Precision Urology

General Urology

General Urology is a broad surgical specialty focused on the diagnosis and treatment of disorders affecting the urinary tract in both men and women, as well as the male reproductive system. This includes conditions such as kidney stones, urinary tract infections, benign prostatic hyperplasia (BPH), bladder disorders, incontinence, hematuria, and male infertility. General urologists provide both medical and surgical management, ranging from lifestyle counseling and medication to minimally invasive procedures and surgery.

Urologic Oncology

Urologic Oncology is a subspecialty of urology dedicated to the diagnosis and treatment of cancers affecting the urinary system and male reproductive organs — including cancers of the prostate, kidney, bladder, testis, adrenal glands, and ureter. Urologic oncologists are trained in advanced surgical techniques such as robotic and laparoscopic surgery, as well as in coordinating multimodal treatment strategies involving radiation, immunotherapy, and systemic therapies. The field combines surgical precision with a deep understanding of cancer biology to achieve the best oncologic and functional outcomes.

General urology encompasses the diagnosis and treatment of conditions affecting the urinary tract in both men and women, as well as the male reproductive system. This includes disorders of the kidneys, ureters, bladder, urethra, and prostate, such as urinary tract infections, kidney stones, benign prostatic hyperplasia (BPH), incontinence, hematuria, erectile dysfunction, and male infertility. General urologists provide both medical and surgical management, including minimally invasive and in-office procedures.

Urologic oncology is a subspecialty focused on the diagnosis and surgical treatment of cancers of the urinary system and male reproductive organs — including prostate, kidney, bladder, testicular, adrenal, and penile cancers. Urologic oncologists are trained in advanced surgical techniques including robotic and minimally invasive surgery, and work within multidisciplinary teams to deliver comprehensive, evidence-based cancer care guided by NCCN guidelines.

Personal medical care means treating every patient as a unique individual — not a diagnosis or a protocol. It begins with genuinely listening, taking the time to understand the patient’s specific symptoms, history, concerns, and life circumstances. Every recommendation is explained thoroughly, every question is welcomed, and every treatment plan is built around what matters most to that patient. The goal is a true partnership between physician and patient.

Precision medicine is an approach to care that tailors treatment to the individual characteristics of each patient — their specific diagnosis, molecular profile, underlying condition, and clinical presentation. Rather than applying a one-size-fits-all protocol, precision medicine uses the most current evidence, advanced diagnostics, and clinical guidelines such as those from the AUA and NCCN, to design a management strategy that is as unique as the patient it serves.

The initial management approach for LUTS (Lower Urinary Tract Symptoms) should be conservative (timed urination and fluid management), followed by medical treatment (Alpha-1 blocker, 5-alpha reductase inhibitor). If this approach is not improving the patient’s quality of life, or the patient is experiencing significant side effects, surgical management options could be discussed.

Prostate cancer is the most common cancer in men. Screening aims to detect it early — when treatment is most effective and curative options are greatest. Current AUA and NCCN guidelines recommend shared decision-making about PSA screening beginning at age 40–45 for high-risk men (African American men or those with a first-degree relative diagnosed with prostate cancer before age 65), and at age 50–55 for average-risk men. Screening is not recommended after age 70 or in men with a life expectancy of less than 10 years. The decision to screen should be individualized based on a thorough discussion of risks, benefits, and the patient’s personal values.

Kidney stones (urolithiasis) are hard mineral and salt deposits that form inside the kidneys when urine becomes concentrated, allowing minerals to crystallize and stick together. They form due to a combination of factors including dehydration, dietary habits, metabolic disorders (such as hypercalciuria, hyperoxaluria, or hyperuricemia), anatomical abnormalities, and genetic predisposition. Stones can vary widely in size, composition (calcium oxalate, uric acid, struvite, cystine), and location — from the kidney to the ureter and bladder. Nephrology plays a crucial role in the long-term prevention of stone recurrence and growth — through 24-hour urine metabolic analysis, identification of underlying systemic conditions, and individualized dietary and pharmacologic prevention strategies. A close collaboration between urology and nephrology is essential for comprehensive stone disease management.

Urologic oncology is the subspecialty of urology dedicated to the surgical and medical treatment of cancers of the urinary system and male reproductive organs — including prostate, kidney, bladder, testicular, adrenal, ureteral, and penile cancers. These malignancies range from highly treatable localized tumors to complex metastatic disease requiring multimodal management. Urologic oncologists work within multidisciplinary teams — alongside medical oncology, radiation oncology, radiology, and pathology — to deliver evidence-based, individualized cancer care aligned with NCCN guidelines. Treatment decisions integrate tumor biology, staging, patient health, and personal goals to optimize both oncologic outcomes and quality of life.

The SUO Fellowship is a rigorous one- to two-year subspecialty training program completed after a full urology residency, offered exclusively at NCI-designated cancer centers and leading academic institutions. Fellows receive intensive training in the surgical management of complex urologic malignancies — including robotic and open radical prostatectomy, radical and partial nephrectomy, radical cystectomy, retroperitoneal lymph node dissection, and adrenalectomy. Equally important, fellows develop deep expertise in oncologic decision-making, cancer staging, systemic therapy principles, and clinical research. Kai Hans Hammerich, MD PhD completed his fellowship training at the Urologic Oncology Branch of the National Cancer Institute (NCI) / NIH in Bethesda, MD — one of the most prestigious programs in the country.

A urologic oncology fellowship represents the highest level of specialized surgical training available in the field. Fellowship-trained surgeons have performed a significantly higher volume of complex oncologic procedures, developed nuanced judgment in high-stakes clinical situations, and are immersed in the most current evidence-based practices. For patients facing a cancer diagnosis, this translates into more precise surgical technique, more accurate staging and risk stratification, a broader range of treatment options, and a deeper understanding of how to balance aggressive cancer control with preservation of function and quality of life. Choosing a fellowship-trained urologic oncologist means entrusting your care to a physician who has dedicated an additional layer of their career to mastering exactly this.

Robotic surgery is a powerful technology — but its outcomes are only as good as the surgeon behind the console. Mastery of the da Vinci Xi requires years of dedicated training, high procedural volume, and deep anatomical expertise. The SUO fellowship, offered exclusively at NCI-designated cancer centers, provides exactly this — intensive, supervised training in complex robotic urologic procedures under world-class mentorship. Fellowship-trained surgeons bring not only technical proficiency, but also the oncologic judgment to know when and how to use robotic surgery to its fullest advantage, ensuring the best possible outcome for each individual patient.

Robotic surgery is technically demanding — the outcomes are directly dependent on the surgeon’s training, volume, and experience. Not all robotic surgeons are equal. The SUO Fellowship — completed at NCI-designated cancer centers — provides concentrated, high-volume training in robotic urologic oncology under the supervision of world-class surgeons. Fellows perform hundreds of robotic cases during training, developing the precision, judgment, and anatomical mastery that distinguish truly expert robotic surgeons. Kai Hans Hammerich, MD PhD received this level of training at the NCI / NIH in Bethesda, MD, ensuring his patients benefit from fellowship-level robotic surgical expertise.

The da Vinci Xi is a powerful surgical tool — but its outcomes are only as good as the surgeon operating it. Robotic surgery requires specialized training that goes far beyond basic urological residency. The SUO (Society of Urologic Oncology) fellowship is one of the few training pathways that provides surgeons with the volume, complexity, and mentorship required to master robotic techniques for complex urologic oncology cases — including nerve-sparing radical prostatectomy, robotic partial nephrectomy, and robotic radical cystectomy. Kai Hans Hammerich, MD PhD received this fellowship-level robotic training at the NCI / NIH in Bethesda, MD, one of the highest-volume urologic oncology programs in the country. For patients considering robotic surgery, the experience and subspecialty training of the surgeon remains the single most important determinant of outcome.