Penile and Testicular Tumor Surgery Unit

Appointments can be booked through the Institute’s Central Booking System (CUP) at: (+39) 02.2390 1. 

First consultations and follow-up visits take place on the Ground Floor, General Outpatient Clinics, Room “C”, at the following times: 

• Monday and Tuesday from 8:30 a.m. to 1:00 p.m. and from 2:00 p.m. to 4:00 p.m. 
• Thursday from 8:30 a.m. to 1:00 p.m. 

Patients must bring a referral from their general practitioner for a “First Urological Visit”. 

• Testicular Cancer
• Diagnosis and Staging
• Treatment of Primary Tumor
• Surgical Treatment of the Retroperitoneum
• Laparoscopy

The IRCCS National Cancer Institute Foundation of Milan has been a reference center for testicular cancer for over 30 years, ever since Dr. Giorgio Pizzocaro began specific research and treatment activities. Currently, Dr. Nicola Nicolai is the vice president of the Italian Germ Cell Cancer Study Group (IGG), whose main mission is to spread knowledge aimed at improving the treatment of the disease in Italy. This activity led to the development of Italian clinical practice guidelines, recognized by the main Italian specialized societies in oncology (AIOM), urology (SIU, SIUrO, AURO), and radiation oncology (AIRO).

The Urology Unit and Testicular Surgery Section of the IRCCS National Cancer Institute Foundation of Milan have participated in international studies that led to the definition of prognostic categories for patients with metastatic disease in the first and subsequent lines of treatment. Dr. N. Nicolai is part of the European board for the development of testicular cancer guidelines of the European Association of Urology and has contributed to the development of the consensus on testicular neoplasia by the European Society for Medical Oncology (ESMO).

Services
Many histopathological diagnoses require a review of the histological specimens, which is conducted by the Pathology Service, with the involvement of a highly experienced Uropathologist with expertise in testicular cancer diagnoses. Some staging exams (CT, MRI) are reviewed collaboratively with the assistance of colleagues from radiology.

Clinical Units
Clinical cases requiring multimodal treatment (i.e., a combination of surgery, chemotherapy, and radiotherapy) are systematically discussed on a weekly basis with colleagues from Medical Oncology and Radiotherapy.

In addition to testicular pathology, Dr. Nicolai has developed significant experience in oncological urological surgery for the major neoplastic diseases of the genitourinary tract (prostate, bladder, kidney, adrenal glands, and penis). In particular, the specific expertise of the team focused on minimally invasive retroperitoneal surgery has allowed the development of minimally invasive surgery in other areas of urological surgery within the Urology Unit.

Minimally Invasive Renal Resection

Renal resection and enucleoresection are emerging surgical techniques in the treatment of kidney cancer, which typically presents in increasingly early forms. This surgery is particularly delicate, as it requires the removal of part of the renal tissue while maintaining organ function as much as possible. The traditional open approach is associated with morbidity related to laparotomy or lombotomy, resulting in an average hospital stay of 6 to 8 days and a social and work recovery time of around 30-40 days.

The laparoscopic technique, progressively developed at the Urology Unit of the IRCCS National Cancer Institute Foundation of Milan, is a high-specialization procedure that can only be performed in centers with significant expertise and volume. It reduces hospital stay to an average of 5 days, minimizes the need for pain management and its functional consequences, and shortens social and work recovery time to approximately 15 days for most candidates for conservative renal surgery (renal resection/enucleoresection). The indication and application of this procedure are steadily increasing.

Laparoscopic Radical Prostatectomy

Minimally invasive radical prostatectomy (either pure laparoscopy or assisted by robotic platform) is now the standard treatment for prostate cancer when surgical intervention is chosen. Open surgery is now performed only on a minority of patients, depending mainly on the characteristics of the disease.

The traditional open approach is associated with morbidity linked to laparotomy, resulting in a hospital stay of 6 to 8 days and a recovery time of around 30-40 days. The pure laparoscopic technique, progressively developed at the Urology Unit of the IRCCS National Cancer Institute Foundation of Milan, is a specialized procedure performed in centers with good expertise and volume. It reduces the hospital stay to an average of 4 days, critically lowers the risk of intra- and postoperative bleeding, reduces the need for pain management and its functional consequences, and shortens the social and work recovery time to approximately 15 days for most candidates for radical prostatectomy. The use and application of laparoscopic procedures are increasing over time.

Laparoscopic Radical Nephrectomy

Radical nephrectomy is the standard surgery for treating kidney cancer. The traditional open approach is associated with morbidity related to laparotomy, resulting in a hospital stay of 6 to 8 days and a recovery time of around 30-40 days.

The laparoscopic technique, progressively developed at the Urology Unit of the IRCCS National Cancer Institute Foundation of Milan, is a highly specialized procedure performed in centers with good expertise and volume. It reduces the hospital stay to an average of 5 days, minimizes the need for pain management and its functional consequences, and shortens the social and work recovery time to about 15 days for most candidates for radical nephrectomy. The indication and application of this procedure have remained fairly constant over time.

Laparoscopic Adrenalectomy

Adrenalectomy is a specialized surgery used to treat various forms of adrenal gland neoplasms, which have heterogeneous biology and are often associated with specific and complex syndromes and metabolic conditions. These cases require interdisciplinary expertise from surgeons, endocrinologists, medical oncologists, and anesthesiologists.

This surgery can have significant functional impacts, which require developed expertise. The traditional open approach is associated with morbidity related to laparotomy or lombotomy, resulting in a hospital stay of 6 to 8 days and a recovery time of around 30-40 days.

The laparoscopic technique, progressively developed at the Urology Unit of the IRCCS National Cancer Institute Foundation of Milan, is a high-specialization procedure that can only be performed in centers with significant expertise and volume. It reduces the hospital stay to an average of 3 days, minimizes the need for pain management and its functional consequences, and shortens the social and work recovery time to about 15 days for nearly all candidates for adrenal surgery. The indication and application of this procedure are steadily increasing.