Anesthesia for Genitourinary and Cystoscopic Surgery

The urology department at Columbia is staffed by a group of surgeons who specialize particularly in prostate, bladder, and kidney surgeries. In the U.S. News & World Report’s national hospital rankings for 2017, NewYork-Presbyterian ranked #4 for kidney disease and #8 for urology. We are #1 and #2 in these categories in the tristate area and hence we are an important referral site for urologic surgery. In the main operating rooms, the caseload includes simple and radical prostatectomies, and nephrectomies for tumor and congenital abnormalities, as well as surgery for incontinence, erectile dysfunction, cystectomies for bladder tumors, and reconstructive surgeries. Robotic surgery is being used for radical prostate surgery and cystectomies. These advances give us new challenges in anesthesia and opportunities for a more rapid perioperative recovery for our patients.

The cystoscopy suite has a large caseload of cystoscopies, as well as lithotripsies, percutaneous nephrolithotomies, transurethral prostatectomies, and bladder tumor resections. Because of the vast caseload, residents on rotation gain experience in sedation techniques and in the administration of spinal and general anesthesia. The patients vary widely in age and health status. A large number are quite elderly with advanced medical illnesses, allowing residents to gain skills in managing sick patients. In addition, they learn to manage hyponatremia and water intoxication ("TURP Syndrome"), dysrhythmias, and other medical problems peculiar to the cystoscopy suite.

We also have a large active renal transplant service and perform both cadaveric and living related/unrelated donor transplants.