PD Dr Jörn H. Witt: Prostate Cancer Specialist in Düsseldorf (NRW)

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PD Dr Jörn H. Witt is a renowned urologist and the head physician and director of the private urological clinic Urokompetenz in Düsseldorf.

The team around PD Dr Witt specializes in the treatment of urological diseases at the highest medical level, with particular expertise in the field of urologic oncological diseases, including prostate cancer, kidney tumors, and bladder cancer. State-of-the-art technologies guarantee comprehensive diagnostics and, therefore, precise individual treatment planning. Particularly worth mentioning is PD Dr Witt's expertise in robot-assisted prostate surgery, which is a particularly gentle treatment option.

Early Detection of Prostate Cancer: State-of-the-Art Imaging Methods for a Precise Diagnosis

Early detection of prostate cancer is decisive for successful treatment. The latest imaging techniques are used at private clinic Urokompetenz under the direction of PD Dr Jörn H. Witt to ensure a precise diagnosis.

In addition to the standard PSA test, we are one of the few centers that also offer the Stockholm 3 test. This test examines various proteins in the blood and determines the risk of significant prostate cancer.

In addition to multiparametric magnetic resonance imaging (mpMRI), a central instrument is the micro-ultrasound examination of the prostate. A 29Mhz transducer is used here. Structures up to 70µm in size can be imaged. For comparison, with mpMRI, the resolution is approximately. 200µm. This high-resolution imaging enables the direct identification of suspicious areas with high accuracy or the correlation with MRI results. An MRI-supported fusion biopsy is then used, in which the previously acquired MRI images are fused with real-time micro-ultrasound images. This allows targeted tissue sampling from suspicious areas and significantly increases diagnostic reliability.

The clinic also offers PSMA-PET-CT. This is a state-of-the-art procedure in which a low-level radioactive substance is administered via the vein. This substance binds specifically to proteins characteristic of prostate cancer cells. In subsequent imaging, even small cancer foci become visible throughout the body.

This makes PSMA-PET-CT exceptionally reliable in detecting tumors and potential metastases, allowing for precise treatment tailored to the individual's stage of the disease. Our cooperation partners carry out the examination, and appointments can usually be arranged at short notice.

This combination of state-of-the-art diagnostic procedures enables individualized and stage-appropriate therapy planning for the patient.

Robot-Assisted Prostate Surgery with an Experienced Prostate Cancer Specialist in Düsseldorf

PD Dr Jörn H. Witt is considered a pioneer of robot-assisted urology in Germany. Having performed over 10,000 robot-assisted prostate surgeries, he is one of the world's most experienced surgeons in this field. He has been Head of Urology at the renowned Clinic Bel Etage in Düsseldorf since April 2024.

Robot-assisted radical prostatectomy using the Da Vinci surgical system offers numerous advantages over conventional methods. The high precision of the robotic system means that surrounding nerve structures can be effectively protected. This significantly reduces the risk of incontinence and impotence as a result of the surgery.

Robot-assisted surgery enables minimally invasive procedures with smaller incisions, a reduced risk of bleeding, and shorter hospital stays. Dr Witt and his team focus on individual consultations and treatment planning to develop the best possible treatment strategy for each patient.

Innovative Intraoperative Evaluation of Marginal Areas

The marginal areas of the prostate are examined intraoperatively by the pathologist. Most clinics send tissue material to the pathologist for a frozen section examination, and in some clinics, a NeuroSafe examination is also carried out. Urokompetenz is already much more advanced in this regard.

The margins are examined using a high-resolution scanner (Histolog®). This has several significant advantages:

1. The result is available within a few minutes (45-60 minutes with a conventional frozen section).
2. The entire surface of the specimen can be scanned, allowing the pathologist to examine the surface of the prostate without requiring sections perpendicular to the surface, as is the case with a frozen section. Instead of less than 0.1% of the margin, almost the entire margin can be evaluated.
3. Additional tissue removed from tumor-positive margins can be examined again, which is usually not possible with conventional frozen sections due to time constraints.

Focal Therapy of Prostate Cancer using HIFU (Focal One)

Thanks to improved diagnostic procedures, prostate cancer is now often diagnosed earlier. Prostate cancer is frequently a disease of the entire gland, but in around 10% of patients, the tumor is only found in one area. In these situations, Urokompetenz offers focal therapy of the affected area. This means that, as with other tumor diseases, only the affected area plus a safety margin is treated.

Urokompetenz is one of 2 centers in Germany with a stationary Focal One HIFU device. Urokompetenz is therefore very flexible in scheduling treatment appointments.

Coordinated Concept in the Treatment of Benign Prostate Enlargement

Benign prostate enlargement is a common condition in older men and can lead to considerable discomfort when urinating. Dr Witt offers a graduated treatment concept at the Urokompetenz private clinic tailored to the individual needs of each patient.

If conservative drug therapy is not sufficient, the following procedures can be offered, depending on the size of the prostate:

1. Water vapor treatment 
   Water vapor is injected through the urethra into the enlarged areas of the prostate. The procedure is remarkably non-invasive, usually preserves antegrade ejaculation, and is suitable for less pronounced enlargement.
2. TURP
   Transurethral resection (excision through the urethra) is a well-established procedure with excellent results in improving urinary stream function. Suitable for moderate enlargement.
3. Laser enucleation (HoLEP)
   Here, the enlarged tissue is removed through the urethra and then shredded and flushed out of the bladder. Suitable for medium and large glands.
4. Robot-assisted adenoma enucleation
   The enlarged parts are removed with robotic assistance. Also suitable for very large glands. It is the only procedure that leaves no wound cavity, as the urethra inside the prostate can either be preserved or the bladder is reconnected to the urethra. There is no urinary discomfort, which often leads to weeks of discomfort with the other procedures.

Dr Witt has extensive experience in carrying out these procedures and attaches great importance to providing patients with comprehensive information about the various treatment options. The aim is to improve the patients' quality of life sustainably.

Gentle Kidney Cancer Surgery with Robot-Assisted Surgery

Kidney tumors often remain asymptomatic for a long time and are therefore often only discovered during routine imaging diagnostics, such as ultrasound or CT. Decisive for the long-term prognosis is not only early detection, but above all, a therapy that combines oncological radicalism with functional organ preservation.

PD Dr Jörn H. Witt has extensive experience in robot-assisted partial nephrectomy. This is a surgical procedure in which the tumor is removed while minimizing damage to the surrounding healthy kidney tissue. The use of the Da Vinci surgical system enables maximum precision, even in complex tumor locations, such as central or hilar areas of the kidney.

The aim of the treatment is always to completely remove the tumor without unnecessarily compromising kidney function. Dr Witt uses intraoperative imaging and the finest suturing techniques to reconstruct the renal parenchyma and the urinary tract. The focus is on preserving organ function, particularly in patients with limited kidney function or a single kidney.

Bladder Cancer Therapy with a Focus on Maintaining Function and Quality of Life

The treatment of bladder cancer requires a differentiated approach that considers both the tumor biology and the individual needs of the patient. At the Urokompetenz clinic, particular attention is paid to preserving bladder function and maintaining the patient's quality of life.

Transurethral resection is the typical first measure and is therapeutically sufficient for non-invasive tumors. Photodynamic diagnostics is used to visualize tumors that are difficult to see under normal white light. We are also one of the very few centers to use the intraoperative tissue scanner for evaluating the deep layers. This reduces the necessity of resections after 6 weeks due to residual tumor to almost zero.

A radical cystectomy may be necessary for muscle-invasive tumors. In such cases, Dr Witt and his team offer the option of robot-assisted bladder removal combined with reconstruction of the urinary tract.

Complex Urological Reconstruction for Ureteral, Bladder, or Genital Defects

Besides treating urological tumor diseases, Dr Witt also specializes in complex reconstructive procedures. These are necessary for congenital malformations, injuries, or after tumor surgeries that can lead to functional disorders in the urinary tract.

Reconstructive procedures include renal pelvic plasty, reimplantation of the ureter into the bladder, ureter replacement, and the closure of fistulas between the bladder and bowel or uterus. Penis shaft straightening for congenital or acquired curvatures is also part of the range of services.

Dr Witt uses conventional and robot-assisted techniques to ensure the anatomical and functional restoration of the urinary tract. Each procedure is planned individually, with a focus always on maintaining or restoring the patient's quality of life.

Please visit the Urokompetenz Private Clinic website for more information.