Introduction

The Department of Urology of Shanghai Sixth People's Hospital, founded by Professor Gao Rimei in 1954, a pioneer in the field of urology in China, has achieved remarkable progress in medical care, scientific research, and education. It stands as a key discipline under the 211 Project of the Shanghai Jiao Tong University School of Medicine and Shanghai Sixth People's Hospital of Shanghai, serving as a training base for master's, doctoral, and postdoctoral students of Shanghai Jiao Tong University. It oversees Shanghai Eastern Institute of Urologic Reconstruction, Urethral Disease Diagnosis and Treatment Center of Shanghai Jiao Tong University, and China-Europe Urethral Training College. It also serves as the East China Training Center of the Chinese Urological Association, the core urological technologies training base for the “Hua Tuo” Project, one of the top 100 hospitals for urological tumors in China, a member unit of the China Bladder Cancer Alliance, and a member unit of Shanghai Kidney Cancer Multi-Center Research Alliance.

The department boasts a gathering of talented individuals and formidable strength. Currently, Professor Fu Qiang serves as the administrative director. He is a chief physician with a medical doctorate, holds the position of T2 professor at Shanghai Jiao Tong University, and supervises doctoral candidates. He is a member of the American Urological Association, a committee member of the Urology Branch of the Chinese Medical Association, and the deputy leader of the Basic and Research Group. He also holds positions such as deputy chairman of the Urology Branch of the Shanghai Medical Association and head of the Urinary Control and Reconstruction Group, national committee member of the Andrology Branch of the Chinese Medical Doctor Association, committee member of the Urology Branch of the Shanghai Medical Doctor Association, and chairman of the Urethral Reconstruction Department of the Health Branch of the Chinese Medical Promotion Association. Professor Fu is proficient in various urinary tract stricture and defect repair and reconstruction, surgical treatment of complex urological tumors, and minimally invasive urological surgery. He has received numerous awards, including Second Prize of the China Medical Science and Technology Award, First Prize of the Shanghai Medical Science and Technology Award, Second Prize of the Huaxia Medical Award, Second Prize of the Shanghai Science and Technology Progress Award, and Third Prize of the Shanghai Medical Award. He has also been selected as Shanghai Leading Talent, Shanghai Outstanding Academic Leader, and Shanghai Medical Leading Talent. Furthermore, he has been honored with the Shanghai May 1st Labor Medal and the title of Shanghai Medical Craftsman.

Specialties

1. Urinary Tract Reconstruction and Andrology Subspecialty:

Since the 1970s, the discipline of urinary tract reconstruction and repair has gained well known recognition both domestically and internationally. In recent years, we have dedicated ourselves to expanding the realm of minimally invasive surgical techniques while maintaining its original characteristics. Through the relentless efforts of several generations, a standardized system for the diagnosis and treatment of urethral reconstruction has been established. This subspecialty currently performs over 1,000 urinary tract repair and reconstruction surgeries annually. Several innovative technologies have been applied and promoted clinically, including: (1) Pioneering the use of urethral stricture ultrasound imaging and establishing the ULTRA urethral stricture scoring system internationally; (2) Conducting the first large-sample investigation in China on the causes and treatment methods of urethral stricture, revealing trends in etiology and treatment changes; (3) Elucidating the risk factors for postoperative recurrence of urethral stricture internationally；(4) Introducing the technique of continuous lateral tongue graft harvesting, modifying the perineal incision, and enlarging the urethral meatus, addressing the challenge of treating long-segment urethral strictures in Asian populations with the traditional dorsal tongue grafting method being insufficient; (5) First reporting internationally on non-transecting urethroplasty for the treatment of postoperative urethral stricture; (6) Pioneering the use of bladder wall flap reconstruction for repairing bladder neck and posterior urethral damage due to various causes, as well as pedicled gracilis muscle repair for urethral rectal fistula, offering possibilities for repairing complex cases; (7) Being the first in China to perform laparoscopic bladder neck Y-V plasty for the treatment of refractory bladder neck contracture; (8) Introducing the bilateral ureteral intestinal anastomosis combined with ileal bladder augmentation surgery (MINZ procedure) for the successful treatment of bilateral ureteral strictures combined with bladder contracture after radiotherapy; (9) For complex female urethral strictures combined with urethrovaginal fistula, comprehensive application of the pubic bone resection approach, labial flap or perineal flap reconstruction of the urethra and vagina, and vaginal wall flap reconstruction of the urethra, achieving good results; (10) Employing novel Allium membrane stent placement under ureteroscopy for the treatment of ureteral strictures, with confirmed efficacy; (11) Achieving good results of implanting artificial sponges, male slings, and artificial urethral sphincters for the treatment of difficult-to-treat male erectile dysfunction and urinary incontinence, particularly in cases of urethral injury post-trauma.

In recent years, under the leadership of Professor Fu Qiang, the field of urinary tract reconstruction and repair has advanced with the times, innovating continuously. It stands as the pioneer in conducting the first and largest number of robot-assisted laparoscopic bladder neck reconstructions and ureteral repair and reconstruction surgeries in China. We also spearheaded the organization of a nationwide multicenter study on robot-assisted bladder neck reconstruction surgeries, marking the advent of the robotic era in urethral reconstruction surgeries. Additionally, it has demonstrated the feasibility of constructing a bionic urethral graft through 3D printing, marking a global first. Moreover, the department has successfully applied innovative 3D printing material (Dura Substitution) in the repair of anterior urethral stricture. We also led the way internationally in enhancing the repair efficacy of urethral grafts by intervening in the Wnt/β-catenin signaling pathway.

2. Urologic Oncology Subspecialty:

In the diagnosis of prostate cancer, apart from routine examinations, we pioneered transrectal ultrasound examinations for prostate diseases domestically. In 1985, we introduced transrectal ultrasound-guided aspiration biopsy of the prostate, significantly increasing the detection rate of prostate cancer. In terms of surgical treatment for prostate cancer, robot-assisted laparoscopic radical prostatectomy using the da Vinci surgical system is widely adopted. We also achieved favorable outcomes by combining "post-reconstruction" with "bladder neck tubular formation" techniques to improve postoperative urinary control recovery. Additionally, we have explored new treatments for prostate cancer such as radiofrequency ablation and green laser vaporization, with promising preliminary results. In the treatment of kidney cancer, we routinely perform robot-assisted laparoscopic radical nephrectomy, laparoscopic partial nephrectomy, and laparoscopic zero ischemia partial nephrectomy. We also have extensive experience in the treatment of "giant renal cancer radical nephrectomy + inferior vena cava thrombectomy" surgeries, which have been widely accepted by patients due to their significant clinical efficacy. For bladder cancer treatment, routine procedures include robot-assisted laparoscopic radical cystectomy with urinary diversion and laparoscopic radical cystectomy with ileal neobladder reconstruction, providing precise treatment for bladder cancer patients. In the treatment of testicular cancer and penile cancer, routine procedures include laparoscopic retroperitoneal lymph node dissection and laparoscopic inguinal lymph node dissection combined with pelvic lymph node dissection, receiving unanimous praise from patients. We have also developed our own expertise in the surgical treatment of extremely large and complex retroperitoneal tumors.

3. Lithiasis Subspecialty:

Adapting to the requirements of minimally invasive surgery, we have equipped with comprehensive minimally invasive lithotripsy devices. We conduct percutaneous nephrolithotomy (PCNL) surgeries through both micro-channels and standard channels, employing multiple lithotripsy methods including Moses laser, high-power holmium laser, pneumatic lithotripsy, and ultrasonic lithotripsy (EMS). Our facility is equipped with an ultrasound scanner and a Siemens examination bed dedicated to urology. Additionally, we utilize 3D printing to produce kidney puncture navigation modules, significantly improving the success rate of percutaneous nephrolithotomy. Currently, we have completed various types of PCNL surgeries, including nearly a hundred cases of complex, infectious, and multiple stag-horn stones. Employing a dual-scope approach (one side percutaneous nephroscope, one side ureteroscope) for the one-stage treatment of bilateral renal stones has greatly improved the efficiency of stone treatment. Furthermore, we have achieved satisfactory outcomes in minimally invasive treatment of urinary tract stones using endoscopic techniques (cystoscope, ureteroscope, laparoscope) and percutaneous microchannel nephrolithotomy. We were among the first in China to perform endoscopic lithotripsy under percutaneous microchannel nephroscopy for the treatment of urinary tract stones. Our department is equipped with the latest generation of stone analyzers, which analyze postoperative stone samples to determine stone types, guiding patients in adopting appropriate diets to prevent stone recurrence. Moreover, we have developed diagnostic and treatment protocols as well as postoperative warning mechanisms to improve the treatment efficacy of postoperative septic shock in stone patients.

4. Prostatic Hyperplasia and Urinary Control Subspecialty:

We extensively perform transurethral laser resection of the prostate. In recent years, we have introduced Moses high-power laser and Raykeen thulium-holmium integrated laser for prostate enucleation. These procedures result in minimal intraoperative bleeding, shorter surgical times, excellent efficacy, and rapid recovery, achieving favorable clinical outcomes. We were among the first in China to perform autologous rectus abdominis muscle flap suspension surgery, urethral suspension surgery with urethral pressure monitoring, and artificial urethral sphincter implantation surgery to treat acquired urinary incontinence after prostate or urethral surgery. Additionally, bladder neck reconstruction surgery is conducted to treat congenital lower urinary tract malformations and urinary incontinence after urethral trauma. Minimally invasive urethral suspension surgery is employed to treat female stress urinary incontinence, while sacral nerve modulation implantation is used to treat non-obstructive voiding disorders, all of which achieve satisfactory results.