Baltic American Clinic performs urological operations and surgical procedures to treat diseases of the male reproductive system and the urinary tract. Phimosis, varicocele, hydrocele, undescended testicles and certain bladder conditions are treated surgically. Vasectomy, testicle removal and endoscopic urinary tract procedures are also performed. Whether surgery is needed and which treatment method is most suitable is decided individually, taking into account your symptoms, test results and state of health.
Based on your diagnosis, test results and state of health.
According to the type of operations performed at the clinic and the medical indications.
A discreet environment and individual attention to sensitive health matters.
From the consultation and preparation for surgery to post-operative monitoring and recovery.
Which urological operations are performed?
Foreskin operations
Circumcision – removal of the foreskin
Circumcision is an operation in which the foreskin covering the head of the penis is removed completely or partly.
The operation may be performed for medical reasons, for example phimosis (narrowing of the foreskin), recurrent inflammation or scarring of the foreskin. It may also be chosen for personal, hygiene or religious reasons.
When may surgery be needed?
- When a narrowed foreskin cannot be pulled back or doing so causes pain.
- When inflammation of the foreskin or the head of the penis keeps recurring.
- When scarring develops that impairs the function of the foreskin.
- When problems with the foreskin cause discomfort during sexual intercourse.
During the operation the planned part of the foreskin is removed and the wound is stitched. The type of anaesthesia depends on the patient’s age, the extent of the operation and the state of health.
Options available at the clinic:
- Circumcision for adults.
- Circumcision for children.
After the operation there may be tenderness, swelling or mild pain. During healing it is essential to follow the advice on hygiene, wound care and restrictions on physical and sexual activity.
Foreskin plastic surgery (frenulotomy, frenuloplasty)
Foreskin plastic procedures correct certain anatomical changes of the foreskin and the frenulum of the penis that can cause tension, pain or discomfort.
Frenulotomy is an incision of the frenulum of the penis to reduce the tension it causes.
Frenuloplasty is a surgical correction of the frenulum that aims to lengthen or release a frenulum that is too short and to improve its function.
These procedures may be considered when a short frenulum causes pain during erection or intercourse, tears repeatedly or restricts the movement of the foreskin.
After the operation there may be temporary tenderness, swelling or slight bleeding. The doctor gives individual advice on wound care and on resuming sexual activity.
Operations on the testicles and the spermatic cord
Varicocelectomy – varicocele surgery
A varicocele is a group of enlarged veins in the scrotum, usually forming around the testicle. In some men it causes no symptoms, while in others it may cause a dragging sensation, aching or discomfort, or be associated with impaired semen parameters.
Varicocelectomy is an operation in which the enlarged veins are tied off or closed in another way to reduce the abnormal blood flow.
When may surgery be needed?
- When the varicocele causes persistent pain or discomfort.
- When fertility problems are found and the varicocele may be one of their causes.
- When changes in testicular growth or size are found, especially in adolescence.
- When the doctor finds other indications for surgical treatment.
Surgical methods used at the clinic:
- Open varicocelectomy. The enlarged veins are reached through a surgical incision and tied off.
- Laparoscopic varicocelectomy. The operation is performed through small incisions in the abdominal wall using laparoscopic equipment.
- Microsurgical varicocelectomy. An operating microscope is used during the operation, helping to distinguish the veins from the arteries and lymphatic vessels more precisely.
The most suitable method is chosen according to the type of varicocele, the symptoms, fertility test results and other individual factors.
After the operation there may be temporary tenderness or swelling in the scrotum or groin. If the operation is performed because of fertility problems, changes in semen parameters are assessed after a few months.
Hydrocelectomy – hydrocele surgery
A hydrocele is a build-up of fluid around the testicle that makes the scrotum larger.
A small hydrocele may not cause significant symptoms, but a larger one may cause a feeling of heaviness and discomfort when moving or during physical activity.
Hydrocelectomy is a surgical operation in which the accumulated fluid is removed and the surrounding tissues are corrected to reduce the likelihood of the fluid building up again.
Surgery may be recommended when the hydrocele is growing, causes discomfort or significantly affects daily activities.
After the operation there may be swelling, tenderness or mild pain in the scrotum. The doctor may recommend supportive underwear, temporary restriction of physical exertion and a follow-up visit.
Orchidopexy – fixation of an undescended testicle
Orchidopexy is an operation in which an undescended testicle is moved into the scrotum and fixed in the correct position.
An undescended testicle is a condition in which one or both testicles do not descend into the scrotum during foetal development. It is usually diagnosed in infancy or early childhood.
The operation is important to create better conditions for the development of the testicle, to reduce the risk of certain complications and to make it easier to monitor the testicle in the future.
During the operation the testicle is freed from the surrounding tissues, moved into the scrotum and secured.
After the operation there may be mild pain, swelling or tenderness in the groin and scrotum. Further care depends on the child’s age and the extent of the operation.
Orchiectomy – removal of a testicle
Orchiectomy is an operation in which one or both testicles are removed, depending on the medical indications.
The operation may be needed when a testicular tumour is diagnosed, when the testicle is irreversibly damaged or in other conditions where it cannot or should not be preserved.
The type of operation and the surgical approach depend on the diagnosis.
If a malignant testicular tumour is suspected, the surgical treatment plan is drawn up in line with the principles of cancer treatment.
After the operation there may be pain or swelling. If one testicle is removed, the remaining healthy testicle can often maintain sufficient testosterone production and fertility, but this depends on the individual condition.
Before the operation, especially if cancer treatment is planned, it may be important to discuss options for preserving fertility.
Male contraception surgery
Vasectomy
Vasectomy is a surgical method of long-term male contraception in which the vas deferens are cut or closed so that sperm cannot enter the ejaculate.
The operation may be chosen by men who do not plan to have biological children in the future and want permanent contraception.
Vasectomy does not change testosterone production, erectile function or the sensation of orgasm. Ejaculation continues after the operation, but once the effectiveness of the procedure is confirmed, the ejaculate no longer contains sperm.
Important to know before the operation:
- Vasectomy is considered a permanent method of contraception.
- The contraceptive effect does not start immediately.
- After the operation a follow-up semen analysis must be done as instructed by the doctor.
- Another method of contraception must be used until it is confirmed, according to the set criteria, that the ejaculate no longer contains sperm.
- Vasectomy does not protect against sexually transmitted infections.
After the operation there may be temporary tenderness, swelling or mild pain in the scrotum. The doctor gives individual advice on physical and sexual activity.
Bladder and urinary tract operations
Transurethral resection of the bladder
Transurethral resection of the bladder is an endoscopic operation in which a special instrument is passed through the urethra into the bladder and the abnormal tissue found there is removed.
The operation may be performed when a bladder tumour or other changes are diagnosed that need surgical removal and histological examination.
When may surgery be needed?
- When a suspicious growth in the bladder is found during cystoscopy.
- When a bladder tumour needs to be removed and the tissue examined.
- When the doctor finds other indications for endoscopic resection.
The operation is performed through the urethra, so an incision in the abdominal wall is usually not needed.
The removed tissue may be sent for histological examination, which helps to determine the nature of the changes and to plan further treatment.
After the operation there may temporarily be blood in the urine, more frequent urination or a burning sensation. In some cases a bladder catheter is left in place for a short time.
If cancer is diagnosed, further treatment and monitoring depend on the results of the histological examination.
Endoscopic urological procedures
Endoscopic replacement of a bladder stent
Endoscopic stent replacement is a procedure in which a previously placed stent is replaced with a new one using endoscopic access through the urinary tract.
Stents may be used to ensure the drainage of urine when it is impaired by certain diseases or anatomical changes.
Whether and when a stent needs to be replaced depends on its type, the reason it was placed and the individual state of health.
After the procedure there may be temporary discomfort when urinating, a more frequent urge to urinate or a small amount of blood in the urine.
Endoscopic removal of a bladder stent
Endoscopic stent removal is a procedure in which a previously placed stent is removed with an endoscopic instrument passed through the urinary tract.
The procedure is performed when the stent is no longer needed or the doctor finds indications for its removal.
After the procedure there may be short-term tenderness of the urethra, a burning sensation when urinating or a small amount of blood in the urine.
Other surgical urological procedures
Suprapubic cystostomy – insertion of a catheter into the bladder through the front abdominal wall
Suprapubic cystostomy is a procedure in which a catheter is inserted into the bladder through the front abdominal wall to drain urine.
It may be needed when urine cannot drain normally and catheterisation through the urethra is not possible, not recommended or not sufficient.
The following procedures are performed at the clinic:
- Insertion of a catheter into the bladder through the front abdominal wall under local anaesthesia.
- Replacement of a catheter in the bladder through the front abdominal wall under local anaesthesia.
After the procedure it is important to look after the catheter properly, monitor urine drainage and follow the catheter replacement schedule set by the doctor.
How to prepare for urological surgery
Before the operation the urologist assesses your symptoms, diagnosis, test results and general state of health.
Preparation depends on the type and extent of the planned operation and the anaesthesia used.
- Diagnostic tests. If needed, blood, urine, heart, ultrasound or other necessary tests are performed.
- Medicines. Tell the doctor about all the medicines and food supplements you take, especially those that affect blood clotting.
- Chronic conditions and allergies. Tell us about any conditions, allergies and previous reactions to medicines or anaesthesia.
- Urinary tract infections. If you develop a fever, a burning sensation when urinating or other signs of infection before the operation, inform the doctor.
- Food and drink. If anaesthesia is planned, follow the instructions you are given about eating and drinking.
- Getting home. If sedation or general anaesthesia will be used, arrange for someone to accompany you.
Important: do not stop prescribed medicines on your own. It is especially important to agree in advance on the use of medicines that affect blood clotting.
Anaesthesia during the operation
Local, regional or general anaesthesia may be used for urological operations.
The method of anaesthesia depends on the type and duration of the operation and the patient’s age and state of health.
Smaller procedures, for example certain foreskin operations or suprapubic cystostomy, may be performed under local anaesthesia.
General or regional anaesthesia may be chosen for more complex operations.
Before the operation, the planned anaesthesia method, preparation and possible risks are discussed with you.
Inpatient stay and care after the operation
After urological surgery, your well-being, vital signs, pain intensity, urinary function and possible signs of post-operative bleeding are monitored.
The length of inpatient care depends on the extent of the operation, the anaesthesia and your individual recovery.
After smaller operations a shorter period of observation may be enough, while more complex interventions may require inpatient care.
In some cases a bladder catheter is left in place for a short time after the operation, or other medical care measures are prescribed.
Before you leave, you are given advice on:
- Care of the surgical wound or catheter.
- Taking medicines and pain control.
- Personal hygiene.
- Restrictions on physical exertion.
- Resuming sexual activity.
- Returning to work.
- Follow-up visits and further tests.
- Signs that require you to seek medical help immediately.
Recovery after urological surgery
The length of recovery depends on the type and extent of the operation and on individual characteristics of the body.
After circumcision and foreskin plastic surgery there may be temporary swelling, tenderness or mild pain. During healing it is important to maintain hygiene and follow the doctor’s advice on restrictions on sexual activity.
After varicocelectomy there may be tenderness in the scrotum or groin. More intense physical activity is resumed gradually. If the operation was performed because of fertility problems, semen parameters are assessed after a few months.
After hydrocelectomy swelling of the scrotum may persist for some time. The doctor may recommend supportive underwear and temporary restriction of physical exertion.
After orchidopexy it is important to monitor the healing of the operated area and follow the doctor’s advice on caring for the child.
After orchiectomy recovery depends on the reason for and extent of the operation. If the operation was performed because of cancer, further care is planned according to the test results.
After vasectomy there may be mild pain or swelling for a few days. Another method of contraception must be used until the effectiveness of the procedure is confirmed by a follow-up test.
After transurethral resection of the bladder there may temporarily be blood in the urine, a more frequent urge to urinate or a burning sensation. The doctor gives individual advice on fluid intake, physical activity and follow-up tests.
After endoscopic procedures there may be short-term irritation of the urinary tract or discomfort. If you develop a fever, severe pain or urine stops draining properly, you must seek medical help.
Frequently asked questions
Does a narrowed foreskin always need surgery?
No. Whether treatment is needed depends on the degree of narrowing, the symptoms, age and other factors. In some cases non-surgical treatment may be used.
What is the difference between circumcision and frenuloplasty?
In circumcision the foreskin or part of it is removed, while in frenuloplasty a frenulum of the penis that is too short is corrected. They are different operations for treating different anatomical changes.
Does fertility improve after varicocele surgery?
In some men semen parameters may improve after the operation, but the result is not guaranteed. It depends on the type of varicocele, other factors affecting fertility and the individual condition.
What is the difference between open, laparoscopic and microsurgical varicocelectomy?
These methods differ in the surgical approach and the equipment used. Microsurgical operations use an operating microscope, and laparoscopic operations use laparoscopic equipment. The most suitable method is chosen individually.
Can a hydrocele go away on its own?
In babies some hydroceles may go away on their own. In adults a hydrocele that persists for a long time more often needs a doctor’s assessment, and surgery may be recommended if there are symptoms.
Does an undescended testicle have to be operated on?
If the testicle does not descend on its own within the usual period, surgical treatment is usually recommended. The timing of the operation is decided by the doctor, taking into account the child’s age and condition.
Is it possible to have children after one testicle has been removed?
Often yes, if the remaining testicle is healthy and functions sufficiently. However, fertility depends on the individual condition and any additional treatment.
Does vasectomy affect potency?
Usually not. Vasectomy does not change testosterone production, erectile function or the sensation of orgasm.
Is contraception no longer needed straight after a vasectomy?
No. After the operation there may still be sperm in the ejaculate. Another method of contraception must be used until a follow-up semen analysis confirms that the vasectomy has been effective.
Is vasectomy reversible?
In some cases an operation to reconnect the vas deferens can be performed, but its success is not guaranteed. Vasectomy should therefore be regarded as a permanent method of contraception.
Is further treatment needed after transurethral resection of the bladder?
This depends on the results of the histological examination of the removed tissue. If a bladder tumour is found, additional treatment and regular monitoring may be needed.
Can I resume sexual activity straight after urological surgery?
Not always. The recommended period of abstinence depends on the type of operation and how the tissues heal. The doctor gives individual advice.
When should I seek urgent help after urological surgery?
Seek medical help immediately if you have heavy bleeding, increasing pain, a fever, marked swelling, you cannot pass urine or urine stops draining through the catheter.
Price of urological surgery
Prices of urological operations and surgical procedures are set according to Baltic American Clinic’s current price list.
The final price depends on the chosen surgical method, the extent and complexity of the operation, the medical supplies used and your individual state of health.
Anaesthesia, inpatient care, post-operative nursing, additional tests and other services, if they are not included in the price of the operation, are charged separately according to the current price list.
Before the operation, your individual treatment plan, the planned extent of the operation and the costs are discussed with you.