Urotour 2013 Maastricht

Center of Excellence: Maastricht University Medical Centre

City: Maastricht, The Netherlands

Director: Prof. Gommert A. van Koeveringe

Visit dates: 13/10-20/10/2013

Trainees: Μanousakis Emmanuel (Athens)

                   Hrisohoidis Giorgos (Athens)


What the Trainees said

Manousakis Emmanuel

Description & Evaluation of the Center

The University Hospital of Maastricht is one of the seven acacemic hospitals in the Netherlands. It is a hyper-modern hospital which is continuously improving both from a building facility and technological point of view. The Urology Clinic is a University Clinic with a capacity of 22 beds covering the entire range of modern Urology and Paedourology, with a special focus on Neurourology due to the particular interest and specialisation of the Professor and Director of the Clinic. However, all other subspecialties and the Emergency Department operate in an outstanding way, as well.

The daily routine of the clinic would start at 8:00 with a morning meeting and briefing on patient cases with the participation of all Urologist Specialists, Residents and pregraduate, postgraduate and doctoral students.  Every member of the group was free to tell their viewpoint and all decisions were made in common. We would like to warmly thank all physicians for all discussions took place in the English language so that we could better understand the proceedings.

Then every Specialist would separately visit their patients. Every patient had one Resident who was personally in charge of them. 

There were also the outpatient clinics and surgeries. I happened to attend a  neurogenic bladder examination carried out by the Professor himself in the outpatient clinic and that was a really very interesting experience.

There was plenty of time dedicated to each patient and, whenever necessary, the examination would take place in collaboration with colleagues of other medical specialties (such as Psychiatrists and Gynaecologists) for the optimal treatment of every case.

After a one-hour lunch break at the amazing hospital restaurant, I followed the Director to the Cystoscopy Department. Words are not enough to express how impressed I was! Five flexible cystoscopes -alternating so as to avoid any delay-, high resonance screens everywhere etc. The ideal working environment for every Urologist! At this point, I would like to mention the incredible work and contribution of the nursing staff who were perfectly trained.

During our stay in Maastricht, we attended the highly interesting oncology and radiology meetings of the clinic, as well as the weekly courses and sessions to present updates on current research and literature.  All this conducted with one and only aim the patient’s benefit –without anyone’s intention to impress, compete or stand out.

First and foremost, the most interesting part for us was experiencing their surgical treatment approach and methods. Making comparisons with the conditions in Greece was inevitable. In order not to be misunderstood, I would like to clarify that the Greek Urologist is not in the least inferior with regard to surgical skills and capacity. However, in Maastricht, Urologists have all the infrastructure and means to perform even robotic surgical procedures once a week. Of course, it should be pointed out that more than half of the endoscopic and laparoscopic procedures are conducted by Residents and, most of the times, without a Specialist’s supervision.

The daily routine would finish at about 17:00, but very often the time schedule might extend due to heavy clinical and academic workload. There were times when elective (non-emergency) surgery might be performed at 16:00.  

In overall, the University Urology Clinic of Maastricht is a perfectly organized department!

Something that I could not possibly omit saying –for I had never seen this anywhere before – is the fact that the patients’ dressing rooms in the operating theaters are UNISEX (common for both men and women)! No further comments….

Words are certainly not enough to talk about the Maastricht University Hospital and the Urology Clinic. They are the ideal working environment, a human-centered healthcare center where there are no discriminations. Everybody is treated equally -irrespective of age, gender and mainly  financial state -always under the best working conditions for the clinician and lab physician.

More specifically, it is a hospital where there is not even the characteristic “hospital smell”, where all time schedules are followed –from the morning and night shift to the physician’s time dedicated to the patient. Only the highest technological equipment is used –something that inevitably makes one feel depressed when comparing to the situation prevailing in public Greek hospitals.

Of course, even there not everything is perfect, and there are still some things that could improve. What is for sure is that the Greek Urologist does not at all lag behing the Dutch Urologist in knowledge, surgical skills and capacity; what makes the difference is that the Urologist in the Netherlands has all the essential means to work undistracted, not having to deal with ten different tasks at the same time. 

To sum up, I would like to say that the Maastricth University Hospital has left us with the best impressions and I personally hope that one day I will be fortunate enough to work in such a Center of Excellence.

Hrisohoidis Giorgos

Description & Evaluation of the Center

It is a clinic hosted in an impressive supermodern building a little further from the center of the city of Maastricht. Impressive reception premises of high aesthetics, state-of-the art operating theaters with high-tech equipment, where all sorts of surgical urological procedures are performed.

The University Urology Clinic of Maastricht serves the population of the area which is 120.000 inhabitants. The medical staff comprises 7 Specialists, under the direction of Professor Gommert A.van Koeveringe, as well as 7 Residents. The physicians’ offices, secretariat and hospital rooms are situated on the 4th floor, while the Outpatient Clinics, One-day Clinic, Paedourology Department and Cystoscopy-Biopsy Unit are located on the ground floor of the hospital. There is also a fully equipped Urodynamics and Video-Urodynamics Department, where the main scientific interest of the clinic focuses. The operating theaters of the hospital are hosted in the same building, and there is one operating theater inbetween that is used exclusively for urological surgical procedures. Lastly, there is a specially arranged room equipped with two Da Vinci systems for Robotic Urological Surgery.

The daily program of the clinic is scheduled and followed by all physicians of the clinic. Specialists are responsible for the department corresponding to their specialty, while Residents train in all departments following a rotation program.

As Visiting Physicians, we followed the daily program of the clinic, which would begin early in the morning with the morning briefing of all physicians and discussion of cases, which lasted about half an hour. Then physicians were spreaded in the various departments and we had a prescheduled program to attend surgeries, outpatient clinics, the Neurourology department with urodynamic studies and neurostimulation techniques, as well as cystoscopies and prostate biopsies. At the afternoon meeting, physicians would discuss surgeries of the day, as well as the interesting cases of the outpatient clinics of the day. Once a week, at the same meeting, a Specialist would present a urological topic within the context of continuing medical education. Once the above meeting was over, then followed another multidisciplinary meeting with the participation of Oncologists and Radiologists. The discussion at this meeting would focus on tough and complex cases where the contribution of other specialties was considered to be absolutely necessary for the proper treatment of these cases.

It is important to point out that all physicians, as well the whole nursing and paramedical staff, were friendly, hospitable and willing to answer any of our questions. Also, it is worth saying that they were speaking English at all meetings, so as to make it easier for us to participate in the discussions sharing viewpoints and experiences.

I was particularly impressed with the state-of-the art electronic computerized organizational structure of the clinic and hospital, making access to the patient data base extremely easy, relieving thus physicians from the burden of time-consuming bureaucracy.

I would like to warmly thank the entire University Urology Clinic and particularly Professor G.A van Koeveringe and Dr. D.M.J Vrijens, who organized a dinner in our honor, where we were given the opportunity to get better acquainted by exchanging viewpoints and experiences while enjoying ourselves and savoring delicious traditional dishes.