Urology

Indiana University Health urologists treat a wide variety of conditions, from male and female urinary incontinence to kidney stones to bladder cancer. Our urologists (physicians who specialize in surgical and medical treatment of the urinary tract) work closely with your primary care physician and specialists to develop a comprehensive treatment plan for your individual needs.

Indiana University Health University Hospital is world renowned for its Urology Department. Patients come to IU Health urologists because we are known for delivering exceptional outcomes and pioneering new treatments in testicular, bladder, prostate and kidney cancer. The Department of Urology was founded in 1887 by Dr. William Wishard and was arguably the first department dedicated exclusively to urology in the United States.

Since that time, IU Health University Hospital has developed into one of the premiere urology departments in the country. We offer access to the latest medical and surgical treatments for urological problems. Through our partnership with the Indiana University School of Medicine, our physicians remain on the forefront of medicine by participating in urology research studies and giving you access to leading edge surgeries and clinical trials. In addition, our urologists are educating the next generation of urology specialists through residencies and fellowships at the IU School of Medicine.

IU Health University and Methodist hospitals are also very active in advanced research and have achieved the following milestones:

  • Pioneered nerve-sparing Retro Peritoneal Lymph Node Dissection (RPLND) for the treatment of testis cancer, dramatically improving survivorship in this disease
  • Developed the Indiana Pouch continent urinary reservoir
  • The first in the nation to use extracorporeal shock wave lithotripsy (ESWL) for the treatment of kidney stones
  • Pioneers in the use of percutaneous and ureteroscopic techniques for kidney stone removal
  • One of the first institutions to utilize the holmium laser for kidney stone treatment
  • The first in Indiana to perform a laparoscopic nephrectomy (kidney removal)
  • The first in the nation to perform a holmium laser enucleation (removal of a mass) of the prostate (HoLEP)
  • One of the pioneering institutions to use the daVinci robot for prostate cancer removal

The primary treatment for kidney cancer is surgical removal of the affected area of the kidney or of the entire kidney. IU Health Urology experts are leaders in the use of a surgical technique called robotic partial nephrectomy or kidney-sparing surgery. You may not have to lose your entire kidney to surgery, depending on your disease state and tumor location. This technique, using the da Vinci Surgical Robotic System, enables us to remove only the diseased part of your kidney and spares the healthy, functioning kidney tissue.

Studies indicate that patients who have their entire kidney removed are more likely to suffer from chronic kidney disease (CKD) following surgery and need dialysis, as compared to patients who received a kidney-sparing robotic partial nephrectomy.

At IU Health, we strive to use minimally invasive and robotic surgery techniques to reduce the impact of surgery on your body. Minimally invasive techniques allow our surgeons to remove all or part of the kidney through a tiny incision. We perform about 80 percent of kidney removals with minimally invasive techniques, including laparoscopic and robotic surgery.

Kidney cancer requires comprehensive care and support. Our multidisciplinary team approach combines the expertise and knowledge of specialists in urology, medical oncology, interventional radiology and other disciplines so you have a wide range of treatment options. Our patient- and family-centered approach ensures that your treatment plan is designed specifically to fit your needs and preferences. 

Kidney cancer does not respond well to chemotherapy, so surgery at an early stage is important for effective treatment. When identified and treated early, kidney cancer has a good long-term outlook.

New studies underway at Indiana University are looking to change the way we treat kidney cancer, shorten healing times, improve outcomes and improve renal function. Results from these studies are published in medical journals, allowing us to share our techniques and outcomes internationally.

Below is information about the treatments offered by the experienced urology team at IU Health University Hospital for some of the most common types of urological cancer.

Cystectomy

IU Health University Hospital is one of the leading facilities in the country performing cystectomy, the surgical removal of the bladder, as a result of bladder cancer. Our hospital performs hundreds of cystectomies a year, and people come from all over the world for treatment. This includes:

  • Radical cystectomy. Removal of the bladder, lymph nodes near the bladder and any nearby organs that contain cancer cells. This procedure is typically used when there are multiple areas of cancerous cells in the bladder and there is metastasis to other sites.

Cystectomy involves an incision (cut) in the lower belly. Sometimes laparoscopic surgery or "Band-Aid” surgery is used, requiring only small incisions. For this type of surgery, the doctor puts a scope, or lighted tube, and other surgical tools through the small cuts, allowing him or her to see your organs.

Following bladder removal, surgeons perform a urostomy procedure. This surgical procedure creates another opening for urine to drain. Women who have a radical cystectomy usually have their uterus, ovaries and part of the vagina removed as well. The prostate gland and seminal vesicles are usually removed in men who have a radical cystectomy.

Retroperitoneal Lymph Node Dissection

IU Health urology specialists use retroperitoneal lymph node dissection (RPLND) to effectively treat testicular cancer. This procedure removes abdominal lymph nodes in order to treat testicular cancer and help establish its stage and type. IU Health pioneered nerve-sparing RPLND for the treatment of testicular cancer, which preserves a man’s ejaculatory mechanism.

Surgery, chemotherapy and radiation are essential treatment options for testicular cancer. If not caught early enough, testicular cancer can metastasize upward into lymph nodes in the abdomen. Further metastasis often appears in the lungs and requires more aggressive treatment.

Removing the affected testicle is usually an essential part of treatment. If we catch the cancer at an early stage, this may be the only treatment necessary. If we decide there is no need for further treatment, careful monitoring will help us catch any cancer that was not visible earlier.

IU Health offers a wide range of treatment options. Our specialists collaborate to treat even advanced testicular cancer that has metastasized (spread) to other organs of the body. Your particular cancer and your preferences are an important part of our treatment decisions. We also provide social workers and counselors who can help you with emotional aspects of cancer.

Lifesaving treatments developed over the last 50 years through clinical trials at Indiana University have made testicular cancer one of the most survivable cancers. Researchers and physicians at IU Health are among those who developed innovative treatments for this cancer. We gained an international reputation for our work, and we remain on the leading edge of treatment for testicular cancer.

With timely diagnosis, testicular cancer is highly treatable and usually curable. Treatment has become so effective that it’s common for a man to have no recurrence and live a completely normal life. Medical advances have made the overall cure rate for testicular cancer about 95 percent. Because testicular cancer is relatively rare, it is important to be evaluated by an experienced team with special expertise and knowledge of testicular tumors.

Prostate Cancer Treatments

In this video, Dr. Michael Koch, chairman of the Department of Urology at IU Health and professor at the Indiana University School of Medicine, discusses current treatment methods used in prostate cancer. IU Health was first to use minimally invasive robotic surgery in Indiana and developed the technique of using high-intensity ultrasound to destroy cancerous tissues. IU Health was also one of the few institutions to collect patient outcomes data and track it to the surgical technique used.

The prostate cancer specialists at IU Health provide care to patients from throughout the United States and around the world. This extensive practice provides a level of expertise you cannot easily find at other medical centers. As a result, we are very familiar with even the rarest forms of these cancers. With experience comes the knowledge to deliver the best outcomes.

When appropriate, therapeutic options for prostate cancer can include one or more of the following:

  • Surgery to remove the cancer.
  • Chemotherapy to destroy cancer cells with drugs.
  • Radiation therapy that uses high energy, penetrating waves or particles to destroy cancer cells or keep them from reproducing.
  • Hormonal therapy to slow or stop tumor growth by using synthetic hormones to block or lower the body’s production of testosterone to the cancer cells.

Should you be diagnosed with prostate cancer that needs removal, this may be done using special robotic tools that require only five keyhole-sized incisions (the da Vinci Surgical Robotic System). This method results in excellent outcomes and faster recovery time.

Radiation therapy treatments can include:

  • Computed tomography (CT) simulation. A radiation-planning process using a CT scan to define tumor targets and internal anatomy in three dimensions to enable the radiation oncologist to precisely target the tumor while saving normal tissues.
  • Four-dimensional CT simulation. A CT simulation which also visualizes internal anatomy changes (such as changes in tumor location with the breathing cycle) allowing the radiation oncologist to target the tumor more accurately and further spare normal tissues.
  • Image guided radiation therapy (IGRT). Uses precise radiographic imaging to more precisely target tumors while sparing normal tissues at each daily radiation treatment.
  • Cone-beam computed tomography (CBCT). An IGRT technique that uses a limited CT scan prior to a daily radiation treatment to verify targeted internal anatomy in three dimensions before the treatment is delivered. This technique allows extreme precision of targeting the radiation beams.
  • Three-dimensional conformal radiotherapy. Guided by a computer-generated, three-dimensional picture of the tumor, allowing the highest possible dose of radiation while sparing the normal tissue as much as possible.
  • Intensity modulated radiation therapy (IMRT). Advanced radiation delivery that allows delivery of radiation to areas surrounding, or in close proximity to, radiation sensitive tissues. This technique uses a computerized optimization algorithm that allows the radiation oncologist to “paint” the dose around critical normal tissues to more effectively spare them from radiation side effects.
  • Stereotactic body radiation therapy (SBRT). We use special equipment to precisely deliver a large radiation dose to a tumor and not to normal tissue.
  • Proton beam radiation. Particle radiation treatments using charged particles (protons) that can be used to treat tumors in close proximity to critical radiation sensitive tissues and re-irradiate previously treated tissues. This type of therapy allows the highest probability of sparing normal tissues, and lessens the possibility of second tumors related to radiation exposure.

Our commitment to research and to advances in prostate cancer distinguishes our program from other cancer centers. We perform many clinical trials, examining new technologies and new medical therapies we feel have the potential to advance clinical care.

Clinical trials are tests of new drugs and other treatments that may be more effective than currently accepted screening, diagnosis or treatments of prostate cancer. Depending on your diagnosis, you may have access to one or more of these trials.

Additional Contact Information

For Patients
800.265.3220

We are located at:
535 North Barnhill Drive, Suite 420
Indianapolis, IN 46202-5289

For Physicians
800.265.3220

We are located at:
535 North Barnhill Drive, Suite 420
Indianapolis, IN 46202-5289