MEN’S STUFF: who should make an appointment with a urologist and why

25. May 2015

Men's health is a hot topic and the term "urology" is familiar to everyone. The most common conditions of the prostate gland are inflammation (prostatitis), benign enlargements and tumours. Benign prostatic enlargement occurs in almost 50% of men over 50. About 15-20% of the male population of Estonia suffers from prostatitis. Prostatic cancer is diagnosed in one man out of six. These are frightening figures, but there is no point in being afraid of making an appointment with a urologist. Urology much more than just surgery and invasive procedures.

More precisely, it covers four different areas: inflammation of the kidneys, urinary tract and prostate gland; urination disorders both in men and women; benign and malignant tumours including those of the kidneys, bladder, prostate, penis and testicles; and kidney and urinary tract stones. Put simply, urology involves early diagnostics and treatment of kidney and urinary diseases.

Effective and quick help

According to Dr. Toomas Tamm, head of the urology department at the East Tallinn Central Hospital, this sphere of medicine now prefers less invasive and more patient-friendly treatment methods.
Over the last decade, only 30% or less of our patients required wound-creating surgery at the East Tallinn Central Hospital. Operations are performed by a well-trained staff using cutting-edge equipment. New methods are introduced all the time.
For instance, from this year on urination disorders will be treated in an innovative way by injecting Botox into the bladder.

What about the waiting time?

“It may be safely claimed that we have enough urologists. Urgent patients can see a specialist rather quickly and everyone who needs help is tended to. I don’t know how the work is organised in other hospitals, but we have managed to bring the waiting time down to 1-2 weeks,” say Dr. Tamm. “The length of the waiting list does not reflect the actual need for medical assistance. 60-70% of walk-in visits involve consultations, confirmation of the existing treatment choices, follow-up checks of cancer patients and provision of additional clarifications. What many actually want is medical advice,“ explains the doctor. “People need not necessarily see a medical specialist right after getting such an idea or discovering a concern. Here, family physicians may be of much help. They can give advice and, if necessary, refer a patient to a specialised doctor. It is not acceptable, however, for people who really need the assistance of a urologist to wait for a long time if that waiting is due to a badly drawn boundary between consultation and provision of medical services. So-called electronic referrals to a urologist issued by family physicians have been a great boost here. I really hope that the East Tallinn Central Hospital will join this system very soon.”

Notice changes, recognise symptoms

Do men at all make appointments with a urologist and with what problems? When should this be done immediately?
According to Dr. Tamm, those who do not have any concerns should not start worrying at the onset of middle age. Men over 50 do indeed need to talk to their family physician and have a blood test, which will show their levels of glucose, creatinine and prostate-specific antigen (PSA). This will help decide what other diagnostic procedures are required. Various changes in the way a man feels that do not go away in a short period of time need medical attention.

Those males, however, who have red urine or urine with spots of blood in it do need to see a doctor urgently.
The same is true if you have high fever and pain in the lumbar region, if urination is painful or if your urine stream is weak and irregular.

You should definitely pay attention to an acute pain attack in your side, be it on the left or on the right. In this case specific tests are necessary to find out the cause and to determine what should be undertaken next. Such symptoms do not point to a specific illness but without thorough medical examination nothing can be ruled out.

When you have noticed the first minor signs of a problem, you should see your family physician to establish whether something more serious might be the matter.
Often, certain changes to your diet and lifestyle will be enough to ease the discomfort. In this case much depends on the person himself and on whether he is ready to take that step.

Cause for alarm is seen when symptoms start disturbing everyday existence

“Many men come to use with erection and other sexual disorders as well as with urination problems," says Dr. Tamm. “On a daily basis we see men whose normal life is already severely hampered by certain symptoms. They tend to book appointments when they cannot go on like that anymore and the discomfort is really intense.

Men over 50 should talk to their family physician about the risks that threaten them and then modify their lifestyles accordingly. Doctors can provide help and support, but patients should also make the effort. When important diagnostic and treatment plans are prepared, impending decisions are discussed jointly.

For instance, in the case of cancer tumours the optimal treatment options are explored by a council consisting of an oncologist, a urologist and a radiation therapist. They try to find the best solution and decide what to do next. We are glad that the treatment of cancer patients is becoming ever more effective and more lives can be saved.

New, more efficient drugs are available for late-stage treatment of kidney and prostate cancer helping to control the disease better than before.

And some problems are common both to men and women, for example, lower urinary tract inflammation. In this case an operation may be recommended and treatment would consist of several stages.

Dr. Tamm believes that although people can influence the development and progress of some diseases by making the right choices, little can be done to ward off the impact of genetic forces and the environment. Varied diet and good habits, however, have never done anyone any harm and can help prevent the development of many diseases, including kidney and bladder conditions.

Source: Elutark


With men’s health in mind, the East Tallinn Central Hospital has developed the prostate examination package, which allows you to quickly and easily get an overview of the state of the prostate gland and major risks threatening it. For more information go to: //