Urology Surgeons, P.C., now publishes a quarterly newsletter, Noteworthy Urology for referring physicians. Because it might also be of interest to patients, we are printing it on our website. The first issue was sent in April 2001. The main article from the April issue appears below. Please check back for future issues.

Eighty-five percent of solid renal masses are renal cell carcinoma. Today, most are discovered incidentally during renal imaging. Many of these serendipitously discovered masses are low stage. Current treatment options include radical nephrectomy, laparoscopic nephrectomy, and partial nephrectomy.

The introduction of partial nephrectomy in the treatment of these lesions has been a major advance in the delivery of urologic care. Today, major research centers such the Mayo Clinic and Cleveland Clinic treat almost 50% of renal masses with partial nephrectomy.

By preserving renal parenchyma, patients with borderline renal function, or diseases that predispose to renal failure (such as hypertension or diabetes) may avoid future renal failure and dialysis.

In addition, there is a 4% risk of metachronous renal cell carcinoma in the contralateral kidney at a mean of 8.8 years. Even if the contralateral kidney must be completely removed, the partial kidney usually has enough parenchyma to obviate dialysis.

Fifteen-year data from 164 patients from the Mayo Clinic show no difference in cause-specific survival between patients treated with partial or radical nephrectomy. However, after 15 years, 22% of patients treated with radical nephrectomy had chronic renal insufficiency, while only 12% of patients had CRI following partial nephrectomy.

There is a 6% risk of local recurrence following partial nephrectomy. These patients must undergo the same postoperative surveillance as other patients with renal cell carcinoma. If recurrent malignancy is detected, the patient usually undergoes radical nephrectomy.

Currently, this procedure is performed through a standard flank incision. In the future we hope to offer laparoscopic partial nephrectomy.

We are proud to be able to offer partial nephrectomy in Grand Rapids. For more information please contact one of our physicians.

Urology Surgeons, P.C.
4070 Lake Drive SE, Suite 103
Grand Rapids, MI 49546-8294
Tel: 616.949.4340
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