Urologist Tbilisi

[Kathrine Selvage]

Urologyis concerned with the study of the human urinary and genital systems, examining their physiology and pathology. Urologists are specialists in the Department of Urology, which provides diagnosis, prevention and treatment of diseases (including cancer) of the urogenital organs: urethra, bladder, ureters, kidneys, and male genital organs. Urology is associated with such areas of medicine as gynecology, andrology, venereology, nephrology, and surgery.

Urologists explain to their patients that urological diseases have peculiarities of development, symptoms and course in men, women and elderly people. This is also true for pediatric urology. Such differences are explained by anatomical and physiological and age-specific features of the organisms.

As pathologies of the male urogenital system, urologists more often distinguish such diseases as orchitis and epididymitis, urethritis, balanopostitis, prostatitis, cystitis, prostate adenoma, and genital infections.

Urologic diseases can affect sexual function in both men and women. Therefore, before making an appointment with a urologist, remember that adequate and timely treatment will help restore or maintain your sexual health and family well-being.

Diagnostic capabilities of urology in our clinic is very great. We use laboratory examination methods, ultrasound and X-ray diagnostics, endoscopic, instrumental and measuring methods of diagnosis, etc. In our medical center not only graduates of Tbilisi State Medical University, but specialists from all over the country and even the world.

ur Department of Urology focuses on the diagnosis and treatment of various problems of urinary system of men and women of all ages as well as male genital and reproductive health issues. The Department provides both outpatient and inpatient services as well as emergency care.

Davit Nikoleishvili Ph.D. is the founder of laparoscopic urology in Georgia. An expert in oncology and laparoscopic urology has never hesitated from mastering innovative surgical technologies and utilizing them. Deputy CMO and Chief of Urology Department at AHT started his medical career in Georgia, followed by postgraduate education in international medical institutions. He learned the basics of urology at the National Center for Urology and mastered in laparoscopy and endoscopy at the Urology Department of the University Clinic in Leipzig.

Urology focuses on the problems of urinary systems of men and women as well as male genital and reproductive health issues. A consultation with a urologist can provide answers to many questions you may have in relation to these problems. Furthermore, regular visits to a urologist whom you already know can help you to discuss health topics that otherwise may seem embarrassing.

You should bring your ID card and, if available, insurance documentation for your scheduled appointment. It is important to have reports and documentation of all previous examinations, such as laboratory test results and radiology reports and images.

It is also helpful to bring with you all available documents related to the past and current treatments such as surgeries or medical prescriptions. It is natural to have a lot of questions on you mind when discussing your health issues with a doctor. Hence, you may write down all questions that might be of interest to you prior to the visit so as you do not forget any of them when meeting your doctor.

A complete urinalysis is one of the most common tests ordered during a urologist appointment. Your doctor may occasionally request that you collect your first voided urine sample in the morning in order to ensure the accuracy of the test.

A digital rectal examination in men is a physical examination performed by a urologist through your rectum to assess the size, shape, and density of the prostate. It may be offered if your doctor thinks that your symptoms can be connected to the prostate gland or if prostate cancer is suspected. The examination lasts for a total of 1 to 2 minutes but it may cause some physical discomfort.

A urethral discharge or swab analysis is performed to look for signs of infection in the male urethra or genitals. It is best not to urinate for around 2 hours before taking the test to ensure its accuracy. The procedure entails an insertion of a special thin stick in your urethra and subsequent laboratory analysis of the collected specimen. The procedure is performed fairly quickly, but some men will find it uncomfortable at times.

A blood may be drawn if your doctor requests some laboratory tests such as prostate-specific antigen (PSA) or evaluation of your kidney function. The doctor will instruct you on how to prepare for these examinations (for example, fasting).

Radiological studies are commonly performed in urological practice for various disorders of abdominal and pelvic regions. Ultrasound, computed tomography, or magnetic resonance imaging may be recommended by your doctor. In this situation, the doctor will tell you how to prepare for the exam and what to expect.

Urologist Guram Karazanashvili, Doctor of Medical Sciences and Professor, is a renowned oncourologist and pediatric urologist. He is a doctor of the highest category and the winner of the National Prize of Georgia, as well as the president of the Association of Oncourologists of Georgia.

Professor Karazanashvili is the only Georgian urologist to present an innovation at the American Association of Urology. In 2018, he introduced his new surgical method, Radical Cystectomy, which was developed over many years of professional practice and is recognized as the most difficult intervention in oncological surgery. The presentation of this method at the MMT Hospital congress amazed

Zinner syndrome is developmental anomalies of the urogenital tract are rare but often encountered. This condition is caused by disrupted embryonic development of the genitourinary system. Only approximately a 100 cases have been reported so far. Most patients with this anomaly are asymptomatic. Radiologic modalities such as intravenous pyelography, ultrasonography, vasovesiculography, contrast enhanced computed tomography, and magnetic resonance imaging are all helpful in diagnosis of this unusual entity. We reported a case of Zinner syndrome, one of the rarest genitourinary system anomalies. Ultrasound as well as CT and MRI can easily detect the abnormalities specific for Zinner syndrome. Asymptomatic patients require active follow-up while symptomatic patients with enlarging seminal vesicle cyst require surgical intervention such as perineal cyst aspiration, subcutaneous cyst drainage, laparoscopic, and open surgery. Male patients need to be followed up for infertility. Our patient is asymptomatic. Therefore, he requires an active follow-up.

Zinner syndrome is a rare congenital anomaly characterizedby renal agenesis, the ipsilateral seminal vesicle cyst, and theobstruction or dilation of vas deferens. This condition is causedby disrupted embryonic development of the genitourinarysystem. Zinner syndrome was first described by Zinner in 1914which is why the syndrome is named after him [1]. Only a fewhundred Zinner syndrome cases are reported in the medicalliterature [2]. This condition belongs to the rarest anomalies ofthe genitourinary tract and is diagnosed in the second to fourthdecade of life [3]. Most patients with this anomaly areasymptomatic. The patients with Zinner syndrome, are usuallydiagnosed in the 2nd-3rd decade of life They are developmentallynormal, may report decreased urine output, increased urinaryfrequency, perineal pain, and ejaculatory dysfunction. Diagnosticevaluation includes CT, ultrasound, MRI, urogenital X-ray,urodynamic studies, and laboratory tests. It is considered to bethe male counterpart of Mayer-Rokitansky-Kuster-Hausessyndrome seen in females [4]. An insult occurring before the 7thgestation week causes maldevelopment of the distal part of themesonephric duct producing atresia of both ejaculatory ductand the ureteric bud [5].

The close embryologic relationship between the genital andurinary tracts explains the developmental aberrations leading tothis anomaly. The Mesonephric or Wolffian duct, which formsthe male reproductive system as well as the ureteric bud, is apaired structure. The orifice of the distal mesonephric duct andthe ureteric bud separates between 6th-8th gestational week,and the ureteric orifice migrates toward the metanephricblastema, whereas the distal part of mesonephric duct underthe influence of testosterone and anti-Mullerian hormone,forms the hemitrigone, the bladder neck, the urethra up to theexternal sphincter, the seminal vesicle, vas deferens, ejaculatoryducts, epididymis, paradidymis, and appendix of the epididymis[6,7]. During the 4th to 6th week of gestation, the metanephricblastema secretes growth factors, which induce the growth ofthe ureteric bud toward it. The ureteric bud too secretes growthfactors and proliferates, fusing with the metanephric blastema,and in turn inducing the blastema to become the primitivekidney on undergoing mesenchymal to epithelial transition [8].

Imaging enables accurate diagnosis of this rare anomaly of thegenitourinary tract. On sonography, ipsilateral kidney is absent,and the obstructed ejaculatory ducts are seen as anechoicstructures in the pelvis, though hemorrhage or infection canproduce internal low level echoes [9]. CT is better thansonography, and CT findings are of a retrovesicular periprostaticcystic mass along with ipsilateral renal agenesis [10]. Aspirationof cyst fluid transperineally and identification of spermatozoa init is also confirmatory for Zinner's syndrome.

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