Urology

At a urology consultation, we diagnose and treat conditions affecting the urinary tract in both men and women, as well as disorders of the male reproductive system.

When should you see a urologist?

You should book an appointment if you:

• suspect kidney stones or experience back or flank pain, blood in the urine, or renal colic;
• have urinary incontinence or experience frequent, painful, or difficult urination;
• have suspected or diagnosed cancers of the urinary tract or the male reproductive system;
• notice a lump in the groin or testicular area;
• have urinary tract or genital infections (except chronic prostatitis, for which a consultation with an andrologist is recommended);
• have congenital or acquired abnormalities of the urinary tract;
• need preoperative or postoperative counselling for a urological procedure;
• would like a second opinion regarding a urological diagnosis or treatment plan;
• are under follow-up for a urological condition requiring ongoing monitoring, such as cancer or a postoperative condition;
• would like a consultation before undergoing a urological procedure.

A follow-up consultation with a urologist to monitor a previously identified condition or ongoing treatment. The doctor evaluates progress, adjusts the treatment plan if necessary, and provides further recommendations.

A telephone consultation is a follow-up service available to patients who have previously had an appointment with a urologist. The consultation can be used to clarify questions related to treatment or examinations, discuss test results, and receive further recommendations from the urologist.

This service is not available as an initial consultation.

A prostate ultrasound examination helps assess the size, shape, and structure of the prostate gland, allowing the detection of inflammation, abnormal growths, and urinary outflow obstruction.

Why is a prostate ultrasound needed?

The examination is recommended to:

• assess prostate inflammation and enlargement;
• identify the causes of frequent, painful, or interrupted urination;
• perform preventive screening after the age of 50;
• monitor the condition following surgery or treatment.

A cystoscopy is a procedure that allows the urologist to examine the inside of the urethra and bladder using a thin, flexible camera (cystoscope). The examination is performed under local anaesthesia.

When is a cystoscopy needed?

The procedure may be recommended to investigate:

• blood in the urine;
• frequent or painful urination;
• recurrent urinary tract infections;
• urinary retention or problems with urine flow;
• suspected tumours, bladder stones, or scarring.

What should you know about the procedure?

• The examination usually takes approximately 5–15 minutes.
• The procedure may be uncomfortable, but it is generally associated with minimal pain.
• After the examination, it is recommended to drink plenty of fluids.

During an indwelling urinary catheter insertion, a thin, flexible tube (catheter) is passed through the urethra into the bladder, where it remains in place for an extended period to drain urine.

When is an indwelling catheter needed?

An indwelling urinary catheter may be required if you:

• are unable to urinate on your own;
• are unable to empty your bladder completely;
• have recently undergone surgery;
• have a serious illness or reduced mobility;
• require accurate monitoring of urine output.

What should you know about the procedure?

• Catheter insertion is generally more uncomfortable than painful.
• A local anaesthetic lubricating gel is used to make the procedure more comfortable.
• You may experience a feeling of pressure or mild stinging afterwards, but this usually settles quickly.

This procedure involves removing the catheter (a thin, flexible tube) from the bladder when it is no longer needed.

What should you know about catheter removal?

The procedure is:

• quick and usually takes only a few seconds;
• generally slightly uncomfortable, but not painful.
• After the catheter has been removed, you may experience mild stinging or a burning sensation when urinating.

Contact us immediately if you:

• are unable to urinate at all;
• experience severe lower abdominal pain;
• have blood in your urine that does not clear;
• develop a fever or chills.

A suprapubic catheter is inserted through the lower abdomen directly into the bladder to drain urine without using the urethra. This procedure is performed when normal urination or insertion of a catheter through the urethra is not possible or would be too painful.

When is this procedure needed?

A suprapubic catheter may be recommended if you:

• have a narrowed, injured, or completely blocked urethra;
• require a long-term indwelling catheter, but urethral catheterisation is not suitable;
• are unable to empty your bladder properly;
• have undergone pelvic surgery;
• experience pain or recurrent infections with a catheter inserted through the urethra.

Contact us promptly if you:

• experience severe or persistent pain or pressure in the lower abdomen;
• notice blood in your urine;
• find that the catheter is not draining or that no urine is passing;
• develop redness, swelling, pus, or an unpleasant odour around the catheter insertion site;
• develop a fever, chills, or feel generally unwell.

The goal of urinary incontinence treatment is to restore bladder control and reduce involuntary urine leakage.

Bulkamid® injections are a simple and effective minimally invasive treatment. During the procedure, a soft hydrogel is injected into the tissue surrounding the urethra, helping it close more effectively and improving urinary continence.

When are Bulkamid® injections recommended?

You should consult us if:

• you experience urine leakage when coughing, sneezing, or during physical activity;
• urinary incontinence is affecting your daily life or limiting your activities;
• you are looking for a treatment option that does not require surgery;
• you have tried pelvic floor muscle exercises, but they have not provided sufficient improvement.

What should you know about the procedure?

• The procedure usually takes 15–30 minutes and is performed under local anesthesia.
• In most cases, you can go home on the same day.
• Bulkamid® provides an immediate effect, and the results typically last for several years.
• A consultation with a gynecologist and a comprehensive evaluation of your urinary incontinence are required before treatment.

• Recommended for men aged 40 and over. The genetic test only needs to be taken once in a lifetime.
• The test is performed using a simple cheek swab.
• You will receive your results within 6 weeks. Doctors can also access the results through the Estonian Health Portal (Terviseportaal).
• Any further examinations for prostate cancer are arranged through appointments with an andrologist or urologist.
• We offer the option of a post-test consultation.

Why should you start by assessing your genetic risk?

• Prostate cancer has a strong genetic component.
• Every man’s risk of developing the disease is different. Men with a high genetic risk may develop prostate cancer as early as their 30s or 40s, and the disease may be more aggressive even at a younger age. This must be carefully considered when planning screening and follow-up examinations.
• In many cases, cancer and related premature deaths can be prevented through timely measures, even before symptoms appear. When detected early, prostate cancer is generally treatable.
• Personalised cancer prevention is based on genetic risk assessment. It is a modern, evidence-based healthcare service supported by the latest international scientific research.
• New technologies make it possible to identify genetic risk even in men who have no family history of prostate cancer or no previously identified genetic mutations.
• A PSA test alone may not be sufficient to detect prostate cancer at an early stage, particularly in men with a high genetic risk. It is now possible to identify men who may need additional examinations even when their PSA levels are within the normal range. This is particularly important because a high genetic risk is also associated with a threefold increase in the risk of premature death, often due to late detection of the disease.
• With this service, you will receive a personalised medical prevention plan that takes into account your genetic profile, age, sex and ethnic background.

Who can benefit from this service?

• Personalised prostate cancer prevention is suitable for all men aged 40–70.

• Health-conscious men aged 40 and over: Those who want to take proactive steps to protect their health through modern, evidence-based personalised cancer prevention.
• Men under 50: Particularly beneficial for identifying risks early and starting appropriate screening and follow-up examinations in a timely manner.
• Men with no family history of cancer: The service is also suitable for men whose close relatives have never had cancer. Genetic risk may still be elevated, and our innovative technology can help identify it.
• Men with a family history of prostate cancer: If prostate cancer has occurred repeatedly among close relatives, we can also provide a free referral to a medical geneticist, if necessary, to investigate hereditary genetic risks in greater detail.
• Men who have already consulted a geneticist: If you have previously undergone genetic testing but no known mutations were identified, our innovative technology can provide additional insight into your genetic risk.
• Men aged 60 and over: The service is also suitable for men who already visit a urologist or andrologist for periodic check-ups. You can find out whether you may need more frequent or more comprehensive monitoring.

What does the testing include?

• The service is based on genetic risk testing using innovative polygenic risk score (PRS) technology in healthcare.
• Antegenes’ advanced, evidence-based PRS technology calculates the combined effect of 121 genetic variants associated with prostate cancer to determine your genetic risk level.
• By combining your PRS result with your personal background (ethnicity, age and sex), we provide accurate risk assessments and personalised medical recommendations for further examinations and healthy lifestyle choices, helping to prevent prostate cancer and detect it at an early stage.
• The test is simple and convenient. All you need to do is collect a sample from the inside of your cheek using a cotton swab.

Test results

You will receive your results within 6 weeks. They will be made available in the MyAntegenes patient portal and the national Estonian Health Portal (Terviseportaal). Antegenes will notify you by email when your results are ready.

• The results are based on an analysis of the combined effect of 121 genetic variants associated with prostate cancer.

Your results will include:

• Your polygenic prostate cancer risk score.
• An interpretation of your test results, together with clinical recommendations for prevention and further examinations and clear next steps.
• An estimate of your likelihood of developing prostate cancer over the next 10 years, compared with a man at average risk.
• A comprehensive set of clinical guidelines for healthcare professionals to support evidence-based, personalised prostate cancer prevention and appropriate medical follow-up.

What happens next?

Based on the results of your genetic prostate cancer risk test, men identified as having a high genetic risk will receive a referral for a private MRI scan (as this examination is not yet covered by the Estonian Health Insurance Fund). This will be followed by a consultation with a urologist.

Book an appointment for the test with a urologist.

Male sterilisation, or vasectomy, is a permanent and highly effective method of contraception for men who do not wish to have children in the future.

During the procedure, the vas deferens (sperm ducts) are divided to prevent sperm from entering the semen.

Book a consultation with a urologist if you:

• are looking for a permanent and reliable contraceptive option;
• would like to discuss the safety of the procedure and the possibility of reversal.

What should you know about a vasectomy?

• The procedure is performed under local anaesthesia and usually takes about 30 minutes.
• Recovery is generally quick, and most patients are able to return to work the following day.
• A vasectomy does not affect testosterone levels, sexual function, libido, or ejaculation.
• Before the procedure, your urologist will explain the procedure in detail, including its risks, benefits, and available alternatives.
• A mandatory one-month waiting period is required between signing the consent form and undergoing the procedure, allowing sufficient time to reconsider your decision.

Mid-urethral sling surgery is one of the most effective long-term treatments for stress urinary incontinence. During the procedure, a thin supportive mesh sling is placed beneath the urethra to provide support and help prevent urine leakage during physical activity.

When should you consider sling surgery?

You should consult us if:

• you experience urine leakage during exercise, coughing, sneezing, or other physical activities;
• urinary incontinence is affecting your work, daily activities, or social life;
• you are looking for a long-term solution to stress urinary incontinence.

What should you know about the procedure?

• The procedure usually takes 30–40 minutes.
• t is performed under local anesthesia or short general anesthesia, depending on your individual situation.
• You can usually go home on the same day.
• Most women notice an improvement in bladder control immediately after the procedure.
• A consultation with a gynecologist and a comprehensive evaluation of your urinary incontinence are required before surgery.

Frenuloplasty and circumcision are surgical procedures performed to correct problems involving the foreskin or the penile frenulum (the small band of tissue connecting the underside of the glans to the foreskin). These procedures improve mobility, relieve pain, and help resolve conditions that interfere with everyday activities or sexual function.

When is surgery recommended?

Surgery may be recommended if you:

• have a tight frenulum or foreskin that causes pain during erections;
• experience recurrent tearing or injury of the frenulum or foreskin;
• have difficulty passing urine due to a tight foreskin;
• suffer from recurrent inflammation or infections;
• experience discomfort during sexual activity or problems related to erections;
• wish to undergo the procedure for hygiene or cosmetic reasons.

What should you know about the procedure?

• The procedure can be performed for both adults and children.
• It is carried out under general anaesthesia, so you will not feel pain during the operation.
• Some discomfort after surgery is normal and usually improves as you recover.
• You should not eat or drink before the procedure and must arrive fasting on the day of surgery.

• Recommended for men aged 40 and over. The genetic test only needs to be taken once in a lifetime.
• The test is performed using a simple cheek swab.
• You will receive your results within 6 weeks. Doctors can also access the results through the Estonian Health Portal (Terviseportaal).
• Any further examinations for prostate cancer are arranged through appointments with an andrologist or urologist.
• We offer the option of a post-test consultation.

Why should you start by assessing your genetic risk?

• Prostate cancer has a strong genetic component.
• Every man’s risk of developing the disease is different. Men with a high genetic risk may develop prostate cancer as early as their 30s or 40s, and the disease may be more aggressive even at a younger age. This must be carefully considered when planning screening and follow-up examinations.
• In many cases, cancer and related premature deaths can be prevented through timely measures, even before symptoms appear. When detected early, prostate cancer is generally treatable.
• Personalised cancer prevention is based on genetic risk assessment. It is a modern, evidence-based healthcare service supported by the latest international scientific research.
• New technologies make it possible to identify genetic risk even in men who have no family history of prostate cancer or no previously identified genetic mutations.
• A PSA test alone may not be sufficient to detect prostate cancer at an early stage, particularly in men with a high genetic risk. It is now possible to identify men who may need additional examinations even when their PSA levels are within the normal range. This is particularly important because a high genetic risk is also associated with a threefold increase in the risk of premature death, often due to late detection of the disease.
• With this service, you will receive a personalised medical prevention plan that takes into account your genetic profile, age, sex and ethnic background.

Who can benefit from this service?

• Personalised prostate cancer prevention is suitable for all men aged 40–70.

• Health-conscious men aged 40 and over: Those who want to take proactive steps to protect their health through modern, evidence-based personalised cancer prevention.
• Men under 50: Particularly beneficial for identifying risks early and starting appropriate screening and follow-up examinations in a timely manner.
• Men with no family history of cancer: The service is also suitable for men whose close relatives have never had cancer. Genetic risk may still be elevated, and our innovative technology can help identify it.
• Men with a family history of prostate cancer: If prostate cancer has occurred repeatedly among close relatives, we can also provide a free referral to a medical geneticist, if necessary, to investigate hereditary genetic risks in greater detail.
• Men who have already consulted a geneticist: If you have previously undergone genetic testing but no known mutations were identified, our innovative technology can provide additional insight into your genetic risk.
• Men aged 60 and over: The service is also suitable for men who already visit a urologist or andrologist for periodic check-ups. You can find out whether you may need more frequent or more comprehensive monitoring.

What does the testing include?

• The service is based on genetic risk testing using innovative polygenic risk score (PRS) technology in healthcare.
• Antegenes’ advanced, evidence-based PRS technology calculates the combined effect of 121 genetic variants associated with prostate cancer to determine your genetic risk level.
• By combining your PRS result with your personal background (ethnicity, age and sex), we provide accurate risk assessments and personalised medical recommendations for further examinations and healthy lifestyle choices, helping to prevent prostate cancer and detect it at an early stage.
• The test is simple and convenient. All you need to do is collect a sample from the inside of your cheek using a cotton swab.

Test results

You will receive your results within 6 weeks. They will be made available in the MyAntegenes patient portal and the national Estonian Health Portal (Terviseportaal). Antegenes will notify you by email when your results are ready.

• The results are based on an analysis of the combined effect of 121 genetic variants associated with prostate cancer.

Your results will include:

• Your polygenic prostate cancer risk score.
• An interpretation of your test results, together with clinical recommendations for prevention and further examinations and clear next steps.
• An estimate of your likelihood of developing prostate cancer over the next 10 years, compared with a man at average risk.
• A comprehensive set of clinical guidelines for healthcare professionals to support evidence-based, personalised prostate cancer prevention and appropriate medical follow-up.

What happens next?

Based on the results of your genetic prostate cancer risk test, men identified as having a high genetic risk will receive a referral for a private MRI scan (as this examination is not yet covered by the Estonian Health Insurance Fund). This will be followed by a consultation with a urologist.

Book an appointment for the test with a urologist.