Urology

| General Overview |--------------

The Department of Urology of Huashan Hospital affiliated to Fudan University was founded in 1955. It is among the first batch of Key Disciplines of the Ministry of Education of China and a "211" Key Construction Discipline; it is a clinical pharmacology base certified in the first batch by the State Food and Drug Administration (SFDA) and one of the first doctoral degree conferral points approved by the State Council. In 1996, Professor Zhang Yuanfang, former hospital president and former department head, led the urology departments of the 5 affiliated hospitals of Fudan University (formerly Shanghai Medical University) in founding the Fudan University Institute of Urology (formerly the Shanghai Medical University Institute of Urology); the Department of Urology of Huashan Hospital serves as the institute's base and a urology postdoctoral research station. In 2012, Professor Ding Qiang, current hospital president and former department head, led Huashan Urology into the Ministry of Health's Clinical Key Specialty Construction Program.

The discipline currently has 101 open beds and 29 physicians on staff, including 8 professors/chief physicians, 11 associate professors/deputy chief physicians, and 9 attending physicians; the proportion holding doctoral degrees exceeds 80%. There are 7 doctoral supervisors and 4 master's supervisors.

Strategic development goals of the discipline: adhering to the development strategy of "building the discipline on distinctive features, invigorating it with innovation, and strengthening it with talent," and fully relying on the platform of the institute, to form a pattern in which clinical work and research interact organically and advance in parallel, developing distinctive subspecialty characteristics in the fields of minimally invasive urological treatment, tumors of the urinary and male genital systems, urinary calculi, urinary continence and pelvic floor functional reconstruction, prostate diseases, male reproduction and health, kidney transplantation and organ preservation. The goal is to become a first-class discipline that leads nationally and in Shanghai, with some academic achievements exerting a certain influence in Asia or internationally.

Subspecialty features include: (1) early diagnosis and comprehensive treatment of tumors of the urinary and male genital systems; (2) minimally invasive treatment and prevention of urinary calculi; (3) urinary continence, urological reconstructive surgery and functional recovery; (4) comprehensive diagnosis and treatment of prostate diseases and research on new minimally invasive techniques; (5) men's health and microsurgery; (6) kidney transplantation; (7) da Vinci robot-assisted laparoscopic minimally invasive surgery. At the end of 2015 the discipline introduced the currently most advanced da Vinci robotic surgical system (SI) in China and smoothly carried out multiple highly difficult operations; it has also introduced advanced specialized diagnostic and treatment equipment such as 3D full high-definition laparoscopy, an integrated urological diagnosis and treatment platform, argon-helium knife cryoablation, CyberKnife, dual-wavelength laser, and a gene sequencer, providing high-quality, safe, domestically first-class medical services.

Discipline building and talent cultivation: the discipline is a Key Discipline of the Ministry of Education and a Clinical Key Specialty of the Ministry of Health; for 3 consecutive years it has been selected into the "China Hospital Best Specialty Reputation Ranking" and the "Top 10 in Urology of the 2014 Ranking of the Scientific and Technological Influence of Chinese Hospitals." The discipline has successively undertaken major national research projects such as a "973" subproject of the Ministry of Science and Technology and major science and technology special projects. Over the past five years it has obtained 30 grants from the National Natural Science Foundation of China (1 of them a key project) and 14 grants from key projects of the Shanghai Municipal Science and Technology Commission, Education Commission, and Health and Family Planning Commission. Two research achievements, "Clinical Research and Application of Surgical Treatment of Adrenal Diseases" and "Research on the Mechanisms of Occurrence and Development of Bladder Cancer and the Creation and Clinical Promotion of New Diagnostic and Therapeutic Methods" (2011 and 2014), successively won the First Prize of the Ministry of Education's Science and Technology Progress Award (with members of the discipline as first completer). "Early Diagnosis and Treatment of Bladder Cancer" received two rounds of funding under the Ministry of Health's Clinical Key Discipline Projects, and its research results won the Second Prize of the Ministry of Education's Science and Technology Progress Award and the Shanghai Medical Science and Technology Second Prize, among others. Cumulative funding obtained exceeds RMB 23 million; more than 190 SCI papers and more than 530 papers in domestic core and authoritative journals have been published. In 2002, the first report of successful re-transplantation after cryopreservation of an intact ovary was published in the journal "Nature." In 2012, the genetic characteristics of prostate cancer in Chinese people were reported for the first time in the journal "Nature Genetics."

Discipline leaders Professor Zhang Yuanfang and Professor Ding Qiang attach great importance to the cultivation of a talent echelon, having successively trained and recruited 2 Shanghai Leading Talents, 1 Ministry of Health Young Post Expert, 2 Ministry of Education Cross-Century/New-Century Talents, 2 members of the Shanghai Health System Hundred Talents Program, 1 Shanghai Silver Snake Award winner, 1 of Shanghai's Top Ten Young Medical Managers, 1 Shanghai Rising Star, 2 Shanghai Outstanding Young Medical Talents, 2 Shanghai New Long March Shock Brigade members, and 2 of Fudan University's Top Ten Young Medical Workers.

At the end of 2015, the discipline recruited Director Shen Zhoujun—chairman-elect of the Shanghai Urological Association, a Shanghai Leading Talent, former director of urology at Ruijin Hospital, and a Grade-2 Professor at Shanghai Jiao Tong University School of Medicine—as the new head of the Department of Urology, who also concurrently serves as assistant to the president of Huashan Hospital and vice president of Huashan East Hospital.

Directors of urology over the successive terms: Shen Jiali, Zhao Weipeng, Song Jianda, Zhang Yuanfang, Ding Qiang, Shen Zhoujun.

Discipline leader Professor Zhang Yuanfang, former president of Huashan Hospital and its previous two-term department head, is a nationally renowned expert who has achieved outstanding results and enjoys renown at home and abroad in the early diagnosis and treatment of urological tumors (including prostate cancer, renal cancer, and bladder cancer), the application of lasers in urology including the development of novel laser devices and the development of photosensitizers, and research on kidney transplantation. From 1992 he served successively as a member of the 4th Urology Branch of the Chinese Medical Association and vice chairman of the 5th and 6th; from December 1998 he served successively as chairman of the Urology Branch of the Shanghai Medical Association, chairman of the Andrology Society, and vice president of the Shanghai Laser Society, among other posts. He served as an editorial board member of the Chinese Journal of Surgery and the Chinese Medical Journal, and deputy editor-in-chief of the Chinese Journal of Urology. He was editor-in-chief of "Andrological Therapeutics," "Modern Urology and Andrology," "Modern Urology: Theory and Practice," and "Practical Urology and Andrology"; deputy editor-in-chief of "Practical Surgery," "Modern Surgery," and the graduate textbook "Surgery—Frontiers and Controversies"; he published more than 300 papers, won the First Prize of the National Science and Technology Progress Award in 1987, the Second Prize of the Ministry of Education's Science and Technology Progress Award in 2003, and the Outstanding Contribution Award of the Urology Branch of the Chinese Medical Association in 2011, among others. He was appointed an expert reviewer for the National Science and Technology Awards. He trained a total of 50 master's and doctoral students. He currently also serves as vice chairman of the Urology Branch of the Chinese Medical Doctor Association and president of the Shanghai Social Medical Institutions Association.

Discipline leader Professor Ding Qiang, current president of Huashan Hospital and former department head, graduated in 1995 from the Department of Clinical Medicine of Shanghai Medical University with a doctoral degree. In 1996 he was exceptionally promoted to associate professor and served as deputy director of urology at Huashan Hospital; in 1999 he was exceptionally promoted to full professor, and from 2002 he served as director of urology. From December 2003 he served as vice president of Huashan Hospital, and from May 2008 as president of Huashan Hospital. As a discipline leader of urology at Fudan University, he was an early performer of radical prostatic surgery, continent total bladder replacement surgery, and urological laparoscopic surgery, and has extensively performed adrenal surgery, radical nephrectomy, kidney transplantation, and other operations, with rich clinical experience; he enjoys a high reputation in the diagnosis and treatment of urinary system tumors, prostate diseases, and urinary calculi. In recent years, he has led his academic team in in-depth research on serum markers of renal cancer and the mechanisms of its progression and metastasis, the molecular mechanisms of male infertility and male sexual dysfunction, the efficacy of prostate biopsy and the mechanisms of prostate cancer growth and metastasis, and many other areas, work of great scientific value and clinical translation significance. He has successively undertaken major national research projects such as a "973" subproject of the Ministry of Science and Technology, major science and technology special projects, and National Natural Science Foundation projects; he has published more than 90 papers and trained more than 20 master's and doctoral students. President and Professor Ding Qiang currently serves as a standing member of the Urology Branch of the Chinese Medical Association and deputy head of its Oncology Group, and chairman of the Urology Branch of the Shanghai Medical Association; he holds posts such as advisor to the Fudan University Institute of Urology and deputy director of the Fudan University Institute of Organ Transplantation. He has received honorary titles including the Communist Youth League Central Committee's "National Young Post Expert," the Ministry of Health's "Outstanding Young Talent," Shanghai Leading Talent, and the Chinese Hospital Association's "Outstanding Hospital President," and enjoys the State Council's special government allowance.

Professor Shen Zhoujun, head of the Department of Urology, concurrently serves as assistant to the president of Huashan Hospital, vice president of Huashan East Hospital, and executive deputy director of the Fudan University Institute of Urology. He was recruited to Huashan Hospital at the end of 2015. Shen Zhoujun is chairman-elect of the Urology Society of the Shanghai Medical Association, head of its Minimally Invasive Group, a Shanghai Leading Talent, a standing member of the Urology Branch of the Chinese Medical Doctor Association, a member and working secretary of the Chinese Urological Association, a member of its oncology and minimally invasive groups, and a standing committee member of the Sexual Medicine Professional Committee of the China Sexology Association and deputy head of its andrology group. In 2012, 2013, and 2014 he was successively rated into the China Top 100 Doctors list as a urological oncology TOP 10 (top ten) expert. He specializes in the diagnosis and treatment of renal cancer, bladder cancer, prostate cancer, adrenal tumors, and urinary incontinence. He is among China's first batch of minimally invasive intelligent laparoscopic (robotic) surgery experts. His surgical volume reached more than 700 cases by the end of 2015, ranking among the very top in China and Shanghai; his robot-assisted renal tumor surgery with non-clamping of the artery and kidney preservation, surgery for high-risk and advanced-age prostate cancer, high-risk adrenal tumor resection, and nephrolithotomy for renal stones have reached internationally leading levels; robot-assisted total bladder replacement plus orthotopic intestinal bladder formation, plastic surgery of the renal pelvis, ureter, and duplicated kidney, retroperitoneal lymphadenectomy for testicular embryonal tumors, and prostatectomy have reached domestically advanced levels.

Assisting Academician Sun Yinghao, president of the Asian Urological Association and chairman of the Chinese Urological Association, he completed and published China's (including the mainland, Taiwan, and Hong Kong) first "Robotic Urological Surgery" and the National Health and Family Planning Commission's "Robot-Assisted Surgery Guidelines (Urology Volume)." He is editor-in-chief of China's newest "Modern Diagnosis and Treatment of Adrenal Diseases," and a co-author of "Wu Jieping Urology" (2nd edition). He has obtained 6 National Natural Science Foundation grants; "Clinical Research and Application of Surgical Treatment of Adrenal Diseases" and "Research on the Mechanisms of Occurrence and Development of Bladder Cancer and the Creation and Clinical Promotion of New Diagnostic and Therapeutic Methods" each won the First Prize of the Ministry of Education's Science and Technology Progress Award. He has published more than 400 academic papers, of which more than 70 are SCI-indexed. He supervises 25 doctoral students and more than 30 master's students.

| Subspecialty Features |--------------

[Robotic Surgery Team]

Minimally invasive surgery is the general trend in the development of urological surgery; precise, high-end robot-assisted laparoscopic surgery represents the future of minimally invasive urological surgery. The team leader is Professor Shen Zhoujun; the clinical team includes 2 professors (chief physicians), 3 associate professors (deputy chief physicians), 1 doctoral supervisor, and 2 master's supervisors. Discipline leader Professor Shen Zhoujun is a member and working secretary of the Urology Society of the Chinese Medical Association and head of its Minimally Invasive and Oncology Groups, as well as chairman-elect of the Shanghai Urological Association and head of its Minimally Invasive Group. Professor Shen began performing intelligent laparoscopic (robot-assisted) surgery in 2009; by the end of 2015 he had completed more than 700 complex robot-assisted operations, one of the highest individual totals among Chinese urologists; he has reached internationally leading levels in "robot-assisted renal tumor resection with non-clamping of the artery and kidney preservation," "robot-assisted radical prostatectomy for high-risk and advanced-age prostate cancer," "robot-assisted resection of high-risk adrenal tumors," and "robot-assisted nephrolithotomy for renal stones"; and he has reached domestically advanced levels in "robot-assisted total bladder replacement plus orthotopic intestinal bladder formation," "robot-assisted plastic surgery of the renal pelvis, ureter, and duplicated kidney," "robot-assisted retroperitoneal lymphadenectomy for testicular embryonal tumors," and "robot-assisted prostatectomy." He has performed surgical demonstrations multiple times at the PLA General Hospital (301), the First Affiliated Hospital of Sun Yat-sen University, Jilin Cancer Hospital, and Kunming People's Hospital; he has also introduced his surgical experience many times at international conferences (such as SIU), Asian conferences, and national conferences. Since Huashan Hospital purchased the currently most advanced intelligent laparoscopic (robotic) da Vinci SI equipment in mainland China at the end of 2015, many operations have been smoothly completed, such as robot-assisted radical prostatectomy plus pelvic lymphadenectomy, robot-assisted nephron-sparing partial nephrectomy, robot-assisted intraperitonealization of the ureter, complex adrenal surgery, and complex pyeloureteral reconstructive surgery.

(1) Robot-assisted radical prostatectomy: especially rich experience has been accumulated in radical prostatectomy plus pelvic lymphadenectomy for high-risk and advanced-age prostate cancer, achieving internationally leading levels in oncological control and urinary continence; for some suitable cases, nerve-sparing surgery offers the greatest possibility of improving postoperative quality of life.

(2) Robot-assisted radical nephrectomy and nephron-sparing partial nephrectomy: rich experience has been accumulated in robot-assisted renal cancer surgery; there are original insights in nephron-sparing partial nephrectomy, with the proposal of the S score for risk assessment of nephron-sparing surgery; internationally leading levels have been reached in robot-assisted renal tumor resection with non-clamping of the artery and kidney preservation.

(3) Robot-assisted total bladder replacement plus orthotopic intestinal bladder formation: using the originally created double-U orthotopic intestinal bladder formation, the surgical procedure is simplified and the occurrence of intestinal complications is reduced. This was the earliest reported such procedure of its kind in China.

(4) Robot-assisted reconstructive surgery: including plastic surgery of the renal pelvis, ureter, and duplicated kidney.

(5) Robot-assisted complex adrenal surgery: especially for giant tumors and tumors in special locations (retrocaval adrenal tumors), rich experience has been accumulated; many operations were reported first at home or abroad, and the number of cases ranks among the top nationally and internationally.

(6) Others: robot-assisted complex nephrolithotomy for renal stones, robot-assisted prostatectomy, robot-assisted retroperitoneal lymphadenectomy, etc.

[Adrenal Minimally Invasive Surgery Subspecialty Team]

The leader of the adrenal minimally invasive surgery subspecialty team is Professor Xu Ke, and the academic leader of the team is Professor Shen Zhoujun.

Professor Xu Ke, MD, PhD, studied under the urology expert Professor Zhang Yuanfang. He specializes in the diagnosis and treatment of genitourinary system tumors (including adrenal tumors, renal cancer, bladder cancer, prostate cancer, etc.) and urinary system calculi, and is especially skilled in minimally invasive urological surgery, including laparoscopy, ureteroscopy, percutaneous nephroscopy, and transurethral resection. He was among the first group selected for the new round of the Shanghai Health System Young Talent Training Program. He is a youth committee member of the Urology Branch of the Shanghai Medical Association and a member of the first editorial board of the "Guidelines for Diagnosis and Treatment of Bladder Cancer" of the Urology Branch of the Chinese Medical Association. In 2012 he was sent on official assignment to the famous Mayo Clinic in the United States for clinical training in urology. During his training he focused on robot-assisted and laparoscopic minimally invasive surgical treatment of urinary system tumors (adrenal tumors, renal cancer, prostate cancer, bladder cancer, etc.), and in particular conducted in-depth and original research on the minimally invasive surgical treatment of adrenal diseases. He currently serves as principal investigator on 4 research grants including a General Program project of the National Natural Science Foundation of China, and 1 teaching research project, with more than RMB 1.3 million in active funding. He has published more than 30 academic papers in domestic and international journals, of which more than 10 are SCI-indexed (with a total IF exceeding 40). He has participated in writing or translating 10 academic monographs. He has won 4 research awards, including the Second Prize of the Ministry of Education's Science and Technology Progress Award, the Shanghai Medical Science and Technology Second Prize, and the Shanghai Science and Technology Third Prize.

Professor Shen Zhoujun is chairman-elect of the Urology Society of the Shanghai Medical Association, head of its Minimally Invasive Group, a Shanghai Leading Talent, a standing committee member of the Urology Branch of the Chinese Medical Doctor Association, a member and working secretary of the Chinese Urological Association, a member of its oncology and minimally invasive groups, and a standing committee member of the Sexual Medicine Professional Committee of the China Sexology Association and deputy head of its andrology group. He studied at Kiel University in Germany, and at Harvard University, Johns Hopkins University, and the University of Miami in the United States. He was the youngest professor at Zhejiang University School of Medicine and its highest-grade (Grade 9) professor and doctoral supervisor, and previously served as director of urology, chief physician, doctoral supervisor, and Grade-2 Professor at Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine. From 2012 to 2015 he was continuously rated as a Urological Oncology TOP 10 doctor in the China Top 100 Doctors list, and is a first-generation Chinese minimally invasive robotic surgeon. Since 2009 he has performed da Vinci robotic minimally invasive surgery for adrenal and urological diseases, covering many highly difficult operations, some of which have reached leading levels at home and abroad. By the end of 2015 he had completed more than 700 robot-assisted laparoscopic operations, including more than 200 adrenal tumor resection operations, among them robot-assisted resection of giant retrocaval or vena cava-compressing pheochromocytomas, which are rarely reported internationally. The surgical outcomes have been good. "Clinical Research and Application of Surgical Treatment of Adrenal Diseases" (first completer) won the 2011 First Prize for Outstanding Scientific Research Achievements (Science and Technology) of Higher Education Institutions of the Ministry of Education. "Research on the Mechanisms of Occurrence and Development of Bladder Cancer and the Creation and Clinical Promotion of New Diagnostic and Therapeutic Methods" won the 2014 First Prize for Outstanding Scientific Research Achievements (Science and Technology) of Higher Education Institutions of the Ministry of Education. He has won 7 awards including the Shanghai Science and Technology Progress Award; he leads 6 National Natural Science Foundation projects and more than 30 other projects including Ministry of Health science funds, talent funds, and Shanghai key funds. He has published more than 400 papers, of which more than 70 are SCI-indexed, and has obtained 7 national invention and utility model patents. He was deputy editor-in-chief of the "Guidelines for Diagnosis and Treatment of Adrenal Surgical Diseases," part of the "Chinese Guidelines for Diagnosis and Treatment of Urological Diseases" (2011 edition). Assisting Academician Sun Yinghao, he helped write and publish China's first monograph "Robotic Urological Surgery" and the National Health and Family Planning Commission's "Robot Surgical Operation Standards Guidelines (Urology Volume)," demonstrating his academic standing in the field of robotic minimally invasive surgery. Professor Shen Zhoujun is editor-in-chief of the currently newest monograph "Modern Surgical Diagnosis and Treatment of Adrenal Diseases."

Main clinical features:

(1) The many endocrine disorders caused by adrenal tumors (moon face, buffalo hump, menstrual irregularities, and so on), as well as symptoms such as secondary hypertension and hypokalemia, are receiving increasing attention from clinicians. However, their diagnosis and treatment are affected by the complex endocrine function of the adrenal glands and have long been a difficulty for the major medical centers in clinical work. How to clarify typing and diagnosis is the key to ensuring treatment effectiveness. Under the leadership of Professor Xu Ke, the adrenal surgery minimally invasive treatment clinical group of the Department of Urology of Huashan Hospital, joining senior experts from the hospital's endocrinology, hypertension, nephrology, neurosurgery, radiology, and interventional departments, has formed a powerful multidisciplinary team consultation (MDT) team, which has accumulated very rich diagnostic and treatment experience in clarifying the endocrine function of adrenal adenomas and hyperplasia and the resulting secondary hypertension and other lesions; at the same time, the multidisciplinary consultations provide patients with the most efficient channel for smooth treatment.

(2) In the localization of adrenal tumors, working with relevant experts from radiology, we can make a clear diagnosis of adenomas as small as 0.5 cm. The diagnosis of primary aldosteronism (PHA) is the most complex; together with experts from the hospital's endocrinology and interventional departments, we have successfully carried out adrenal venous sampling (AVS), achieving marked diagnostic and therapeutic results in patients with simple hyperplasia.

(3) On the surgical side, this includes traditional laparoscopic surgery and robot-assisted laparoscopic surgery. Over the past 5 years, the adrenal surgery team has summarized the experience of hundreds of adrenal operations; for pheochromocytomas as large as 10 cm and ectopic tumors, complex retroperitoneal tumor lesions, and the different laparoscopic routes—transperitoneal and retroperitoneal—rich perioperative patient management experience has been accumulated, and a proficient clinical management pathway has been formed covering both preoperative blood pressure control with medication and postoperative hormone supplementation.

Research directions

Main focus: clinical diagnosis and minimally invasive treatment of genitourinary system tumors, especially adrenal tumors, and basic research on bladder tumors. In addition to traditional laparoscopic surgical treatment, nanotechnology is being combined to explore multi-directional comprehensive treatment targeting tumors.

[Oncology Team]

Early diagnosis and comprehensive diagnosis and treatment of tumors are the focus of the discipline's development. Discipline leader Professor Ding Qiang is deputy head of the Oncology Group of the Urology Branch of the Chinese Medical Association; in each tumor disease area, the senior experts of the whole department pool their efforts in division of labor and collective tackling. The team leader is Professor Xia Guowei; the clinical team includes 4 professors (chief physicians) and 6 associate professors (deputy chief physicians); there are 3 doctoral supervisors and 2 master's supervisors. There are 2 National Natural Science Foundation projects and 3 provincial/ministerial-level projects providing funding. Research results on "bladder cancer" and "renal cancer" have won the Second Prize of the Ministry of Education's Science and Technology Progress Award and the Shanghai Medical Science and Technology Second Prize.

Main clinical features:

(1) Early diagnosis, minimally invasive treatment, and prognostic evaluation of renal cancer. Research on serum markers of renal cancer has been carried out, providing a basis for the early diagnosis and prognostic evaluation of renal cancer. With skilled individualized minimally invasive surgical treatment, laparoscopic partial nephrectomy with continuous double-layer suturing of the renal cut edge is performed for patients with small renal tumors, a solitary kidney, or poor contralateral renal function, preserving as much renal function as possible, with few complications and rapid recovery. For intermediate- and advanced-stage tumors, comprehensive treatment combining laparoscopic radical nephrectomy with targeted therapy is adopted.

(2) Early diagnosis and minimally invasive treatment of bladder cancer: basic and clinical research on photodynamic therapy for bladder cancer was carried out relatively early in China, and a new generation of domestically produced photosensitizer with independent intellectual property rights was developed for the treatment of bladder cancer. The procedure of laparoscopic radical cystectomy plus orthotopic ileal neobladder was carried out relatively early in China, reducing surgical trauma and improving patients' quality of life.

(3) Minimally invasive diagnosis and treatment of renal pelvis and ureteral cancer: urinary cytology combined with ureteroscopic minimally invasive techniques is used to diagnose patients with hematuria and detect renal pelvic and ureteral tumors early, and laparoscopic techniques are used for radical resection of the renal pelvis, ureter, and bladder cuff on the affected side. For high-risk tumors, comprehensive treatment combining immunotherapy and chemotherapy is adopted.

(4) Minimally invasive diagnosis and treatment of retroperitoneal tumors such as adrenal tumors: an MDT team is formed with endocrinology, radiology, oncology, and other departments to standardize the diagnosis and treatment of retroperitoneal soft tissue tumors mainly adrenal tumors; classic laparoscopic surgery is used to resect the tumors, achieving good results.

[Urinary Calculi Team]

In 2002, our department was the first in China to establish the urinary calculi (endoscopy group) subspecialty. Under the leadership of the specialty head Professor Wu Zhong, it is dedicated to the minimally invasive treatment of urinary calculi and genitourinary system tumors and research on new techniques. Especially in the past 10-plus years, Professor Wu Zhong has led the urinary calculi team in actively introducing and carrying out a series of the currently world's most advanced minimally invasive or non-invasive urological techniques, ushering in a new era of minimally invasive or non-invasive treatment of urinary calculi. The application of these new techniques has brought about a fundamental change in the treatment of urinary calculi; at present, more than 95% of urinary calculi can be satisfactorily treated through minimally invasive or non-invasive techniques.

At the same time, in order to reduce the incidence rate and recurrence rate of urinary calculi, attention is paid to etiological research on urinary calculi, especially strengthening etiological diagnostics such as metabolic evaluation, genetic screening, and stone composition analysis to effectively reduce stone recurrence. Leveraging the advantages of multidisciplinary cooperation, uniting teams from ultrasound, imaging, DSA, laboratory medicine, endocrinology, and other disciplines, a new concept of comprehensive treatment of urinary calculi has been established that pursues minimally invasive treatment and etiological prevention in parallel, addresses both the symptoms and the root causes, and integrates prevention and treatment, together with individualized stone treatment plans. The department is a committee member of the International Alliance of Urolithiasis (IAU)—the world's most authoritative academic institution on urinary calculi—a national committee member unit of the Stone Group of the Urology Branch of the Chinese Medical Association (CUA)—China's most authoritative academic institution on urinary calculi—and a lecturer unit of the Swiss EMS National Training Academy; it participated in the writing and formulation of China's first "Guidelines for Diagnosis and Treatment of Urinary Calculi," "Guidelines for Diagnosis and Treatment of Ureteral Calculi," "Guidelines for Diagnosis and Treatment of Staghorn Calculi," "Chinese Expert Consensus on Flexible Ureteroscopic Technique," and "Standardized Technical Course of Flexible Ureteroscopy," among other standardized operation and diagnostic-treatment programs for urinary calculi and rigid/flexible ureteroscopy.

After years of effort, the urinary calculi subspecialty has formed an excellent team integrating clinical care, teaching, and research. The specialty leader is Professor Wu Zhong. The team currently has 1 professor (chief physician), 1 doctoral supervisor, 2 associate professors (deputy chief physicians), 3 attending physicians, 3 residents, 3 doctoral students, and 2 master's students. It has successively undertaken projects including National Natural Science Foundation projects, a national "Tenth Five-Year Plan" key research subproject, a Ministry of Health key clinical project, a key project of the Shanghai Municipal Science and Technology Commission, a Natural Science Foundation project of the Shanghai Municipal Science and Technology Commission, and research funds of the Shanghai Municipal Health Bureau and the Baoshan District Science and Technology Commission. It is currently devoted to research on the minimally invasive treatment of urinary calculi and genitourinary system tumors and on stone etiology, pathogenesis, prevention of recurrence, and new minimally invasive techniques.

The main clinical features are:

(I) Minimally invasive treatment of urinary calculi: (1) Rigid ureteroscopic holmium laser lithotripsy (URSL): since 2002, semirigid ureteroscopy combined with holmium laser lithotripsy has been carried out first in China for the treatment of ureteral stones. Addressing the common clinical difficulty of upper ureteral stones that "during lithotripsy the stone easily migrates upward into the kidney, resulting in a low stone fragmentation success rate," the department first carried out in China "rigid ureteroscopic holmium laser lithotripsy combined with the stone capturer (Ntrap) and pipeline occluder (Innovex) for the treatment of upper ureteral stones," satisfactorily solving this difficulty and greatly improving the success rate and stone clearance rate of minimally invasive treatment of upper ureteral stones. The results are efficient, minimally invasive, and safe, with rapid recovery, short hospital stay (day surgery), and mild complications. Presentations were given at the 25th World Congress of Endourology (25th WCE), the 11th Asian Congress of Urology (11th UAA), and the 19th National Urological Congress (19th CUA). This technique is currently at an internationally advanced and domestically leading level. (2) Flexible ureteroscopic holmium laser lithotripsy (fURSL): since 2009, the currently world's most advanced flexible ureteroscopic holmium laser lithotripsy has been carried out relatively early in China for the treatment of upper urinary tract stones (upper ureteral stones and kidney stones). Using the body's natural passages, no incision or puncture tract needs to be made. In particular, in recent years the new concept of "powdered lithotripsy" was first proposed in China, and since flexible ureteroscopic holmium laser powdered lithotripsy was first carried out in China, the clinical results have been remarkable, achieving efficient stone fragmentation with safety and minimal invasiveness (non-invasiveness) and few complications, and rich clinical experience has been accumulated. Presentations were given at the 12th and 13th Asian Congresses of Urology (UAA) and the 21st and 22nd National Urological Congresses (CUA). This technique is currently at an internationally advanced and domestically leading level. (3) Percutaneous nephroscopic lithotripsy (PCNL): one of the units that carried out PCNL relatively early in China. Ultrasound-guided establishment of mini tracts or standard tracts combined with holmium laser lithotripsy is used to treat giant or complex kidney stones, sparing such patients with complex renal stones the suffering of open surgery. In recent years, the currently world's most advanced new technique of percutaneous nephroscopy combined with ultrasound and pneumatic lithotripsy with stone clearance (EMS) has been introduced and carried out, taking PCNL technology to another new level and greatly improving the fragmentation efficiency and stone clearance rate for giant or complex kidney stones, demonstrating the distinctive features and clear advantages of PCNL technology. (4) Urethroscopic or cystoscopic holmium laser lithotripsy: since 2002, urethroscopy or cystoscopy combined with holmium laser, pneumatic, or ultrasonic lithotripsy has been carried out first in China to treat urethral stones or bladder stones, sparing patients with urethral stones or bladder stones—especially patients with benign prostatic hyperplasia combined with bladder stones—the suffering of open surgery, with high efficiency, safety, and mild complications. (5) Extracorporeal shock wave lithotripsy (SWL): this technique was carried out first in China in the early 1990s, and it is the preferred treatment method for kidney stones under 2 cm. It requires no anesthesia and can be performed on an outpatient basis; it is a truly super-minimally invasive technique, and rich experience has been accumulated. (6) Laparoscopic technique: laparoscopic techniques are applied to treat ureteral stones or kidney stones that are difficult to treat with URSL, fURSL, PCNL, or SWL. (7) Formulation of individualized treatment plans: an individualized treatment plan is formulated for each patient according to the specific condition. For example, for patients with upper ureteral stones, the optimal treatment plan can be selected according to actual circumstances, such as rigid or flexible ureteroscopic lithotripsy, percutaneous nephroscopic lithotripsy, SWL, or laparoscopic lithotomy, or a combination of multiple techniques. The clinical diagnostic and treatment process for urinary calculi and the standardized operation of minimally invasive techniques have been regularized, providing comprehensive, systematic, and individualized diagnostic and treatment plans for patients with all kinds of urinary calculi. (8) Etiological research and prevention of stones: leveraging the advantages and platform of the Fudan University Institute of Urology, etiological diagnostics such as metabolic evaluation, genetic screening, and stone composition analysis are actively carried out; postoperative monitoring or preventive guidance for stone patients or people at high risk of stones is strengthened, establishing a new model of comprehensive treatment of urinary calculi that pursues minimally invasive treatment and etiological prevention in parallel, addresses both the symptoms and the root causes, and integrates prevention and treatment.

(II) Minimally invasive treatment of genitourinary system tumors: laparoscopic radical prostatectomy, radical total cystectomy plus urinary diversion, partial nephrectomy for renal cancer, radical nephrectomy or nephroureterectomy for renal cancer or renal pelvic cancer, resection of adrenal tumors (including adrenal pheochromocytoma), and other highly difficult complex operations are performed proficiently, with remarkable clinical results and rich accumulated experience.

[Continence and Reconstructive Team]

The team leader is Professor Fang Zujun; the clinical team includes 1 professor (chief physician) and 2 associate professors (deputy chief physicians), with an attached urodynamic examination room and a specialized urinary incontinence clinic. The team participates in the writing of the "Guidelines for Diagnosis and Treatment of Urological Diseases" (urinary incontinence, overactive bladder, benign prostatic hyperplasia, etc.) organized by the Urology Branch of the Chinese Medical Association. It undertakes one Young Scientists Program project of the National Natural Science Foundation of China as well as multiple projects of the Shanghai Municipal Science and Technology Commission and Health Bureau, and has carried out research on stress urinary incontinence, interstitial cystitis, and long-segment urethral injury.

Main clinical features:

(1) Female stress urinary incontinence: since 2002, mid-urethral sling procedures have been carried out to treat female stress urinary incontinence, with an effectiveness rate of 85-90%. Using different sling methods and materials, different surgical approaches are adopted for stress urinary incontinence caused by different causes to achieve individualized treatment; in cooperation with obstetrics and gynecology, multidimensional, integrated repair and treatment of female pelvic floor dysfunction diseases is carried out.

(2) Interstitial cystitis: multiple treatment modalities including drug therapy, hydrodistention, and intravesical drug instillation are used, following a step-by-step medical philosophy, to treat refractory lower abdominal symptoms caused by interstitial cystitis, and rich clinical experience has been accumulated.

(3) Neurogenic bladder: for patients with neurogenic bladder caused by diabetes, cerebrovascular accident, and other diseases, we adopt the treatment principle of "protecting the patient's renal function as the premise, while improving the patient's quality of life as much as possible"; on the basis of actively treating the primary disease, combined drug and surgical treatment methods are used to treat neurogenic bladder and urethral dysfunction.

(4) Plastic repair of renal pelvis and ureteral diseases: laparoscopic minimally invasive techniques are used to complete pyeloureteral stenosis reconstruction, ureterovesical reimplantation, and primary anastomotic repair of lower ureteral injuries, as well as bladder suspension combined with bladder muscle flap repair of mid-ureteral injuries. Ureteroscopic techniques are used to treat intraluminal ureteral strictures.

(5) Urodynamic testing: we are one of the earliest hospitals in China to carry out multichannel urodynamic testing and video-urodynamic testing, with strong hardware and software facilities. At present, in addition to basic multichannel urodynamic testing, we are also equipped with a mobile urodynamic testing unit, making the testing of bladder and urethral function more convenient, more physiological, and more accurate in results, providing us with more reliable diagnostic evidence.

[Prostate Diseases Team]

The team leader is Professor Jiang Haowen; the clinical team includes 2 professors (chief physicians) and 2 associate professors (deputy chief physicians); there are 2 doctoral supervisors. Research on prostate cancer and metabolic imbalance, and on genetic characteristics and prostate cancer, has obtained funding for 9 National Natural Science Foundation projects and 6 provincial/ministerial-level projects. Recent research on novel prostate cancer molecular markers such as PCA3 and [-2]proPSA has entered the stage of clinical translation and application, and the team participates in the writing of the "Guidelines for Diagnosis and Treatment of Urological Diseases" (prostate cancer) organized by the Urology Branch of the Chinese Medical Association.

Main clinical features: (1) laparoscopic radical prostatic surgery, using the intrafascial or interfascial approach to preserve the neurovascular bundles according to the different clinical stages of the tumor, enabling early recovery of the patient's postoperative urinary continence function; (2) comprehensive treatment of prostate cancer, including CyberKnife, particle implantation internal radiotherapy, and cryotherapy; (3) comprehensive treatment models for advanced prostate cancer such as intermittent endocrine therapy and novel anti-androgen therapy and immunotherapy for hormone-resistant prostate cancer (CRPC); (4) establishment of an early diagnosis model for prostate cancer combining prostate multiparametric MRI, real-time ultrasound elastography, and serum PSA screening, carrying out MRI-ultrasound fusion image-guided prostate targeted biopsy and MR-guided focused ultrasound (MRgFUS) for the treatment of prostate cancer bone metastases; (5) for benign prostatic hyperplasia, transurethral plasma resection of the prostate (TURP), transurethral plasma enucleation of the prostate, and transurethral laser resection/enucleation of the prostate are carried out, selecting the optimal minimally invasive treatment modality according to prostates of different shapes and sizes;

The team has the qualification, approved by the State Food and Drug Administration, to undertake international multicenter clinical trials on prostate cancer; it has completed pre-marketing registration studies in China for goserelin (Zoladex), leuprorelin (Diphereline), ZD4054, and others; the former two have already become the first-choice drugs for endocrine therapy of advanced prostate cancer in China. It is currently carrying out 7 large international multicenter clinical studies including abiraterone, enzalutamide, and radium-223 dichloride, bringing the good news of treatment to prostate cancer patients.

[Andrology Team]

The team leader is Professor Shen Zhoujun (concurrently), with 1 chief physician and 2 associate professors (deputy chief physicians); there is 1 doctoral supervisor. The team has long been engaged in clinical research on the androgen dependence of the erectile neurotransmitter vasoactive intestinal polypeptide (VIP), male fertility and cryobiology, the effects of seminal tract obstruction and recanalization on epididymal function, and androgen receptor mutations and abnormal sexual characteristics; it undertakes 1 subproject of the national "973" program and 7 National Natural Science Foundation projects. It has won 2 awards including the Shanghai Medical Science and Technology Second Prize and the Shanghai Science and Technology Third Prize, and participated in writing the textbook "Basic Theory and Practice of Microsurgery."

Main clinical features: microsurgical treatment of varicocele: compared with traditional open surgery and laparoscopic surgery, microsurgical treatment of varicocele can be completed under local anesthesia, with one day of hospitalization; it features good efficacy, rapid recovery, little pain, few complications, and a low recurrence rate, and is currently recommended as the gold-standard surgical method for treating varicocele. To date, our hospital has completed nearly 1,000 such operations and has accumulated extensive clinical experience. (2) Seminal vesiculoscopy minimally invasive surgery is a frontier andrological technique for treating difficult male conditions such as hemospermia, azoospermia, and infertility, mainly used for the diagnosis and treatment of diseases such as oligoasthenospermia, hemospermia, painful ejaculation, seminal vesiculitis, and seminal vesicle calculi. (3) Vasectomy reversal and microsurgical treatment of obstructive azoospermia: microsurgical vasovasostomy and vasoepididymostomy were carried out relatively early in China and have achieved good results. (4) Penile prosthesis and testicular prosthesis implantation surgery. (5) Plastic surgery of the male external genitalia, including penile curvature folding correction, intersex conditions, long-segment urethral stricture and hypospadias reconstruction, and repair of extensive scrotal skin lesions in scrotal Paget's disease. (6) Standardized treatment of male infertility, prostatitis, and male sexual dysfunction, especially targeted treatment according to the different classifications of chronic prostatitis, with good clinical results. (7) Diagnosis and treatment of male endocrine dysfunction, including late-onset hypogonadism and congenital hypogonadism.

[Transplantation Team]

The team leader is Chief Physician Qu Lianxi; the team has 1 chief physician/professor and 1 deputy chief physician. Kidney transplantation research projects have received funding from the National Natural Science Foundation of China and key projects of the Shanghai Municipal Science and Technology Commission; the projects "Allogeneic Kidney Transplantation" and "Autologous Kidney Transplantation for the Treatment of Renovascular Hypertension" successively won the National Science and Technology Achievement second prize (Class B) and the Shanghai Major Science and Technology Achievement Progress Award. Research results have been published in more than 60 articles in domestic core journals and foreign SCI-indexed journals. The discipline has performed nearly 800 kidney transplant operations; a kidney transplant patient operated on in 1977 is still alive today. It was among the first in Shanghai to establish an Organ Procurement Organization (OPO organization), relying on the strong disciplinary advantages of the hospital's neurology, neurosurgery, and critical care medicine departments to actively identify potential organ donation donors.

Main clinical features: kidney transplantation: allogeneic kidney transplantation and living-related donor kidney transplantation are carried out. Huashan Hospital's basic research and clinical work in kidney transplantation have a long history and great strength; under the leadership of the older generation of experts and professors, China's first flat-panel hemodialysis machine was developed and successfully applied in clinical practice; peritoneal dialysis was carried out relatively early in China; it was one of the earliest units in China to carry out allogeneic kidney transplantation, and it carried out pediatric allogeneic kidney transplantation earliest in Shanghai. A kidney transplant patient operated on in 1977 is still alive today, the case with the longest survival after kidney transplantation in China. In February 2002, the Fudan University Institute of Organ Transplantation, led by Academician Zheng Shusen, was established at Huashan Hospital, providing strong technical and personnel support for our department's basic and clinical research on kidney transplantation and enabling our kidney transplantation work to advance by leaps and bounds. In 2005, our department implemented subspecialty grouping, and the transplantation group became one of the 6 subspecialty groups, which marked the entry of our department's kidney transplantation work into a brand-new stage, steadily developing in the direction of specialization and in-depth development. Over the past 10 years, we have completed nearly 800 kidney transplant operations of various types, with both graft and patient survival rates reaching world-leading levels. In particular, the minimally invasive donor nephrectomy for living-related kidney transplantation involves little trauma and rapid postoperative recovery, greatly improving the surgical success rate. Recently, our department introduced the da Vinci surgical robot system; under the leadership and guidance of Director Shen Zhoujun, we will apply this advanced technology to the procurement of living-related donor kidneys, which will strongly promote the development of living-related donor kidney transplantation.

We were among the first in Shanghai to establish an Organ Procurement Organization (OPO organization), relying on the strong disciplinary advantages of the hospital's neurology, neurosurgery, and critical care medicine departments to actively identify potential organ donation donors. A group of well-trained professionals selflessly devote themselves to this sacred work; the annual organ donation procurement rate ranks among the top in Shanghai, saving the lives of countless patients with end-stage renal disease. Because of the outstanding work of the OPO organization, we received the 2015 Touching Huashan Award, and reports by Shanghai TV, Dragon TV, and other major media have produced a favorable social impact. The transplantation team is currently headed by Chief Physician Qu Lianxi as leader and Deputy Chief Physician Tong Shijun as deputy leader, and routinely carries out the various basic and clinical work of kidney transplantation and general urology.