpatie nt s urge ry to th e e xte rnalge nitalia, one - day
inpatie nt tre atm e nt (ch e m o- , im m uno- and pain th e rapy) and th e provis ion of donor
organs in coope ration w ith th e organ trans plantation ce ntre Ros tock (Ge rm an
as s ociation for organ trans plantation).
Afte r individualtalks w ith th e patie nts and th e ir e xam ination urologic dis e as e s are
diagnos e d w ith th e h e lp of non- and m inim alinvas ive e xam ination te ch niq ue s
(s onograph y, vide o urodynam ic, e ndos copy) com bine d w ith laboratory m e dicine and
diagnos tic im aging proce dure s (CT, M RT, angiograph y).
Th e individualth e rapie s for h e aling or at leas t im proving dis e as e s follow h olis tic
m e dicalconce pts w ith th e aim to k e e p th e q uality of life on th e h igh e s t pos s ible leve l.
M axim alinvas ive s urge ry is m ainly us e d for th e tre atm e nt of advance d tum ours .
Surge ry trie s to re m ove as m uch of th e tum our as pos s ible and to pre s e rve or to
re s tore th e norm alorgan function, for e xam ple organ pre s e rving in cas e s of k idne y
tum ours , prote ction of urinary contine nce and e re ction in cas e s of pros tate
carcinom as and building of an artificialbladde r out of th e inte s tine in cas e s of
bladde r carcinom as .
QU ALITY R E PO R T FO R PATIE NTS
2006
U NIVE R S ITY CLINIC GR E IFS W ALD
CLINIC AND O U TPATIE NT CLIN IC FO R U R O LO GY
Th e ne urourology tre ats controldis orde rs of th e urinary and th e ge nitaltract in cas e s
of re naland m e tabolic dis e as e s and afte r accide nts (m ultiple s cleros is , apoplexy,
Park ins on’s dis e as e , diabe te s m e llitus , paraplegia). Th e clinic and outpatie nt clinic
for urology of Gre ifs w ald Unive rs ity is th e only ce ntre in th e ne w ly- form e d Ge rm an
s tate s th at offe rs th e w h ole range of ne urourologic diagnos tics and th e rapy.
Conce rning re h abilitation w e w ork in clos e coope ration w ith th e ne urologic
re h abilitation ce ntre Gre ifs w ald.
Th e s e xualm e dicine offe rs diagnos tic and th e rape utic h e lp to patie nts w ith s e xual
function dis orde rs , patie nts w ith s e xualdis orde rs due to dis e as e s or th e rapy and
patie nts w ith de viant s e xualbe h aviour. Be s ide cons ultations and inte rvie w - bas e d
tre atm e nt w e offe r drug- bas e d or te ch nicalproce dure s to tre at patie nts w ith dis e as e re late d dis orde rs to re s tore organ functions .
If oth e r th e rapie s failpros th e tic m e as ure s are also a pos s ibility in urology. In cas e s of
urinary incontine nce w e im plant artificialcons trictor m us cles in m e n and w om e n. In
cas e s of th e rapy re s is tant e re ction dys functions w e im plant e re ctile/ cave rnous body
im plants . Ne rvaldys functions of th e urinary bladde r can be tre ate d w ith e lectronic
im plants de pe nding on th e caus e of th e dys function. Allth e rape utic m e as ure s
m e ntione d above are s ucce s s fully pe rform e d by th e clinic for urology in Gre ifs w ald.
U NIVE R S ITY CLINIC GR E IFS W ALD
QU ALITY R E PO R T FO R PATIE NTS
2006
CLIN IC A ND O U TPA TIE N T CLIN IC FO R U R O LO GY
M E AS U R E S O F INTE R NAL QU ALITY M ANAGE M E NT
T
h e m os t im portant ins trum e nt for q uality m anage m e nt w ith in our de partm e nt is
th e w ork according to clinicalpath w ays . Th is is valid for th e w ork of our nurs ing
s taff and our doctors . Urologicaldis e as e s are tre ate d according to nationaland
inte rnationalguide line s w h ich corre s pond to th e curre nt leve lof s cie ntific k now ledge .
Our nurs ing s taff w ork s according to s tandardis e d w ork ing ins tructions , s tarting w h e n
th e patie nt arrive s in our clinic and e nding w h e n th e patie nt leave s th e clinic. Th e
s tandardis e d w ork ing ins tructions include various proph ylactic m e as ure s . D uring h is
adm is s ion th e patie nt is inform e d h ow to pre ve nt falls. Oth e r inform ation conce rning
th e pre ve ntion of th rom bos is , cys titis , be d s ore s and oth e r follow . Las t ye ar w e could
im prove th e dis ch arge proce s s , w h ich led to a bigge r s atis faction of our patie nts .
For clinic inte rnalq uality m anage m e nt focus s ing on th e fie ld of urology w e k e e p a
s tatis ticals urve y conce rning contine nce afte r pros tate and bladde r s urge ry and afte r
bladde r trans plantations . For th e s urve y th e patie nts are as k e d to com e back and to
s e e one of our doctors about 3 m onth s afte r th e tre atm e nt in h os pitalh as e nde d. Las t
ye ar w e initiate d a s e cond s tudy conce rning th e e xam ination of incontine nce and
functionalre s trictions afte r radicalre m ovalof th e pros tate in cas e of pros tatic cance r.
QU ALITY R E PO R T FO R PATIE NTS
2006
U NIVE R S ITY CLINIC GR E IFS W ALD
CLINIC AND O U TPATIE NT CLIN IC FO R U R O LO GY
As a ve ry h igh pe rce ntage of our patie nts s uffe r from cance r, w e k e e p for th e s e
patie nts a s tatis ticals urve y conce rning h ow long th e y are fre e of tum ours . From th is
w e h ope to draw conclus ions for th e th e rapy of oth e r patie nts .
To im prove th e inte rnalcom m unication be tw e e n th e e m ploye e s of our de partm e nt w e
conduct re gular te am m e e tings on allde partm e ntalleve ls. Th e re s ults of th e s e
m e e tings are docum e nte d and forw arde d to colleague s w h o h ave not be e n pre s e nt at
th e m e e ting. Th is im prove s also th e inform ation flow .
Furth e r ins trum e nts of q uality m anage m e nt are inte rnaland e xte rnaltraining
m e as ure s .
To k e e p th e num be r of infe ctions as low as pos s ible, th e e valuation of our de partm e nt
inte rnalinfe ction s tatis tics is alw ays part of th e clinic inte rnaltraining m e as ure s .
Th e Unive rs ity Clinic organize s patie nt inte rvie w s . Th e re s ults are e valuate d in an
as s e m bly of th e w h ole clinic and in various s m allgroups to draw conclus ions for th e
furth e r im prove m e nt of th e q uality of our m e dicalcare . On a re gular bas is e m ploye e s
of our de partm e nt tak e part in th e m orbidity and m ortality confe re nce of th e Unive rs ity
Clinic.
U NIVE R S ITY CLINIC GR E IFS W ALD
QU ALITY R E PO R T FO R PATIE NTS
2006
CLIN IC A ND O U TPA TIE N T CLIN IC FO R U R O LO GY
M ain diagnos e s according to ICD in 2006
RANKING ICD
NAM E
CASES
1
C61
M alignantne oplas m ofpros tate
19 2
2
C67
M alignantne oplas m ofbladde r
185
3
N40
H ype rplas ia ofpros tate
138
4
N13
Obs tructive and re flux uropath y
128
5
N20
Calculus ofk idne y and ure te r
125
6
C64
M alignantne oplas m ofk idne y, e xce ptre nalpe lvis
99
7
N39
Oth e r dis orde rs ofurinary s ys te m
92
8
C79
Se condary m alignantne oplas m ofoth e r s ite s
88
9
G9 5
D is orde rs ofbladde r in com bination w ith unde rlying ne urologic dis e as e
73
10
N32
Oth e r dis orde rs ofbladde r
45
Com pe te ncy diagnos e s according to ICD in 2006
ICD
NAM E
C67.2
M alignantne oplas m s ofbladde r: Late ralw allofbladde r
N20.1
Calculus ofure te r
C67.8
M alignantne oplas m s ofbladde r: Ove rlapping les ion ofbladde r
N20.0
Calculus ofk idne y
G9 5.80
Paralys is ofbladde r w ith les ion ofuppe r m otor ne uron (UM NL)
C65
M alignantne oplas m ofre nalpe lvis
N9 9 .1
Pos tproce duralure th rals tricture
N31.88
Oth e r ne urom us cular dys function ofbladde r
C62.1
M alignantne oplas m s ofte s tis : D e s ce nde d te s tis
G9 5.81
Paralys is ofbladde r w ith les ion oflow e r m otor ne uron (LM NL)
C67.4
M alignantne oplas m s ofbladde r: Pos te rior w allofbladde r
N31.80
Oth e r ne urom us cular dys function ofbladde r
C67.5
M alignantne oplas m s ofbladde r: Bladde r ne ck
N48.8
Oth e r s pe cifie d dis orde rs ofpe nis
C67.0
M alignantne oplas m s ofbladde r
C67.3
M alignantne oplas m s ofbladde r: Ante rior w allofbladde r
D 41.0
Ne oplas m ofunce rtain or unk now n be h aviour ofk idne y
C67.1
M alignantne oplas m s ofbladde r: D om e ofbladde r
C77
Se condary and uns pe cifie d m alignantne oplas m oflym ph node s
Inform ation s tate d h e re are additionalcom pe te nce s for th e m ain diagnos e s m e ntione d above (inde pe nde ntof
th e cas e s tre ate d in th e re portye ar 2006)
QU ALITY R E PO R T FO R PATIE NTS
2006
U NIVE R S ITY CLINIC GR E IFS W ALD
CLINIC AND O U TPATIE NT CLIN IC FO R U R O LO GY
M ain proce dure s according to OPS in 2006*
RANKING OPS
NAM E
CASES
1
5- 560
Th e rape utic de h ydration ofurinary organs
410
2
5- 573
Proce dure s affe cting th e urinary bladde r
19 1
3
5 - 572
Ure te re ctas ia via ure te r and k idne y
176
4- 1
8- 542
Incis ion, re m ovalor de s truction of(affe cte d) tis s ue ofth e bladde r,
trans ure th ralacce s s
162
4- 2
1- 661
Circum cis ion or e xcis ion ofre trope ritone altis s ue
162
6
5 - 601
Cre ation ofartificialbladde r ope ning
147
* Th e s urve il
l
ance ofvitals igns during ope rations and anae s th e s ia/s e dations , anae s th e s ia on its ow n and bl
ood
trans fus ions during th e proce dure s are nots tate d s e parate l
y.
Com pe te ncy proce dure s according to OPS in 2006
OPS
NAM E
5- 553.00
Partialne ph re ctom y: ope n s urgicalvia lum bar s pine
5- 562.4
Ure te ralorifice , calculus tre atm e ntofk idne ys and ure te r: lith e ctom y
5- 554.40
Ne ph re ctom y: ope n s urgicalvia lum bar s pine
5- 576.20
Cys te ctom y: w ith oute xcis ion ofth e ure te r, in cas e ofm e n: ope n s urgical
5- 59 7.01
Surge ry to bladde r clos ing apparatus : im plantation: conce rning m e dulla oblongata
5- 577.00
Subs titution ofbladde r: re cons truction us ing parts ofs m allinte s tine : ope n s urgical
5- 550.3
Endos copy ofk idne ys and incis ion to k idne ys , ins e rting ofa tube to drain urine com ing from th e k idne ys ,
lith e ctom y and pye lectas ia: calculus de s truction th rough ch rus h ing
5- 554.41
Ne ph re ctom y: ope n abdom inal
5- 404.d
Re s e ction ofalllym ph node s as inde pe nde ntproce dure : re trope ritone al,ope n s urgical
5- 584.71
Re cons truction ofure te r: plas tic re cons truction, one - s ide d: w ith pe nis s k in
5- 059 .02
Oth e r ope ration to ne rve s or ganglion: im plantation or e xch ange ofne urs tim ulator (m ach ine for pain th e rapy)
for s tim ulation ofpe riph e ralne rvous s ys te m : m ulti- ch anne ls ys te m , w h olly im plantable, non- re ch argable
5- 566.10
D raining ofurine via th e s k in w ith a cath e te r w ith inte s tinalre s e rvoir: building a re s e rvoir for parts ofth e s m all
inte s tine and th e cae cum : ope n s urgical
5- 9 85
Surge ry w ith us e oflas e r ins trum e nts
5- 603
Ope rative de s truction or re m ovalofpros tatic tis s ue w ith laparotom y
5- 604.41
Radicalre s e ction ofpros trate due to pros tatic cance r: laparos copic: w ith outre gionalre s e ction oflym ph node s
Inform ation s tate d h e re are additionalcom pe te nce s for th e m ain diagnos e s m e ntione d above (inde pe nde ntof
th e cas e s tre ate d in th e re portye ar 2006)
U NIVE R S ITY CLINIC GR E IFS W ALD
QU ALITY R E PO R T FO R PATIE NTS
2006
CLIN IC A ND O U TPA TIE N T CLIN IC FO R U R O LO GY
R E S E AR CH
In our re s e arch data bas e you can alw ays find curre nt re s e arch re ports of our clinic:
h ttp://fodb.uni- gre ifs w ald.de /inde x.ph p.
QU ALITY R E PO R T FO R PATIE NTS
2006
U NIVE R S ITY CLINIC GR E IFS W ALD