NEARLY 20 YEARS AGO, DR. NICHOLAS KARANIKOLAS JOINED STATEN ISLAND UNIVERSITY HOSPITAL WITH A BOLD VISION: TO TRANSFORM A SMALL UROLOGY DIVISION INTO A COMPREHENSIVE, WORLD-CLASS PROGRAM. TODAY, HIS VISION IS A THRIVING REALITY, DELIVERING ADVANCED UROLOGIC CARE TO THE COMMUNITY AND BEYOND

BY AMANDA McCOY PHOTOS BY AMESSE PHOTOGRAPHY

When Nicholas Karanikolas, MD, a board-certified urologic oncologist, joined Staten Island University Hospital nearly two decades ago, he had big ambitions for the emerging urology division. At the time, he was one of only two in-house urologists; he specialized in open and minimally invasive surgery, while his colleague focused on general urology and kidney conditions. Over the next 18 years, with substantial support and resources from Northwell Health, Dr. Karanikolas and his colleague transformed a two-person urology division into a comprehensive, multidisciplinary program that offers a full spectrum of urologic care from urinary and reproductive health to kidney diseases, stones, and urologic cancers.

“What appealed to me about SIUH was the chance to help build a truly world-class urology program,” said Dr. Karanikolas, who joined the hospital after completing his fellowship at Memorial Sloan Kettering Cancer Center in Manhattan. “We had the resources to expand the division into something substantial, providing invaluable care to the Staten Island community. When I started, there were just two of us, but over time, we grew to three, four, and then five urologists. With Northwell’s support, we had both the resources and the vision to recruit top-tier talent. Today, we’re proud to have some of the greatest physicians in medicine.”

Today, there are eight general and subspecialist urologists in SIUH’s urology program, along with three physician assistants and one nurse practitioner in family health. Over the last decade, the program has received dozens of accolades, most recently being recognized by Healthgrades in its 2025 America’s 100 Best for prostate surgery. His team now works out of a dedicated office for Northwell Health Physician Partners Smith Institute for Urology.

“Expanding into this impressive office allows our patients to experience and appreciate the high-quality care we offer,” noted Dr. Karanikolas, who currently serves as the program’s director of urologic oncology. “The facilities are immaculate, and the equipment we have is state-of-the-art. We’ve invested in advanced lasers, cuttingedge imaging technology, and the latest in robotics. When we first started, we had one robot shared across three disciplines. Now we have five.”

Through investments in technology, the department has developed a wide range of minimally invasive techniques, including partial kidney surgery, robotic prostatectomy, and Focal One, a robotic platform that uses high-intensity ultrasound waves to precisely target and destroy diseased prostate tissue. However, technological innovation is only one piece of the puzzle, explained Dr. Karanikolas. One of the primary drivers of the program’s ongoing success is the team’s multidisciplinary approach. By collaborating, Dr. Karanikolas and his team can often devise treatment plans for patients with rare and highly complex conditions patients who were previously considered untreatable at other hospitals. “Our team is exceptionally well-rounded, and we all work together to achieve the best outcome for each patient,” noted Dr. Karanikolas. “Many times, we’ve taken on cases that were deemed by major centers to be non-surgical, where palliative care was instead recommended.”

The doctor recalled one particularly memorable case: “Several years ago, we treated a patient with congestive heart failure who had a thrombus in his heart that extended from his left renal vein, causing his heart to be unable to refill with blood. Ideally, this surgery would be performed in a major cancer center, as outcomes aren’t historically favorable, but we needed to act quickly given the patient’s instability. Together with a cardiothoracic and vascular surgeon, we were able to remove the thrombus, and today, that patient is alive and thriving.”

Sadly, as Dr. Karanikolas pointed out, not all cases are curable, and in such situations, the physician’s responsibility is to provide patients with the highest quality of life for the time they have left.

“Two years ago, I assisted in a case involving a man with advanced, aggressive cancer,” he recalled. “The patient had already been turned away from a hospital in the city, but he wanted to live long enough to see his grandchild’s birth in a few months. After a long, complex surgery, we were able to remove a 25-pound tumor, and the patient lived for over a year to enjoy that life milestone and then some.”

Looking ahead, Dr. Karanikolas hopes to continue growing the department while educating both local and greater NYC communities about the level of complex care available at SIUH. Although his department has received international recognition as a world-class urologic care center, it still operates with the compassion and agility of a community hospital.

“The patient experience here is unique,” he said. “We don’t deal with numbers; we deal with people. Our sole commitment is to provide the best outcome for each patient. When I look around this office, I can’t help but feel proud of everything I see, from the way our physicians interact to the quality of care we provide. We’ve grown from a division of two to a department of eight, and we now have patients traveling from Manhattan and beyond. It’s been an incredible journey, and we’re still growing.”

Smith Institute for Urology at Staten Island

1441 South Avenue, Suite 701 To schedule an appointment: 718.226.6461