Systemic medical treatment (androgen deprivation, immunomodulatory therapy, and cytotoxic therapy) is an integral part of urology when managing patients with advanced or metastatic cancer of the urogenital tract. In the past, however, an increasing number of urologists in private practice and urological institutions have transferred this competence to neighbouring disciplines, so a thorough education of the young urologist in the field of uro-oncology is highly jeopardized. We present a regional, cooperative network structure between urologists in private practice and in hospitals, which has resulted in a standardization of indication, realization, documentation, quality control, and supportive strategies for systemic medical treatment of patients with metastatic urologic cancer. Furthermore, a well-functioning and cooperative platform was established for the recruitment and realization of clinical trials, which could serve as a model for the structure of future cooperation among German urologists in private practice and in hospitals.