--- title: "Frequently asked questions: PSA, biopsy, prostate-cancer surgery · robot-assisted urology section Hamm" description: "Answers to common questions about a raised PSA level, MRI fusion biopsy, prostate-cancer surgery, bladder, kidney, second opinion and making an appointment at the robot-assisted urology section of St. Barbara-Klinik Hamm-Heessen." source: "https://robotik-barbaraklinik.de/en/haeufige-fragen/" language: "en" generated: "2026-11-05" --- Frequently asked questions # Frequently asked questions about prostate, bladder and kidney Short answers drawn from our pages – with the way to the full information. ## Topics - [First steps](#erste-schritte) - [Investigations](#diagnostik) - [Prostate-cancer surgery](#prostatektomie) - [Benign prostate enlargement](#gutartig) - [Bladder](#blase) - [Kidney](#niere) - [Appointments and contact](#termin) ## First steps ### My PSA level is raised – what happens next? The MRI shows the suspicious area — the fusion biopsy samples it precisely. Through the perineum, under local anaesthesia. The basis is your multiparametric MRI. The finding is graded by PI-RADS — the scale for how suspicious an area is. We take the conspicuous areas as our target. Previous findings and medication are discussed in the consultation. Find out more: [MRI fusion biopsy of the prostate — targeted diagnosis in Hamm](https://robotik-barbaraklinik.de/en/diagnostik/fusionsbiopsie/) ### Can I assess my own risk with an online tool? The nomograms of the Memorial Sloan Kettering Cancer Center (MSKCC) assess the risk. The tool belongs to MSKCC and is used on mskcc.org; it is no substitute for a consultation — please discuss the result with us. Find out more: [Prostate cancer: disease, diagnosis and treatment options](https://robotik-barbaraklinik.de/en/prostata/prostatakrebs/) ### I have been diagnosed with prostate cancer – what are the options? The German S3 guideline on prostate cancer names four options. What is right for you, we discuss together – based on the findings, risk group, age and your life situation. The choice is not a one-way street. Some men combine options, others switch. What matters is that the decision fits you and your findings. Find out more: [Prostate cancer: disease, diagnosis and treatment options](https://robotik-barbaraklinik.de/en/prostata/prostatakrebs/) ### How do I get a second opinion? A cancer diagnosis forces a decision few people are prepared for. A second look costs you one conversation and a few days — and it confirms the chosen path just as often as it points to another one. Either is a good outcome. You do not have to switch hospitals and you do not have to decide anything. You remain in the care of your own urologist. Find out more: [Second opinion on prostate cancer, bladder and kidney tumours](https://robotik-barbaraklinik.de/en/zweitmeinung/) ### What should I bring to the second opinion? Referral from your urologist — with Knappschaft, the insurance card is sufficient; privately insured and self-paying patients do not need one; Your PSA history — ideally every value with its date, not just the most recent one; The biopsy report and, if available, the number of the tissue block; MRI or CT images on CD or DVD — the images themselves, not just the written report; Doctors' letters from your treatment so far; A list of your medications If something is missing, come anyway. Much of it can be requested afterwards — the appointment need not fail because of it. Find out more: [Second opinion on prostate cancer, bladder and kidney tumours](https://robotik-barbaraklinik.de/en/zweitmeinung/) ## Investigations ### What is an MRI fusion biopsy? The MRI shows the suspicious area — the fusion biopsy samples it precisely. Through the perineum, under local anaesthesia. MRI and ultrasound work together: the MRI knows the target, the ultrasound shows the prostate live, and the software lays one over the other. Find out more: [MRI fusion biopsy of the prostate — targeted diagnosis in Hamm](https://robotik-barbaraklinik.de/en/diagnostik/fusionsbiopsie/) ### Is the biopsy painful? You stay awake and responsive: we numb the perineum and the prostate locally — no general anaesthesia. Find out more: [MRI fusion biopsy of the prostate — targeted diagnosis in Hamm](https://robotik-barbaraklinik.de/en/diagnostik/fusionsbiopsie/) ### How will I learn the biopsy result? The samples go to the laboratory. We discuss the result with you in person and plan the next steps together. Find out more: [MRI fusion biopsy of the prostate — targeted diagnosis in Hamm](https://robotik-barbaraklinik.de/en/diagnostik/fusionsbiopsie/) ## Prostate-cancer surgery ### Does the robot operate on its own? It transmits. Every movement of the hand is passed on to the instruments precisely and freed of tremor — and the instrument tips are more mobile than a human wrist. Nothing happens automatically; with no hand on the controls, nothing moves. Find out more: [Prostate cancer surgery in Hamm: robot-assisted prostatectomy](https://robotik-barbaraklinik.de/en/prostata/prostatektomie/) ### What does NeuroSAFE mean? How much nerve tissue can be preserved without leaving tumour behind? That question is answered on the tissue itself — while the operation is still under way. Find out more: [Prostate cancer surgery in Hamm: robot-assisted prostatectomy](https://robotik-barbaraklinik.de/en/prostata/prostatektomie/) ### Will I be continent again after surgery? of patients in large studies from experienced centres are continent again one year after the operation — no pad, or at most one pad per day. With advanced tumours it more often takes longer at first; between the third and the twelfth month the results largely converge. Ficarra V, Novara G, Rosen RC, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol 2012;62(3):405–417 — and Ficarra V, Novara G, Ahlering TE, et al. Systematic review and meta-analysis of studies reporting potency rates after robot-assisted radical prostatectomy. Eur Urol 2012;62(3):418–430. The share of around 68% comes from NeuroSAFE PROOF (Lancet Oncol 2025). These figures come from large published studies; your personal result depends on tumour stage, age and baseline function. Find out more: [Prostate cancer surgery in Hamm: robot-assisted prostatectomy](https://robotik-barbaraklinik.de/en/prostata/prostatektomie/) ### Will erections still be possible? regain an erection sufficient for intercourse one year after bilateral nerve-sparing surgery — depending on age and baseline function. With the intraoperative frozen section this share rises to around 68%, because nerve-sparing surgery becomes possible far more often. Ficarra V, Novara G, Rosen RC, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol 2012;62(3):405–417 — and Ficarra V, Novara G, Ahlering TE, et al. Systematic review and meta-analysis of studies reporting potency rates after robot-assisted radical prostatectomy. Eur Urol 2012;62(3):418–430. The share of around 68% comes from NeuroSAFE PROOF (Lancet Oncol 2025). These figures come from large published studies; your personal result depends on tumour stage, age and baseline function. Find out more: [Prostate cancer surgery in Hamm: robot-assisted prostatectomy](https://robotik-barbaraklinik.de/en/prostata/prostatektomie/) ### How experienced is the surgeon? Experience can be measured. Published learning curves show the number of operations beyond which results no longer improve appreciably: surgical margins from roughly 200 to 250 procedures, potency results from roughly 600 to 700, continence results from roughly 700 to 800. Your surgeon is above all of these thresholds. Vickers AJ, Bianco FJ, Serio AM, et al. The surgical learning curve for prostate cancer control after radical prostatectomy. J Natl Cancer Inst 2007;99(15):1171–1177. Find out more: [Prostate cancer surgery in Hamm: robot-assisted prostatectomy](https://robotik-barbaraklinik.de/en/prostata/prostatektomie/) ### How long will I stay in hospital after prostatectomy? After five to six days. Before you leave, you talk to your surgeon once more. The histology result is discussed with you separately. Find out more: [Your hospital stay after prostatectomy — day by day](https://robotik-barbaraklinik.de/en/prostata/aufenthalt/) ### How do I prepare for surgery? Start pelvic floor training before the operation. Prepared tissue recovers faster afterwards. Have the exercises shown to you instead of guessing them. Exercise, stopping smoking and stable control of any accompanying conditions improve the starting position for the operation and the recovery after it. Find out more: [Before and after prostatectomy — continence and potency](https://robotik-barbaraklinik.de/en/prostata/vor-und-nach-der-operation/) ### When does the follow-up rehabilitation start? The rehabilitation programme should be applied for **during** your inpatient stay. The rehabilitation programme usually lasts three weeks and typically begins a few weeks after discharge. The costs are usually carried by the German pension insurance (Deutsche Rentenversicherung). It includes, among other things, physical reconditioning, pelvic floor training, dietary advice and psychological support. Find out more: [Before and after prostatectomy — continence and potency](https://robotik-barbaraklinik.de/en/prostata/vor-und-nach-der-operation/) ## Benign prostate enlargement ### Is an enlarged prostate cancer? Benign prostate enlargement is **not cancer** and does not become cancer. It arises in the inner part of the gland, which grows over the years and narrows the urethra. Prostate cancer typically arises in the outer part — they are two different diseases that can only coincidentally occur side by side. Find out more: [Benign prostate enlargement — laser or robot in Hamm](https://robotik-barbaraklinik.de/en/prostata/prostatavergroesserung/) ### Which operation helps with benign enlargement? Both procedures relieve the obstruction and improve symptoms and urinary stream equally. **It is not the technique that decides.** Both procedures are equivalent in their effectiveness. What suits you follows from the size of the gland, from what the bladder additionally shows, and from what matters to you. We will tell you openly if the procedure without the robot is the better one for you. Find out more: [Benign prostate enlargement — laser or robot in Hamm](https://robotik-barbaraklinik.de/en/prostata/prostatavergroesserung/) ## Bladder ### I had blood in my urine – what will be investigated? The most common first sign — and usually painless. That is exactly why it is often watched for too long. Even a single episode of blood that has disappeared again should be investigated. Transurethral resection of a bladder tumour (TURBT) is diagnosis and treatment in a single step. An instrument about the thickness of a pen is passed into the bladder through the urethra — with no external incision. The visible tumour is removed and examined histologically. Find out more: [Recognising bladder cancer — TURBT, blue light and treatment planning](https://robotik-barbaraklinik.de/en/blase/diagnose-und-therapie/) ### Why is the muscle layer of the bladder so important? **Without involvement of the muscle layer**, the bladder can as a rule be preserved. Treatment is carried out through the urethra, often supplemented by a therapy instilled directly into the bladder; regular check-ups follow. **With involvement of the muscle layer**, complete removal of the bladder is the established approach with curative intent. What that means in practice is described on the page on Find out more: [Recognising bladder cancer — TURBT, blue light and treatment planning](https://robotik-barbaraklinik.de/en/blase/diagnose-und-therapie/) ### What does „completely intracorporeal“ mean? The new urinary diversion, too, is created entirely inside the body — not through an additional abdominal incision. Find out more: [Bladder cancer: robot-assisted cystectomy in Hamm](https://robotik-barbaraklinik.de/en/blase/zystektomie/) ### Which urinary diversion is the right one? The guideline is unambiguous on this point: ileal conduit, continent cutaneous diversion and orthotopic neobladder are to be discussed with every patient unless something speaks against them. We keep to that. Which route fits depends on the tumour, on kidney function, on comorbidities — and on how you live and what you feel able to manage. We state the medical limits clearly; within those limits, the decision is yours. Find out more: [Urinary diversion after cystectomy — conduit, neobladder, pouch](https://robotik-barbaraklinik.de/en/blase/harnableitung/) ## Kidney ### Can my kidney be preserved? Where the findings allow it, only the tumour is removed and not the organ. For tumours up to about 7 cm the oncological safety of partial nephrectomy is equivalent. NCCN, AUA and EAU recommend it as the standard for these findings wherever it is technically feasible. Find out more: [Kidney tumour surgery in Hamm: kidney-preserving, robot-assisted](https://robotik-barbaraklinik.de/en/niere/nierentumor/) ### What is a pyeloplasty? When urine backs up in the kidney, it suffers silently. The narrowing can be corrected. Find out more: [Pyeloplasty — correcting impaired drainage of the kidney](https://robotik-barbaraklinik.de/en/niere/nierenbeckenplastik/) ## Appointments and contact ### How do I get an appointment? Appointments are arranged by the urology secretariat. +49 2381 681-1589[Book an appointment online](https://www.doctolib.de/urologie/hamm/sami-ramzi-leyh-bannurah-731c5f05-a922-48c8-9188-ccff1f461f23) Find out more: [Contact, appointment and second opinion — Urology Hamm-Heessen](https://robotik-barbaraklinik.de/en/kontakt/) ### When is the consultation hour? Tuesday · 09:00–14:00, Thursday · 08:30–16:00. Appointments are arranged by the urology secretariat. Find out more: [Contact, appointment and second opinion — Urology Hamm-Heessen](https://robotik-barbaraklinik.de/en/kontakt/) ### Can you call me back? Leave your name and number. The urology secretariat will call you back within one working day (Monday to Friday). Find out more: [Contact, appointment and second opinion — Urology Hamm-Heessen](https://robotik-barbaraklinik.de/en/kontakt/) ### Where do I find the section? Urologie, Ebene 1, St. Barbara-Klinik Hamm-Heessen, Am Heessener Wald 1, 59073 Hamm Find out more: [Contact, appointment and second opinion — Urology Hamm-Heessen](https://robotik-barbaraklinik.de/en/kontakt/) ### What do I do in an emergency? **In an emergency**, please dial 112 or contact the emergency department. This page is for appointments and second opinions, not for acute symptoms — e-mails are not read around the clock. Find out more: [Contact, appointment and second opinion — Urology Hamm-Heessen](https://robotik-barbaraklinik.de/en/kontakt/) ## Your question is not among them? Call us – the urology secretariat will be glad to help. Second opinion Received a diagnosis? We will go through your findings with you in the second-opinion clinic. [+49 2381 681-1589](tel:+4923816811589) [Book an appointment online *Bild: Doctolib*](https://www.doctolib.de/urologie/hamm/sami-ramzi-leyh-bannurah-731c5f05-a922-48c8-9188-ccff1f461f23) [Send an e-mail](mailto:urobotik@barbaraklinik.de) [More about the second opinion](https://robotik-barbaraklinik.de/en/zweitmeinung/) Contact ## Second opinion and appointments You have received a diagnosis and are unsure what comes next? Talk to us about the options. Please bring previous findings and imaging with you if you can. Consultation hours - Tuesday · 09:00–14:00 - Thursday · 08:30–16:00 PD Dr. med. Sami-Ramzi Leyh-Bannurah. Appointments are arranged by the urology secretariat. [Book an appointment online *Bild: Doctolib*](https://www.doctolib.de/urologie/hamm/sami-ramzi-leyh-bannurah-731c5f05-a922-48c8-9188-ccff1f461f23) [Call us +49 2381 681-1589](tel:+4923816811589) [Send an e-mail urobotik@barbaraklinik.de](mailto:urobotik@barbaraklinik.de) [Request a callback We will call you back – in a time window that suits you.](https://robotik-barbaraklinik.de/en/kontakt/#rueckruf)