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General and Oncology Urology Centre

The General and Oncology Urology Centre originated from the Emergency Medicine Hospital's urology department, which opened in 1988. The centre consists of a urology department and a urology polyclinic. We have 7 urologists, 16 nurses and 10 caregivers on staff. In the inpatient department we have 22 patient beds, including six level 2 intensive care beds. More than 8,000 appointments take place in the polyclinic annually. The department treats 1,200-1,250 patients and performs 1,000-1,110 operations annually. Around 50% of the operations we perform are minimally invasive endoscopic surgeries, including laparoscopic operations. In 1999, we became the first in Estonia to begin systematically performing urologic laparoscopy. We perform laparoscopic nephrectomy, kidney resection, adrenal surgery, plastic surgery of renal pelvis, and we are currently the only ones in Estonia to perform radical prostatectomy and cystectomy.

The Centre operates on the principle of teamwork. Doctors and nurses attend joint visitations on a daily basis, and urologists participate in operations and procedures in accordance with their skills and specialisation.

Thanks to close co-operation with oncologists, we are able to apply the principle of multimodality in the treatment of urologic tumours. To this end, an oncological/urologic council meets each week, involving urologists, a chemical and radiotherapy doctor, and a radiologist. Together with the pathologists, we hold monthly discussions on the more interesting and complicated medical cases and examine tissue preparations.

In addition to conventional and laparoscopic surgery, we also perform cry ablation for kidney tumours as well as radiofrequency ablation procedures in co-operation with radiologists. Prostate cancer operations are also performed using both open and endoscopic methods. Since 2011, we have been introducing LDR prostate brachytherapy in co-operation with the radiotherapy centre. In treatment of bladder cancer we offer all of the modern treatment options, such as transurethral resection of bladder (TURB), photodynamic diagnostics (PDD) and radical cystectomy with different urinary diversion methods. Each year, we perform nearly 40% of radical bladder cancer operations in Estonia.

For treatment of stone disease, we use fibre ureterorenoscopy (RIRS, retrograde intrarenal surgery), common ureterorenoscopy (URS), and percutaneous nephrostomy (PCNL). Stones are shattered with the use of a HoYAG laser, pneumatic/ultrasonic lithotripter. The laser's maximal capacity is 60W, so we can use it both for ablation of smaller tumours in the urethra and renal pelvis, as well as for treating urethral strictures.

Since 2005, the urology polyclinic has been using fibre cystoscopes, making bladder examination more comfortable for men.

As an accredited centre, we provide urethral sphincter prosthesis for male patients with incontinence and penile prosthesis for impotence.  We are American Medical Systems Inc.'s reference centre for urologic implants in the Baltics. We also deal on a daily basis with reconstructive urology, prostatic hyperplasia surgery and andrological surgery.

As the training centre of Tartu University, we train urology residents and student doctors to secure generational continuity.  Through the hospital's training centre, we also offer colleagues from elsewhere in Estonia and from abroad the opportunity to gain experience in our department.

In the name of improved quality of care, we co-operate with experts from many other fields. In order to attract partners, we must demonstrate excellence.

Dr Ülo Zirel
Director of the General and Oncology Urology Centre

General and Urology Oncology Centre

Margot Unt

Secretary

617 1613

Dr Ülo Zirel

Dr Ülo Zirel

Head of Centre

617 1665

Ave Miilmets

Ave Miilmets

Chief Nurse

617 1247