Uro-oncology (Prostate, Bladder, Kidney and Testicular Cancer)
Surgical treatment of cancers of the urinary tract and male reproductive organs. Two things matter most here: not missing a single warning sign, and not making the treatment decision in a hurry.
Last medically reviewed: October 4, 2026 — Assoc. Prof. Dr. Müslüm Ergün
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- Procedure time
- Initial assessment 30–45 minutes
- Anesthesia
- Not required for assessment
- Hospital stay
- Depends on diagnosis and extent of surgery
- Stay in Türkiye
- 7–14 days depending on the operation
- Return to work
- Depends on the operation
- Flight clearance
- According to review and recovery
About the condition
Uro-oncology covers the diagnosis and surgical treatment of cancers of the kidney, bladder, urinary tract, prostate and testicle. What these cancers have in common is that they often produce few symptoms early, and that when symptoms do appear they are easily attributed to something else.
THE MOST IMPORTANT SENTENCE ON THIS PAGE: BLOOD IN THE URINE MUST BE INVESTIGATED, EVEN WHEN IT IS PAINLESS. Painless blood in the urine is the classic first sign of bladder cancer. Seeing it once and having it settle does not mean it has resolved; on the contrary, being intermittent is a known feature of this picture. In anyone who smokes or has smoked, it must be investigated. Being told "it is a urinary infection" and treated with antibiotics is the commonest reason for delayed diagnosis.
THE SECOND WARNING: A PAINLESS FIRM LUMP IN A TESTICLE. Testicular cancer occurs in younger men and is frequently noticed late precisely because it does not hurt. Painlessness is not reassuring; it is typical. It should be assessed without delay.
THIRD: a substantial proportion of kidney tumours are now found incidentally on imaging performed for another reason. That sounds like bad news but is in fact good news, because tumours found early and small can often be treated with organ-sparing surgery.
DO NOT RUSH THE TREATMENT DECISION. For most cancers in this field a few weeks of deliberation causes no medical harm. If you are being pressed to decide immediately, that pressure may be commercial rather than medical. A second opinion is your right, and seeking one does not oblige you to change where you are treated.
Who is it suitable for?
May be suitable
- Anyone with blood in the urine — even if painless and even if it happened only once
- Men who notice a painless firm lump or enlargement of a testicle
- Men with a raised PSA or a suspicious finding on examination
- People found to have a renal mass on imaging
- Patients previously treated for a bladder tumour who require surveillance
- Patients wanting a second opinion before deciding on treatment
- People with a smoking history who develop urinary symptoms
May not be suitable
- Patients wanting surgery planned before diagnosis and staging are complete: accurate staging comes first
- Patients expecting surgery alone to address widespread disease: systemic treatment takes priority there
- Patients whose general health and comorbidities make major surgery inadvisable, in whom less invasive options are considered
- Some very small, slow-growing tumours for which surveillance is more appropriate than surgery
Technology used
- Contrast-enhanced CT and MRI for staging
- Multiparametric prostate MRI and fusion biopsy
- Cystoscopy — direct inspection of the bladder
- Urine cytology
- Robot-assisted and laparoscopic surgery
- Organ-sparing (partial) nephrectomy
- Pathological examination — establishing the true stage and the surgical margins
- Multidisciplinary tumour board review
Surgeon's experience
Verifiable information
- Surgeon's experience
- Assoc. Prof. Dr. Müslüm Ergün121270
Step-by-step journey
- Remotely
Review of your file
Your pathology reports and imaging are reviewed. Send the imaging as image files (DICOM), not only as reports: reading someone else's report is not an independent assessment.
- Days 1–2
Arrival and staging
Examination, completion of any missing staging investigations, blood tests and anaesthetic assessment.
- Decision stage
Discussing the options
Surgery, other treatments and, in suitable patients, active surveillance; the side effects and follow-up requirements of each are stated plainly.
- Day of surgery
The operation
Robotic or laparoscopic where appropriate, and organ-sparing wherever that is possible.
- After discharge
Pathology and plan
Examination of the removed tissue establishes the true stage and whether further treatment is needed. The result usually arrives after you are home; how it reaches you and who explains it is agreed in advance.
- Long term
Surveillance
In these cancers, follow-up is part of the treatment. The schedule, which tests are done and how often, and who reviews the results are all planned in writing.
Method comparison
| Finding | What it may be | Urgency | First step |
|---|---|---|---|
| Painless blood in the urine | Bladder or urinary tract tumour | Investigate without delay | Cystoscopy and imaging |
| Painless firm lump in a testicle | Testicular tumour | Without delay | Examination and scrotal ultrasound |
| Raised PSA | Benign enlargement, inflammation or cancer | Not urgent, but must be followed up | Repeat test, examination, MRI |
| Renal mass on imaging | Benign or malignant mass | Planned assessment | Contrast-enhanced CT |
| Flank pain + fever + shivering | Infection behind an obstruction | EMERGENCY | Attend an emergency department |
The purpose of this table is not to alarm but to show how much time each finding can safely be given. Painless blood in the urine that appears once and settles does not make investigation unnecessary — being intermittent is a known feature of it.
Risks
- DELAYED DIAGNOSIS: the greatest risk in this field is not a surgical complication but a missed warning sign. Blood in the urine attributed to infection and left uninvestigated is the commonest example
- Bleeding, infection and the general risks of surgery and anaesthesia
- Change in organ function, depending on the extent of surgery
- Incontinence and changes in sexual function after prostate surgery
- The period of adjustment after urinary tract reconstruction in bladder surgery
- Reduction in kidney function after renal surgery; organ-sparing surgery aims to limit this
- Collection of lymph fluid where lymph nodes have been removed
- A PATHOLOGY RESULT WORSE THAN EXPECTED, requiring further treatment
- The possibility of recurrence, and therefore the need for continuous follow-up — lapsing from surveillance can undo the value of the treatment itself
Alternatives
- Active surveillance — in selected low-risk prostate cancer and some small renal masses. Not postponing treatment but following it in a disciplined way
- Radiotherapy — an alternative to surgery in prostate cancer, with a different side-effect profile
- Intravesical therapy — for superficial bladder tumours
- Ablative techniques — in selected small renal tumours
- Chemotherapy, immunotherapy and targeted treatments — according to stage, before or after surgery
- Organ-sparing surgery — removing only the tumour rather than the whole organ where that is possible
- Supportive care — prioritising quality of life in older patients with significant comorbidity
Recovery
First week
Varies with the extent of surgery. Early mobilisation matters, both to reduce the risk of clots and for bowel recovery.
Weeks 2–4
A graded return to daily life. Lifting is avoided. When to resume each activity is explained specifically for the operation performed.
After pathology
The result determines whether further treatment is advised. If it is, when and where is planned; this is not bad news but an updated plan.
First year
Follow-up is more frequent in this period, with blood tests and imaging at set intervals.
Long term
Intervals lengthen according to the course but follow-up does not end. Dropping out of surveillance risks a recurrence being found late that could have been found early.
Frequently asked questions
I saw blood in my urine once and then it stopped. Should I have it investigated?
Yes, without question. Painless blood in the urine is the classic first sign of bladder cancer, and being intermittent is a known feature of it. Its stopping does not mean it has resolved. If you have a smoking history, it must be investigated. Being told it is an infection and treated with antibiotics is the commonest reason for delayed diagnosis.
There is a painless lump in my testicle — surely painless means harmless?
The opposite. Testicular cancer characteristically does not hurt; the absence of pain is not a reassuring finding. Any firm lump should therefore be assessed without delay by examination and scrotal ultrasound.
Do I have to decide immediately?
For most cancers in this field a few weeks of deliberation causes no medical harm. Pressure to "decide now" is more often a sign of a commercial approach than a clinical necessity. Ask questions, get a second opinion, and make your decision understanding it.
Is seeking a second opinion disrespectful to my doctor?
No. There is usually more than one reasonable path here, and comparing them is how you find out which suits you. Biopsy grading also involves interpretation, and a second pathology review can change the grade — which can change the recommendation. Seeking a second opinion does not commit you to being treated here.
Will my whole kidney be removed?
Not always. For tumours of suitable size and position only the tumour itself can be removed (organ-sparing surgery). This matters for preserving kidney function, particularly in patients with a single kidney, diabetes or already reduced function. The decision is made from the imaging and the position of the tumour.
Will I need further treatment after surgery?
That is determined by the pathology. Tumour may be found at the surgical margin, or the disease may be more advanced than thought; this does not mean the operation failed, it means the plan is updated. It matters that this possibility was discussed before surgery.
How long does follow-up last, and why does it matter so much?
Follow-up is part of the treatment, not an optional extra afterwards. A recurrence found early is far more easily dealt with. In bladder tumours in particular, regular cystoscopic surveillance is decisive. Ask for your schedule in writing: which test, how often, and who reviews the results.
I am travelling from abroad — how will follow-up work?
This should be settled before you fix your travel dates. Which tests can be done in your own country, how results will be sent and who will review them are agreed in advance. Ask too for your operation note, pathology report and discharge summary in a language you understand; your own doctor will need them.
Does stopping smoking help at this stage?
Yes, and the question matters more than people assume. Smoking is the best-established modifiable risk factor for bladder cancer, and its relevance does not end at diagnosis. It also affects wound healing and the risk of pulmonary complications after surgery. The period before an operation is not too late to stop — it is when most people are most motivated.
What should I send?
All of your pathology reports, the imaging itself as DICOM files, your blood results, any previous operation notes, your medication list and your other medical conditions. Sending report text alone limits what can be assessed.
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This page is for general information only and is not a substitute for medical advice.
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