Services | Ida-Tallinna Keskhaigla

Allergen-specific immunotherapy

Allergen-specific immunotherapy is the only modern treatment changing the course of an allergic disease; it is used to develop a tolerance to the allergen causing the allergy. We can perform allergen-specific immunotherapy for the treatment of pollen allergy, household dust allergy, insecticide allergy and animal allergy. It is possible to carry out the treatment using subcutaneous injections or sublingual drops. We perform allergen-specific immunotherapy on both children and adults.

Clinic of Internal Medicine, Centre for Allergology and Immunology

Outpatient appointment with an allergist-immunologist

Both children and adults who have already been diagnosed with or are suspected of having an allergic disease (such as allergic rhinitis, asthma, allergic skin rash or hives, food allergies, insecticide allergies, drug allergies), immunodeficiency (including abnormally common or abnormally severe infections) or other disorder encompassing the immune system are welcome to an appointment with an allergist-immunologist.

Clinic of Internal Medicine, Centre for Allergology and Immunology

Appointment with an allergology-immunology nurse

Allergology-immunology nurses advise patients with different types of immune system disorders. In the case of allergic diseases (asthma, allergic rhinitis, atopic dermatitis), nurses provide recommendations to patients and loved ones on how to better cope with allergic diseases. Among other things, they will be trained in the use of medications and technical aids, and given recommendations regarding nutrition and skin care. The treating physician will refer you to a nurse’s appointment.

Clinic of Internal Medicine, Centre for Allergology and Immunology

Appointment with a dermatovenerologist

A dermatovenerologist, i.e. a physician of the skin, deals with diagnosing, treatment and monitoring of different skin disorders and sexually transmitted diseases. We perform different dermatological procedures for the purpose of diagnosis and treatment: various minor surgeries (removal of skin formations), skin biopsies, cryotherapy, i.e. cold therapy, diathermocoagulations for the removal of haemangiomas.

Clinic of Internal Medicine, Centre for Allergology and Immunology

Appointment with a dermatovenerology nurse

A dermatovenerology nurse provides consultations to patients with skin disorders. The nurse will give recommendations regarding skin care in the case of chronic skin disorders and acne, or after the treatment of fungal infections. The treating physician will refer you to a nurse’s appointment.

Clinic of Internal Medicine, Centre for Allergology and Immunology

Appointment with a geneticist

A geneticist deals with an already diagnosed genetic disease or the diagnosing, treatment and counselling of patients suspected of having one. Patients suspected of having or having been diagnosed with the following are welcome to an appointment:

Clinic of Internal Medicine, Centre for Allergology and Immunology

Digital dermatoscopy

Digital dermatoscopy is a test which enables nevi (birthmarks) to be diagnosed, recorded, and monitored over time. Digital dermatoscopy permits the early discovery of changing nevi and melanoma.

Clinic of Internal Medicine, Centre for Allergology and Immunology

Epicutaneous tests

Epicutaneous tests are used for identifying the potential allergen when diagnosing allergic contact dermatitis. To perform the test, allergens are placed on the upper back using patches (the number of patches depends on the number of allergens studied). Patches will be left on the back for two whole days (48 hours), after which they will be removed. The result of the test will be evaluated during the third appointment (usually 48 hours after the patches have been removed).

Clinic of Internal Medicine, Centre for Allergology and Immunology

FeNO test

Measurement of fractional exhaled nitric oxide (FeNO) is a method of assessing eosinophilic inflammation of the airways. It allows for the assessment of the worsening and treatment results of eosinophilic diseases of the airways.

Clinic of Internal Medicine, Centre for Allergology and Immunology Centre of Internal Medicine

Removal of benign neoplasms with liquid nitrogen (cryotherapy)

Cryotherapy is the removal of benign neoplasms of the skin using liquid nitrogen. Liquid nitrogen freezes the water in skin cells, during the melting of which the bonds between cells break and a blister forms. With the healing of the blister, the formation will be removed.

Clinic of Internal Medicine, Centre for Allergology and Immunology

Outpatient appointment with a paediatric allergist

Children who have already been diagnosed with or are suspected of having an allergic disease (such as allergic rhinitis, asthma, allergic skin rash or hives, food allergies, insecticide allergies, drug allergies) are welcome to an appointment with a paediatric allergist. In order to refer a patient to a consultation with a paediatric allergist, one’s family physician will prepare an e-consultation referral, to which we will respond within 4 working days (we will contact you and agree on an appointment date).

Clinic of Internal Medicine, Centre for Allergology and Immunology

Light therapy of the skin

Light therapy has a positive effect against many skin problems, for example allergic and bacterial skin inflammation. The main (albeit not the only) indication for light therapy of the skin is psoriasis.

Clinic of Medical Rehabilitation, Centre for Allergology and Immunology Outpatient Rehabilitation Centre

Minor outpatient surgery performed by dermatologists*

Surgical removal of smaller neoplasms of the skin using local anaesthetic. Sutures will be applied to the wound, if necessary, which must be removed after a period of 1–2 weeks, depending on the site and size of the wound.

Clinic of Internal Medicine, Centre for Allergology and Immunology

Skin biopsy

Histological examination of a tissue sample (biopsy) might be required to identify a skin disorder. For this, a piece of skin with a diameter of 2 to 4 millimetres will be taken using a biopsy drill. You will not feel any pain due to a previously injected local anaesthetic, but you will retain touch sensitivity. The samples will be sent to the pathology centre where a result will usually be reached within 3–4 weeks.

Clinic of Internal Medicine, Centre for Allergology and Immunology

Skin prick tests

Skin prick tests are used to identify the causal allergen. To perform the test, a drop of the allergen solution will be placed on the skin of the forearm or back, and a special lancet will be used to do a gentle prick through the drop. The result of the test will be evaluated after 15 minutes have passed.

Clinic of Internal Medicine, Centre for Allergology and Immunology

Provocation test

It is possible to verify whether a suspected allergen causes issues or not using a provocation test. To do so, the allergen will be given/administered under controlled conditions and constant supervision. We conduct allergological provocation tests in the event of the suspicion of a drug allergy, insecticide allergy, food allergy, as well as allergic rhinitis and asthma.

Clinic of Internal Medicine, Centre for Allergology and Immunology

Treatment of viral warts and corns with liquid nitrogen (cryotherapy)

Clinic of Internal Medicine, Centre for Allergology and Immunology

Spirometry and bronchodilator test

Spirometry is a test of breathing function, during which lung capacity, elasticity and airway resistance during forced breathing is assessed. Inhalation and exhalation with maximum depth and speed is studied during the test. The test is mainly used for diagnosing asthma and chronic obstructive pulmonary disease (COPD), and monitoring the treatment of these.

Clinic of Internal Medicine, Centre for Allergology and Immunology Centre of Internal Medicine

Spirometry

Clinic of Internal Medicine, Centre for Allergology and Immunology

Anti-gravity treadmill (AlterG)

AlterG has been developed to reduce the impact of gravity on the patient's lower extremities, thus enabling patients suffering from injuries to their lower limbs to start with gait training significantly earlier on in the rehabilitation process. Benefits of the AlterG treadmill, based on anti-gravity technology:

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Instrument assisted physiotherapy

The treatment has a therapeutic effect which relieves pain, reduces skin irritability, improves peripheral circulation and increases the nutritional condition of tissues. Electromagnetic therapy Electromagnetic therapy is a type of physical therapy in which tissues are affected on the cellular level by a low-frequency magnetic field.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Instrumental lymphatic massage

Lymphatic drainage promotes the flow of lymph in the lymphatic system. The goal is to stimulate lymphatic circulation and to improve the drainage of fluids and waste matter in the organism. The Lymphastim BTL device operates on the principle of periodic compression. The drainage parameters, pressure, compressions and pause duration are configurable. The tissues are affected by cuffs, which cover specifically constructed junctions and which are inflated in a specific order.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Automatic water massage

Automatic water massage improves the circulation and metabolism of tissues. The massage relieves muscle tension and pain. Underwater massage has a gentle and pleasant effect. Automatic water massage is performed in a special massage bath. We ask you to bring your own swimwear, hygienic products, hand towel and shoes with anti-slip soles. The service is paid.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Infant swimming in group

Infant swimming strengthens the child’s skeletal and muscular system, improves joint mobility, relieves muscular tension and develops body flexibility. The water environment calms the baby and helps them relax. In an individual swimming lesson, the baby learns how to float on water, move on their back or belly, jump into water and practise their diving reflex.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Blood tests package for recreational athletes

The blood tests package determines: Creatinine is the end product of muscle metabolism. The amount depends on the size of the muscle mass. Helps assess the functioning of the kidneys. Urea is the end product of protein cleavage. Reflects the amount of protein cleavage in the body.

Diagnostic Clinic, Outpatient Rehabilitation Centre

Cardiopulmonary exercise test

The cardiopulmonary exercise test is a diagnostic test method which allows for the evaluation of metabolism in blood circulation, breathing and muscles as a whole during exercise. Alongside monitoring adaptation processes of the cardiovascular system, changes in breathing function, inhaled oxygen and exhaled carbon dioxide are constantly registered using a breathing mask and gas analyser.

Clinic of Internal Medicine, Outpatient Rehabilitation Centre Centre of Internal Medicine

Custom insoles

Custom orthopaedic insoles offer relief from various foot disorders. The insoles are manufactured using state-of-the-art technology to ensure the best fit of the insoles into the footwear. An accurate analysis of the pressure distribution of the feet, modern materials and new technologies make it possible to manufacture custom insoles tailored to a patient's specific needs.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Physiotherapy (1 hour)

The aim of physiotherapy is preventing possible health problems, maintaining or improving the range of mobility of joints and the strength and endurance of muscles, restoring impaired functions or, if necessary, compensating for them and managing pain.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre Inpatient Rehabilitation Centre

Physiotherapy in a pool

Physiotherapy in a pool builds muscles, stimulates the respiratory organs and regulates cardiac activity. Water aerobics stimulates circulation and normalises blood pressure. Additionally, water massage relaxes and relieves stress. Regular water aerobics helps to maintain and improve endurance, balance and the coordination of movements.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Gameready cold compression therapy

The procedure promotes faster recovery from injuries. In addition to providing localised cryotherapy, the device provides compression therapy, which is ideal for reducing post-traumatic and/or post-surgical (endoprostheses, amputation, etc.) swelling and pain. The duration of the procedure is up to 30 minutes. The procedure is paid.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

GRAIL – gait analysis and gait training system 60 min

GRAIL is a device for performing gait analysis (60 min) and training (30 min). It allows extremely detailed real-time gait analysis to be conducted and the results saved for subsequent use to clarify the patient’s problems and/or adjust their therapy. The GRAIL system is ideal for patients with neurological, orthopaedic and musculoskeletal conditions who need gait analysis or gait training.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Infant massage

Infant massage has an all-round positive effect on the baby’s development. Infant massage strengthens muscles, balances the tone of skeletal muscles and the motor development of the child, improves coordination, increases the elasticity and mobility of muscles and stimulates metabolism and circulation.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Individual infant swimming

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Jalgade koormusjaotuse kompleksuuring 60 min

Sensorplaadiga uuringut teeme lastele alates 35 kg kehakaalust, väiksemaid lapsi nõustame vajadusel ilma uuringut teostamata. Uuringu järel nõustab arst patsienti jalaharjutuste, jalgade deformatsioonidega seotud abivahendite, ortooside ning sobivate jalanõude valiku osas. Uuringule tulles

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Kehaskoostise määramine (SECA mBCA 515 analüsaatoriga)

Võimaldab määrata kehakaalu, kehamassiindeksit, rasvamassi, skeleti lihaskonna massi, lahjade pehmete kudede massi, keha üldist veesisaldust, keha salvestatud energiat, energiakulu puhkeolekus; mass indexes: fat-free mass index, fat mass index; general energy consumption of the body, amount of extracellular water and phase angle. The phase angle evaluates the health condition, for example, small phase angle indicates health deterioration (malnutrition, alcoholism, infection, or advanced years).

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre kehaskoostise määramine

Kinesio taping

Kinesio taping is effective for alleviating complaints related to the musculoskeletal system. It helps in the recovery of areas injured by overuse or trauma. It relieves oedema and alleviates pain.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre kinesioteipimine

Light therapy

Light therapy is a form of an artificial sun which relieves springtime lethargy and winter depression, which is very prevalent here in the North.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Localised mud therapy

Besides a thermal and mechanical effect, mud therapy also has a chemical and radioactive effect. The goal is to warm tissues and give a deep heating effect. An increase in skin temperature improves skin circulation and increases the pulse rate (the temperature of tissues may increase to 45–55°C and remain for a while).

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre mudaravi

Speech therapist’s appointment (60 min)

A speech therapist develops and/or corrects the patient’s ability to communicate, i.e. the ability to create and understand spoken and written language, pronunciation accuracy, voice and nonverbal communication. They also treat swallowing disorders.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre Inpatient Rehabilitation Centre logopeed

Shockwave therapy

Shockwave therapy is a type of physical therapy. Shockwaves are acoustic waves which propagate in tissues and have healing properties. The first procedure is performed by a doctor, the following ones by a nurse.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre lööklaineteraapia

Lymphotherapy

In lymphotherapy, manual lymphatic drainage (superficial massaging of the skin and subcutaneous tissues, which stimulates the flow of lymphatic fluid) is performed in combination with special therapeutic techniques, as well as compression therapy and skin care. The lymphotherapy procedure involves taking a thorough medical history in order to determine the need for lymphotherapy, to prepare a plan, perform the therapy, assess the progress of the therapy, and provide counselling.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Massaaž

Massaaž aitab parandada kudede vereringet ning soodustab ainevahetust. Massaaži abil normaliseeritakse ka närvisüsteemi ja lihaste talitlust, mis omakorda aitab vabaneda lihaspingetest. Massaaži kasutatakse ka stressi maandamiseks ja töövõime tõstmiseks ning selle pikemaajaliseks säilitamiseks. Massaaž ehk kätega ravimine on iidne ravivõte, mis pärineb vanast Indiast. Pakume erinevaid ravimassaaže:

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Noorsportlaste terviseuuringud

Noorsportlaste terviseuuring annab ülevaate noorsportlaste tervislikust seisundist ja kehalisest võimekusest. Peamisteks eesmärkideks on vastunäidustuste ja osaliste piirangute väljaselgitamine spordiga tegelemiseks ning terviseriskide kindlaks tegemine. Noorsportlaste terviseuuringule on oodatud kuni 19 aastased noored (k.a.), kes osalevad lisaks kooli kehalise kasvatuse tundidele regulaarselt spordiklubi, spordikooli või kooli juures tegutsevates treeningutes vähemalt 6 tundi nädalas (1 treeningtund = 45 minutit).

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Nurse’s appointment in the field of rehabilitation (lifestyle consultation)

The provision of outpatient nursing care in the field of rehabilitation (lifestyle consultation), which encompasses, above all, patient instruction and counselling on how to cope with their illness and changes resulting from the illness, and also a healthy diet, physical exercise and healthy lifestyle choices. Inpatient referral by a specialist is required for you visit.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Occupational therapy 60 min

Occupational therapy involves teaching the patient the skills necessary for coping with everyday life. The goal is to assist the patient in coping with everyday activities as independently and safely as possible. In the case of hand and wrist problems, we carry out hand therapy sessions, make hand and finger orthoses and provide counselling as to the selection of orthoses.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre Inpatient Rehabilitation Centre

Paraffin wax therapy

The procedure relieves muscle tension and dilates the vessels in subcutaneous tissue, which improves circulation and reduces the sensation of pain. Paraffin wax therapy has a pain-relieving and anti-inflammatory effect. It is well-suited for relieving chronic muscle and joint complaints.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre parafiinravi

Pearl bath

A pearl bath has a relaxing effect on the whole body. Warm pearl baths are suitable for relieving excess tension and stress. Water relieves muscle tension, reduces the sensation of pain in the diseased regions of the body, stimulates metabolism, improves blood and lymph circulation and helps to relieve stress.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre pärlivann

Physiotherapy for pelvic floor muscles

In the case of urinary problems and uterine prolapse, it is necessary to learn how to correctly tighten the pelvic floor muscles to prevent and treat urinary incontinence and organ prolapse.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Prosthetist´s appointment

Our prosthetists make individual orthopaedic insoles and prostheses. All devices produced at our centre are registered and entered into the Medical Device Registry of the Health Board. A referral is not required to make an appointment for a consultation with a prosthetist. The consultation is paid.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre Inpatient Rehabilitation Centre

Rehabilitation physician´s appointment

A rehabilitation physician is a medical specialist who evaluates the patient’s condition, decides on the need for medical rehabilitation and prescribes further treatment depending on the patient’s problem, by referring the patient to rehabilitative services (physiotherapy, occupational therapy, massage, etc.).

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre Inpatient Rehabilitation Centre taastusravi

Salt therapy

The main indication for salt therapy is chronic airway disease. It also relieves the symptoms of allergy patients. Salt therapy is suitable for disease prevention. Salt therapy is also indicated for skin disorders. In the salt chamber, a low-concentration dry NaCl aerosol is used. After inhalation, salt deposits form on the mucous membranes of the airways.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Training room (HUR machines) 1 person, 30 min in group

The training room is fitted with exercise equipment by the Finnish company HUR and enables targeting of all muscle groups. The equipment has been designed to also ensure convenient use by patients confined to a wheelchair. The training room is used for 30-minute individual as well as group therapy sessions under the instruction of physiotherapists.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre huri masinad

Underwater shower massage

An underwater massage with a strong jet is suitable for muscle problems, limited joint mobility and lymphostasis. An underwater massage is performed with a hose which is directed under water and ejects a water jet with a pressure of 1–3 atmospheres. Underwater massage improves circulation, increases the amount of oxygen entering the blood and accelerates metabolism. This in turn helps to remove waste matter from the organism. Underwater massage is pleasant and has a gentle effect.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre duššmassaaž

Water aerobics for the pregnant

The Clinic of Medical Rehabilitation offers water aerobics for pregnant women. Water is a good method for relaxation, You will feel lighter in water and relax your overstrained muscles and reduce lower back pain. The physiotherapist’s instructions help you to perform the exercises and leave your everyday worries behind. We await women in all stages of pregnancy and the exercises are suitable for everyone.

Clinic of Medical Rehabilitation, Outpatient Rehabilitation Centre

Anaesthesiologist's appointment

An outpatient appointment with an anaesthesiologist will take place for patients undergoing surgery in order to get acquainted. A surgeon will refer you to an appointment. Anaesthesiologists deal with patients with chronic pain at the pain management doctor's appointment.

Surgery Clinic, Centre of Anaesthesiology and Intensive Care Анестезиология

Pain management doctor's appointment (pain treatment office)

In the pain service pain treatment office, we help patients with chronic pain with a referral Chronic pain is often caused by a long-term illness, for instance, joint wear, nerve damage. Chronic pain may decrease a person’s quality of life, disrupting their work, daily life, and sleep. Chronic pain requires an even and long-lasting pain treatment.

Surgery Clinic, Centre of Anaesthesiology and Intensive Care

Advanced problems involving the diabetic foot / Foot care council

In the case of difficult problems (poorly healing diabetic foot ulcers), the patient is referred by a physician to the special council, where they will participate in a consultation with several designated specialists at once – an endocrinologist, a vascular surgeon, an orthopaedist and an orthotist – who will prepare the best possible treatment plan for the patient.

Clinic of Internal Medicine, Centre of Endocrinology Inpatient Rehabilitation Centre Centre of General and Oncological Surgery

Appointment with a Diabetes Nurse

The diabetes nurse consults the patient and, if necessary, their family (or sponsor), explaining the nature of diabetes.

Clinic of Internal Medicine, Centre of Endocrinology

Appointment with a foot care nurse for diabetics

A foot care nurse’s appointment is recommended if you need treatment for or advice about skin injuries, ulcers, early-stage inflammatory diseases or post-amputation conditions.

Clinic of Internal Medicine, Centre of Endocrinology

Appointment with an Endocrinologist

Endocrinologists consult patients in the following disease groups:

Clinic of Internal Medicine, Centre of Endocrinology

Eye pathology accompanied by thyroid disease (dysthyroid orbitopathy)

Eye pathology accompanied by thyroid diseases requires the attention of a specialist. This is often an issue that responds poorly to treatment.

Clinic of Internal Medicine, Centre of Endocrinology

Thyroid puncture

Diagnosis and treatment of thyroid nodules. A thyroid puncture is performed if it is necessary to specify the cellular structure of a nodule located at the thyroid. In the course of a thyroid puncture, we puncture a suspected malignant nodule under ultrasound guidance and send the material for cytological examination.

Clinic of Internal Medicine, Centre of Endocrinology

Thyroid ultrasound scan

Assessing the size and structure of the thyroid. Necessary testing in case of thyroid nodules, in diagnosing malignant thyroid tumours and illnesses accompanied by hyperthyroidism.

Clinic of Internal Medicine, Centre of Endocrinology

Balloon-assisted enteroscopy

A test for identifying diseases of the small intestine. With the help of a balloon located at the endoscope, the small intestine is pulled onto the endoscope, and the endoscope is advanced inside the intestine in this way. During the examination, it is possible to take tissue samples and perform treatment procedures, if necessary (taking a biopsy, polypectomy). Since the procedure may take a long time, it is usually performed under anaesthesia and in the day treatment ward.

Clinic of Internal Medicine, Centre of Gastroenterology

Capsule endoscopy

Mainly the small intestine is examined. A swallowed capsule transmits images from inside the intestinal tract. Movement of the capsule inside the intestine may take hours.

Clinic of Internal Medicine, Centre of Gastroenterology

Colonoscopy

This is an examination of the lower gastrointestinal tract. The large intestine, and sometimes also the end of the small intestine is observed. The examination generally lasts for up to half an hour.

Clinic of Internal Medicine, Centre of Gastroenterology

Endosonography

The upper gastrointestinal tract with an unclear nature and pancreatic tumours are mainly examined. A special endoscope with an ultrasonic probe at its head is used for endosonography. This allows for the nature of the tumour to be assessed more accurately and there is a possibility to take tissue samples, if necessary.

Clinic of Internal Medicine, Centre of Gastroenterology

ERCP

ERCP is the endoscopic examination of bile ducts and the pancreatic duct. The test is required for removing stones from the common bile duct, identifying tumours of the bile ducts/pancreas and treating complications (taking a biopsy, stenting).

Clinic of Internal Medicine, Centre of Gastroenterology

Outpatient appointment with a gastroenterologist

A person should see a gastroenterologist if a disease of the gastrointestinal tract, liver, or pancreas is suspected – the patient exhibits stomach ache, diarrhoea, anaemia, weight loss.

Clinic of Internal Medicine, Centre of Gastroenterology

Oesophagogastroduodenoscopy, i.e. gastroscopy

This is an examination of the upper gastrointestinal tract where a video camera is used to examine the oesophagus, stomach, and beginning of the duodenum via the mouth.

Clinic of Internal Medicine, Centre of Gastroenterology

Zenker's diverticulectomy

Zenker’s diverticulum is a diverticulum at the upper gastrointestinal tract which causes difficulty in swallowing; in the most extreme cases, eating is not possible at all. This can be endoscopically treated (diverticulectomy) and after a successful procedure, the patient is able to eat normally again.

Clinic of Internal Medicine, Centre of Gastroenterology

Home nursing

Home nursing is intended for people who require nursing care due to their health condition without requiring inpatient hospital care. The home nursing service includes various nursing procedures which can be performed in the lovely ambience of your own home. Home nursing is intended for patients who have been discharged from hospital, a family health centre or care institution. The following, among others, qualify for the service:

Nursing Clinic, Centre of Nursing Care

Hospice

Hospice provides attention and care for the entire family and loved ones who are about to lose somebody. Death is sad, yet inevitable, and sometimes people and their loved ones need help coping with it. Here at the hospice, we support a person’s right to die with dignity.

Nursing Clinic, Centre of Nursing Care

Inpatient nursing care

In our nursing care departments, we alleviate patient discomforts and provide recommendations on how to cope in the future. For a patient still requiring the help of a nurse after the need for inpatient nursing care ends, we offer the home nursing service. The hospice unit in our clinic provides attention and care to the family and loved ones who are about to lose somebody.

Nursing Clinic, Centre of Nursing Care

Anaemia screening test

Anaemia means a decrease in blood haemoglobin concentration and erythrocyte count below the age- and sex-adjusted normal values. Signs of anaemia are gradually increasing fatigue, weakness, shortness of breath, loss of productiveness, pale skin, etc. Erythrocytes or red blood cells (RBC) contain haemoglobin. Haemoglobin’s (Hb) task is oxygen transportation. Hb and RBC are a part of a haemogram (CBC-5Diff), i.e a complete blood count.

Diagnostic Clinic, Central Laboratory

Screening test for hepatitis B

Hepatitis B and C are some of the most common infections in the world.

Diagnostic Clinic, Central Laboratory

Cholesterol

Cholesterol (Chol) is an important structural component of the cells of the human body and the parent substance for the biosynthesis of vitamin D, bile acids and several hormones.

Diagnostic Clinic, Central Laboratory

Diabetes screening test (glucose)

Glucose (Gluc) or blood sugar is the body’s primary source of energy – 40–60% of the necessary energy comes from glucose and it’s level in blood is kept within tight limits. Glucose measurement is used to diagnose or monitor the treatment of diabetes mellitus. It’s recommended to fast for 8 hours before the test.

Diagnostic Clinic, Central Laboratory

Diabetes screening test (glycohaemoglobin)

Glycohaemoglobin (HbA1c) indicates the blood glucose level in the longer term. Glycohaemoglobin production is a slow process, taking place in red blood cells during their lifetime (approx. 120 days) and depending on their glucose content. It is used to diagnose or monitor the treatment of diabetes mellitus.

Diagnostic Clinic, Central Laboratory

Folate

Folic acid (Fol) is a part of B-group vitamins. It’s necessary for cellular growth and multiplication, especially for the normal functioning of haematopoiesis. During pregnancy, it’s necessary for the development of the fetus. Folic acid is found in most foods, especially plant-based food. It’s recommended to fast for 8 hours before the test.

Diagnostic Clinic, Central Laboratory

HDL cholesterol

Lipoproteins are complexes of proteins and lipids which are classified according to density into high-density lipoproteins (HDL) and low-density lipoproteins (LDL). HDL binds excess cholesterol to remove it from cells. A higher blood level of HDL-cholesterol (HDL-Chol) or “good” cholesterol is a protective mechanism against atherosclerotic changes. LDL-cholesterol or “bad” cholesterol promotes cholesterol deposition on the walls of blood vessels. A high blood level of LDL-cholesterol is a prognostic indicator for atherosclerosis.

Diagnostic Clinic, Central Laboratory

HIV screening test

The human immunodeficiency virus (HIV) attacks the cells of the immune system and causes acquired immunodeficiency syndrome (AIDS).

Diagnostic Clinic, Central Laboratory

Inflammation screening test (C-reactive protein)

C-reactive protein (CRP) is a protein produced in the liver and it’s blood level increases in case of inflammation and tissue damage. The change in blood CRP level helps evaluate the course of the inflammation.

Diagnostic Clinic, Central Laboratory

Iron deficiency screening test

The test of choice for detecting iron deficiency is plasma ferritin (Fer) which is reduced in relation to iron deficiency.

Diagnostic Clinic, Central Laboratory

Thyroid function screening test (TSH)

Thyroid function is regulated by the thyroid stimulating hormone (TSH). Changes in TSH help in the early detection of thyroid functional disorders. An overactive thyroid may be indicated by weight loss, fatigue, feeling hot, irritability, heart palpitations or diarrhoea and an underactive thyroid by weight gain, sleepiness, feeling cold or constipation. A decrease of TSH most often indicates hyperthyroidism and an increase indicates hypothyroidism; additional tests are necessary for specification.

Diagnostic Clinic, Central Laboratory

Screening test for kidney and urinary tract diseases (urine dipstick test)

An urine dipstick test is the first test for diagnosing kidney and urinary tract diseases. It’s necessary to collect the sample properly. Changes in the levels of leukocytes, nitrites, protein and erythrocytes on the dipstick test may indicate an urinary tract or kidney disease if the sample has been collected correctly. If the sample has been collected incorrectly, a repeat test is recommended.

Diagnostic Clinic, Central Laboratory

Screening test for kidney and urinary tract diseases (creatinine)

Creatinine (Crea) is the final product of muscular tissue metabolism which is excreted through kidneys. Blood creatinine level indicates the kidneys’ ability to excrete waste products and is directly related to kidney function and the person’s muscle mass and physical activity. You should avoid intensive physical exercise 24 h before the blood test.

Diagnostic Clinic, Central Laboratory

Pregnancy screening test (chorionic gonadotropin)

Human chorionic gonadotropin (hCG) is a pregnancy hormone produced by the trophoblast of the blastocyst and later placenta and it can be detected in blood starting from the 11th day after fertilisation. It’s used for detecting pregnancy and monitoring fetal development. hCG measurement is also used in urine pregnancy tests but a blood test is significantly more accurate.

Diagnostic Clinic, Central Laboratory

Screening tests for Lyme disease bacterium (IgG)

Tick-borne borreliosis or Lyme disease is a infectious disease which spreads through tick bites and is caused by the spirochete Borrelia burgdorferi. Diagnosis of Lyme disease is primarily based on symptoms and a history of tick exposure. An antibody test is not indicated if there’s a typical ring-shaped rash or just general symptoms (e.g. fatigue, muscle aches. It’s recommended to confirm a borderline or positive result on the initial tests for specific antibodies with a second test. At least 4–6 weeks should have passed from the tick bite before testing.

Diagnostic Clinic, Central Laboratory

Screening test for gastrointestinal bleeding (faecal occult blood test)

Occult blood is an amount of blood in the faeces which is above physiological levels but invisible to the naked eye. An occult blood test allows early detection of gastrointestinal bleeding which might be caused by many different diseases of the gastrointestinal tract. The test is also used as a early screening test for colorectal cancer.

Diagnostic Clinic, Central Laboratory

Screening test for intestinal parasites (microscopy)

A microscopic evaluation for parasites is indicated in chronic diarrhoea, abdominal pain and weight loss. A negative result does not rule out parasites, it’s recommended to repeat the test for samples taken on three different days.

Diagnostic Clinic, Central Laboratory parasiidid soolestiku häired

Screening test for syphilis bacterium (T. pallidum)

Syphilis is an infectious disease caused by the spirochete Treponema pallidum. The source of infection is an infected person and transmission is primarily sexual. The infection starts with a painless ulcer forming at the entry site of the pathogen, an untreated infection will progress. Syphilis diagnosis starts with a screening test. If the screening test result is “Referred for confirmation”, a confirmative test is necessary. After having syphilis, the antibodies remain for years.

Diagnostic Clinic, Central Laboratory

Triglycerides

Triglycerides (Trigl) or fats are one of the primary sources of energy for the organism as stored fats and also a building block for cells. After a meal, triglyceride blood levels are higher. A persistently high blood level of triglycerides indicates a lipid metabolism disorder. It’s recommended to fast for 8 hours before the test.

Diagnostic Clinic, Central Laboratory

Vitamin B12

Vitamin B12 (Vit B12) is necessary for the normal functioning of the nervous system and haematopoiesis. Vitamin B12 is found in food of animal origin. Vitamin B12 deficiency in the organism may develop due to malabsorption or lack of the vitamin in food. It’s recommended to fast for 8 hours before the test.

Diagnostic Clinic, Central Laboratory

Vitamin D (25-OH)

Vitamin D (Vit D) is important in the metabolism of calcium and phosphorus, including bone development. Vitamin D deficiency causes rickets in infants and small children and low bone density in adults. Vitamin D taken as a food additive in excessive doses may cause muscular weakness, abdominal pain and elevated blood pressure and bone development disorders in children.

Diagnostic Clinic, Central Laboratory

Audiology

Audiology is a medical field which deals with hearing and balance disorders. Audiological tests include standard hearing tests which assess the hearing function, including tone audiometry, tympanometry, acoustic reflex assessment, and speech tests.

Surgery Clinic, Centre of Ear, Nose and Throat Diseases

Audiometry nurse's appointment

Audiometry nurse handles routine hearing tests. Audiometry nurse's appointment includes:

Surgery Clinic, Centre of Ear, Nose and Throat Diseases

Ear-nose-throat doctor's appointment

Our hospital provides assistance for adults and children with questions about ear-nose-throat disease tests, treatment and rehabilitation. A referral letter from your general practitioner is needed to book an appointment. You can come to a fee-based appointment without a referral letter and with a shorter waiting period.

Surgery Clinic, Centre of Ear, Nose and Throat Diseases

Hearing tests

East Tallinn Central Hospital has one of the two higher stage hearing centres in Estonia. We offer help for patients with a hearing disability from the age of 2 months to advanced age. The centre has two special sound isolation booths for hearing tests and in addition to other tests, we also carry out the third stage test of hearing screening for newborns.

Surgery Clinic, Centre of Ear, Nose and Throat Diseases

Voice disorder test

In order to determine the disease more accurately an endoscopic throat examination has to be carried out.

Surgery Clinic, Centre of Ear, Nose and Throat Diseases

Setup of the hearing equipment according to the hearing curve, its maintenance and counselling

Based on the needs arising from hearing damage and the wish of patients, it is possible to program different hearing aids at our hospital (Sivantos GmbH, Phnoak). At the hearing centre we also take and order individual ear tip imprints and offer maintenance and counselling.

Surgery Clinic, Centre of Ear, Nose and Throat Diseases

Surgical treatment of ear-nose-throat diseases

At the third surgery department of the Ear-Nose-Throat Centre, we treat diseases surgically and install hearing implants. The department has 5 inpatient hospital beds. We treat all major ear-nose-throat diseases:

Surgery Clinic, Centre of Ear, Nose and Throat Diseases

Laryngologist´s appointment

A laryngologist is a ear-nose-throat disease doctor who is more narrowly focused on the diagnostics and treatment of the throat area.

Surgery Clinic, Centre of Ear, Nose and Throat Diseases

Speech therapist’s appointment

A speech therapist is an educated specialist who deals with the treatment of communication problems. At the speech therapist's you can receive help in the elimination or mitigation of voice disorders and learn comfortable voice production.

Surgery Clinic, Centre of Ear, Nose and Throat Diseases

Instrumented decompression of one vertebral column interval

The aim of surgical treatment is the stabilisation of the spine (with screws and metal rods). In addition, the spinal canal is expanded at critical narrowings.

Surgery Clinic, Centre of Spinal Surgery lülisammas

Lumbar radiculitis or spinal stenosis surgery

The aim of the surgical treatment of lumbar radiculitis is the release of neural elements; in case of spinal stenosis, the release of neural elements and the expansion of the spinal canal.

Surgery Clinic, Centre of Spinal Surgery lülisammas

Vertebra slipping, i.e. spondylolisthesis surgery on two vertebral column intervals

The aim of surgical treatment is the stabilisation of the spine (with screws and metal rods). In addition, the individual position of the spine is restored and the spinal canal is expanded at critical narrowings.

Surgery Clinic, Centre of Spinal Surgery lülisammas

Vertebra slipping, i.e. spondylolisthesis surgery on one vertebral column interval

Surgery Clinic, Centre of Spinal Surgery lülisammas

Spinal surgeon's appointment

A spinal surgeon is a doctor with special training, who is focused on the treatment of spine pathologies in adults and children. You can book an appointment with a spinal surgeon with a referral letter to an orthopaedist.

Surgery Clinic, Centre of Spinal Surgery

Spinal surgery nurse's appointment

A spinal surgery nurse is a specially trained health care worker, who specifically focuses on spinal pathologies. You can book an appointment with a spinal surgery nurse with a specialist's referral letter. The appointment takes place on Ravi Street. Activities at the spinal surgery nurse's appointment:

Surgery Clinic, Centre of Spinal Surgery lülisammas selg

Hysteroscopy

Uterine cavity examination or outpatient hysteroscopy without anaesthesia.

Women's Clinic, Centre of Gynaecology hüsteroskoopia

Breast health office (mammologist)

Women who want to check their breasts or who have complaints related to their breasts can make an appointment at the breast health office. The breast examination is performed by experienced gynaecologists and midwives. The breast office also provides help and instructions for independent breast examination. Women should certainly make an appointment when they feel lumps, knots, bumps or other changes in their breasts. If necessary, the patient will be referred for further investigations.

Women's Clinic, Centre of Gynaecology

Cervical conisation under anaesthesia

Cervical conisation – surgical treatment method to treat cervical dysplasia. The purpose of conisation is to remove an area from the cervix, the cells of which have changed, either for diagnostic or treatment purposes. The need for the operation shall be determined by a gynaecologist, a referral is required. The cervical conisation shall be performed in an outpatient setting by using local anaesthesia. The operation will not be performed during menstruation. After the operation, the patient shall be allowed to go home.

Women's Clinic, Centre of Gynaecology emakakaela konisatsioon

Cervical examination with a colposcope or colposcopy

Colposcopy is an examination that helps to detect cervical cancer and precancerous conditions (cervical dysplasia). The examination shall be conducted by a gynaecologist.

Women's Clinic, Centre of Gynaecology kolposkoopia

Inserting the intrauterine contraceptive device or the coil

The intrauterine contraceptive device or the coil is a contraceptive which is inserted inside the uterus to prevent pregnancy. The device shall be installed by a woman’s doctor during an appointment. Analyses and examinations should be performed beforehand.

Women's Clinic, Centre of Gynaecology spiraal

Endometrial ablation

During the procedure, we shall remove the lining of the uterus. We shall send the sample to histopathological tests to specify the diagnosis. The need for the operation shall be determined by a gynaecologist, a referral is required.

Women's Clinic, Centre of Gynaecology

Gynaecologic oncology

Gynaecologic oncology focuses on the early detection of malignant genital tumours and their treatment. Cancer and precancerous conditions on genitals may be found on the cervix, in the vagina, on the external genitals, on the ovaries, inside the fallopian tubes or in the pelvic or stomach region.

Women's Clinic, Centre of Gynaecology Centre of Oncology pahaloomulised kasvajad

Gynaecological ultrasound test

During a gynaecologist’s appointment, an ultrasound test is often performed after the examination. All gynaecologist offices at the women’s clinic have ultrasound machines. An ultrasound test allows to diagnose gynaecological abnormalities.

Women's Clinic, Centre of Gynaecology ultraheli

Hysteroscopic operation

During outpatient hysteroscopy, the gynaecologist can examine the patient’s uterus from the inside.

Women's Clinic, Centre of Gynaecology

Inserting the contraceptive implant, the Nexplanon

Women's Clinic, Centre of Gynaecology rasestumisvastase implantaat

Medical abortion

Medical abortion refers to removing the embryo or the foetus from the uterine cavity by administering appropriate medicinal products.

Women's Clinic, Centre of Gynaecology abort

Woman’s doctor appointment

The woman’s doctor, also referred to as the gynaecologist, receives women of all ages. You do not need a referral to book an appointment. Paid appointments have a shorter waiting time. You should book an appointment with a woman’s doctor before starting active sex life to receive advice on using contraceptives. If you are already sexually active, you should book an appointment at least every three years. Should any complications arise, book an appointment with a woman’s doctor.

Women's Clinic, Centre of Gynaecology

Botulinum toxin therapy in case of motor disorders and spasticity

The treatment is performed under myographic or ultrasonic guidance, when the medication is injected into specific muscles or muscle groups.

Clinic of Internal Medicine, Centre of Neurology

EEG – electroencephalography

EEG is a test for evaluating the electrical activity of the cerebral cortex. The test is performed during wakefulness and also during sleep (if necessary). The test provides information about the condition and functioning of the cerebral cortex. EEG allows to specify epilepsy, different seizures, loss of consciousness episodes, brain damage caused by trauma, disorders of consciousness, and brain death.

Clinic of Internal Medicine, Centre of Neurology

ENMG – electroneuromyography

Electroneuromyography is a test used to examine peripheral nerves and muscles. The test consists of two parts: neurography is used to measure nerve conduction velocity; for this, electrodes are attached to the skin, and light electrical impulses are used to stimulate the nerve; myography is used to examine a muscle (or muscles) with a thin needle. Both parts of ENMG are not always performed. The test is safe and has no aftereffects, but it may be slightly unpleasant and painful for the patient. It generally lasts about 30 minutes to 1 hour.

Clinic of Internal Medicine, Centre of Neurology

Epilepsy

Epilepsy is a general term for conditions characterised by recurring epileptic seizures without a clear external cause. There are various forms of epilepsy, each with different causes, manifestations and treatment methods.

Clinic of Internal Medicine, Centre of Neurology

Headache

Our main focus is on patients with multiple sclerosis. We diagnose and treat multiple sclerosis using all available treatment options. Patients with multiple sclerosis are monitored by specialised doctors and nurses.

Clinic of Internal Medicine, Centre of Neurology

Neurodegenerative diseases

We specialise in the treatment of Parkinson's disease and Parkinson-plus syndromes. In addition to medical specialists and nurses, a speech therapist and physiotherapist are involved in the treatment of this group of diseases.

Clinic of Internal Medicine, Centre of Neurology

Neuroimmunology

Clinic of Internal Medicine, Centre of Neurology

Outpatient appointment with a neurologist

Neurology is a branch of medicine dealing with diagnosing and treatment of diseases of the nervous system.

Clinic of Internal Medicine, Centre of Neurology

Vascular neurology

Thrombolysis and thrombectomy (recanalisation therapy) are used to restore blood flow to the brain. During thrombolysis, blood clots formed in the blood vessels are broken down. Before the procedure, the indication and contraindications for thrombolysis are assessed. In most cases, thrombolysis is performed within 30 minutes of arrival at the hospital.

Clinic of Internal Medicine, Centre of Neurology

Bone metastasis pain management with Radium-223 (1 treatment procedure)

Radium-223 Dichloride (Xofigo®) is indicated for patients who have castration resistant metastatic prostate cancer and who have pain caused by bone metastases.

Diagnostic Clinic, Centre of Nuclear Medicine luumetastaas valuravi

Check-up examination after thyroid cancer radioiodine treatment (with thyrotropin; Thyrogen®)

The check-up examination shall be performed no later than within 6 months after the thyroid radioiodine treatment.

Diagnostic Clinic, Centre of Nuclear Medicine radiojoodravi

Prostate cancer isotope treatment with 177Lu-PSMA or RLT (1 procedure)

RLT or radioligand therapy is a treatment method, in which a particular ligand (PSMA or prostate-specific membrane antigen) shall be marked with radioactive lutetium and the drug shall be administered to the patient intravenously as a slow drip infusion.

Diagnostic Clinic, Centre of Nuclear Medicine radioligandteraapia eesnäärmekasvaja isotoopravi

Pheochromocytoma or adrenergic tissue or medullary thyroid cancer scintigraphy

This examination is used to evaluate the spread of pheochromocytoma, neuroblastoma or medullary thyroid cancer, to detect relapses and plan 131I-MIBG treatment.

Diagnostic Clinic, Centre of Nuclear Medicine kilpnäärmevähk medullaarne kilpnäärmevähk

Isotope cystography

This examination helps to detect a reflux or backflow between the urinary bladder and the ureter as well as its extent. This examination is performed by inserting a temporary catheter into the urinary bladder via the urethra, through which saline solution with radioactive technetium (99mTc) shall be injected into the bladder. If the urinary bladder becomes full, the patient needs to urinate within the viewport of the machine.

Diagnostic Clinic, Centre of Nuclear Medicine isotooptsüstograafia

Joint radiosynovectomy

Radiosynovectomy is an intra-articular local treatment method, used for chronic inflammatory joint diseases in case systemic (main) treatment has not achieved the required results for individual joints.

Diagnostic Clinic, Centre of Nuclear Medicine radiosünovektoomia põletikulised liigesehaigused liigesed

Kidney function tests

This examination allows to detect kidney function disorders, caused by kidney damage or urinary tract obstruction.

Diagnostic Clinic, Centre of Nuclear Medicine neerud neerude talitluse häire

Kidney tissue damage examination

This examination helps to detect the extent of kidney tissue damage during and after acute pyelonephritis. The examination includes intravenously injecting a substance marked with radioactive technetium (99mTc) which will accumulate in the kidney tissue. You can come to the examination only with a specialist’s referral.

Diagnostic Clinic, Centre of Nuclear Medicine neerukoe kahjustus

Thyroid function scan with radioactive iodine

A thyroid scan with iodine is an isotopic test which shall be performed to evaluate thyroid function to plan radioiodine therapy for hyperthyroidism.

Diagnostic Clinic, Centre of Nuclear Medicine kilpnäärme funktsiooniproov joodiproov

Thyroid scintigraphy

Thyroid scintigraphy is an isotopic test which shall be performed to specify a thyroid disease, evaluate thyroid function before surgical or radioiodine therapy or to select a lesion for fine needle aspiration. Loe uuringu kohta täpsemalt patsiendile mõeldud infolehest SIIT ITK637

Diagnostic Clinic, Centre of Nuclear Medicine kilpnäärme stsintigraafia kilpnääre

Lung perfusion and ventilation scintigraphy

This examination helps to detect circulation and ventilation disorders of the lungs and it is done in two stages.

Diagnostic Clinic, Centre of Nuclear Medicine verevarustuse häired stsintigraafia

Liver function tests

This examination allows to detect liver function disorders, caused by liver tissue damage or biliary tract obstruction. The examination includes intravenously injecting a substance marked with radioactive technetium (99mTc) which will accumulate in the liver tissue and will be quickly excreted into the bowels with bile. You can come to the examination only with a specialist’s referral.

Diagnostic Clinic, Centre of Nuclear Medicine maksa funktsioon maksatalituse häired

Palliative treatment of bone metastases

Men primarily develop bone metastases with prostate cancer and women develop them with breast cancer. Palliative isotope treatment is indicated for patients with bone metastases who have bone pain and whose pain cannot be alleviated with regular drugs.

Diagnostic Clinic, Centre of Nuclear Medicine luumetastaas

Skeletal scintigraphy

This examination allows to detect metabolic disorders in bones in case of tumour metastases or osteitis.

Diagnostic Clinic, Centre of Nuclear Medicine stsintigraafia ainevahetuslikud häired

Lymphography. Marking the sentinel lymph node

Lymphography is used in case of lymph drainage disorders of the limbs.

Diagnostic Clinic, Centre of Nuclear Medicine lümfograafia valvurlümfisõlm

Myocardial perfusion scintigraphy after physical or pharmacologic stress (STRESS) and during rest (REST)

This examination allows to detect myocardium (cardiac muscle) blood circulation disorders and their extent.

Diagnostic Clinic, Centre of Nuclear Medicine müokard südamelihased

Neuroendocrine tumour isotope treatment with 177Lu-peptide or PRRT (1 procedure)

PRRT or peptide receptor therapy is a treatment method, in which a tumour cell specific peptide shall be marked with radioactive lutetium and the drug shall be administered to the patient intravenously as a slow drip infusion.

Diagnostic Clinic, Centre of Nuclear Medicine peptiidretseptor isotoopravi

Radioisotopic scanning of brain

This examination shall be used to evaluate the blood circulation of the brain if there is a doubt of Alzheimer’s disease or to evaluate the function of dopamine receptors in case of suspected Parkinson’s disease.

Diagnostic Clinic, Centre of Nuclear Medicine alzheimer peaaju

PET/CT scan

The PET/CT is a combo device based on hybrid technology and it consists of a positron emission tomography (PET) and a computed tomography (CT) scanner. PET/CT scan with 18F-PSMA

Diagnostic Clinic, Centre of Nuclear Medicine

Scintigraphy in inflammation

This examination enables detecting sources of inflammation ̶ ̶ both in soft tissues and the bones and joints (including around joint prostheses).

Diagnostic Clinic, Centre of Nuclear Medicine

Radio-iodine treatment procedure in case of hyperthyroidism

For the treatment of hyperthyroidism, the patient shall be orally administered a gelcap which contains a standard dose of radioiodine which influences the thyroid tissue, inhibiting its functioning. The procedure shall be conducted in an outpatient setting, the patient shall not be hospitalised.

Diagnostic Clinic, Centre of Nuclear Medicine hüpertüreoos

Radio-iodine treatment procedure in case of thyroid cancer

Radio-iodine treatment for thyroid cancer shall be performed after the surgical removal of the thyroid to destroy the remnants of thyroid tissue.

Diagnostic Clinic, Centre of Nuclear Medicine radiojoodravi

Somatostatin receptor scintigraphy

This examination is used to evaluate the spread of neuroendocrine tumours, to detect relapses, and to plan lutetium treatment.

Diagnostic Clinic, Centre of Nuclear Medicine neuroendokriintuumor

Emergency eye treatment

Diagnostics and treatment of all eye traumas and emergency eye inflammations.

Eye Clinic, Centre of Ophthalmology

Examinations and procedures for children and premature babies

Retinopathy screening and monitoring on premature children. If required, laser treatment of the fundus and surgical treatment.

Eye Clinic, Centre of Ophthalmology

EYE PROSTHESES

Inspection of the mucous membrane of the eye socket. Selecting a standard prosthesis with the help of a nurse. Consultation regarding the selecting of individual prosthesis. Hinnakirja link koos kõigi erinevate proteesidega.

Eye Clinic, Centre of Ophthalmology

Topical eye serotherapy

Dry eye treatment with autologous serum drops.

Eye Clinic, Centre of Ophthalmology

Nurse’s appointment

Advising and monitoring glaucoma patients, fundus photography for the early discovery of diabetic retinopathy, monitoring patients with age-related macular degeneration, performing orthoptic examinations, examination and treatment of eye movement and coordination disorders.

Eye Clinic, Centre of Ophthalmology

Ophthalmologist’s appointment

Sub-specialising in the field: fundus diseases, vitreoretinal surgery, corneal diseases, paediatric ophthalmologist, uveitis.

Eye Clinic, Centre of Ophthalmology

Optometrist’s appointment

Evaluating the visual function of the eye, prescribing glasses.

Eye Clinic, Centre of Ophthalmology

Silmapõhja laserravi

Teeme erinevaid silmapõhja laserravi protseduure:

Eye Clinic, Centre of Ophthalmology

Silmasisene ravimi süstimine

Silma täidab Iäbipaistev geel ehk klaaskeha. Silmasisese süsti tegemisel viiakse ravim silma sisemusse ehk klaaskehasse. Erinevate ravimite klaaskehasiseste süstetega saab ravida silma tagumise segmendi haiguslikke seisundeid, võimaldab tõsta ravimi silmasisest kontsentratsiooni ja ära hoida süsteemse manustamisega kaasnevat toksilist toimet. Silmasisese süsti näidustused:

Eye Clinic, Centre of Ophthalmology

Silmauuringud

Teeme erinevaid silmauuringuid: silma ultraheliuuringuid fluorestseiinangiograafia silmapõhjast erinevate võrkkestahaiguste puhul:diabeetiline retinopaatiasilma veresoonte sulgusedpärilikud silmapõhja haigused ilmapõhja fotode tegemine silmaarstide ja silmaõe vastuvõtul vaatevälja uuringute teostamine silmaarsti, neuroloogi ja endokrinoloogi suunamisel silmapõhjahaiguste diagnoosimiseks tehtavad uuringud uuringud makulahaiguste diagnostikaks ja makulahaiguste ravitulemuste hindamiseks ning jälgimiseks

Eye Clinic, Centre of Ophthalmology

Appointment with a palliative care nurse

The palliative care nurse’s appointment is a service that is intended for patients with an oncological disease and their loved ones. Our hospital oncologist can refer you for the appointment. Palliative care nurse: raises patients’ awareness of the disease and its treatment

Clinic of Internal Medicine, Centre of Oncology

Appointment with a psychologist’s (for oncology patients)

This is a service in which a psychologist with special training provides advise to oncology patients at the oncology centre. A referral from a family physician or specialist physician is necessary for the appointment.

Clinic of Internal Medicine, Centre of Oncology

Appointment with a social worker

The social worker helps the centre of oncology patients with various practical matters of the social field, such as sick leave, application for disability assessment and assessment of work capacity, application for social and occupational rehabilitation services, further care of patients (when at home, in a medical institution or a nursing home). The social worker also provides the patients with an overview of the services and support provided by the state, local governments and various organisations.

Clinic of Internal Medicine, Centre of Oncology

Genetic tumour test FoundationOne CDx

The test is suitable for examining the diseases of patients with a solid tumour.

Clinic of Internal Medicine, Centre of Oncology

Genetic tumour test FoundationOne Heme

The test is suitable for examining the diseases of patients with haematological cancers (leukaemia, lymphoma and myeloma) or sarcoma.

Clinic of Internal Medicine, Centre of Oncology

Oncological surgery

At the Centre of General and Oncological Surgery at East Tallinn Central Hospital we diagnose and treat all tumours of organ systems within our field of activity:

Surgery Clinic, Centre of Oncology Centre of General and Oncological Surgery Онкологическая хирургия

Outpatient appointment with an oncologist

This is a service in which an oncologist diagnoses, treats, monitors and consults patients with a malignant tumour. A referral from your family physician or specialist physician is needed to book an appointment.

Clinic of Internal Medicine, Centre of Oncology

Arthroplasty

Joint replacement; the mutilated articular surfaces are removed and replaced with artificial joints. In some cases it is possible to partially remove the articular surface and place a partial artificial joint. The majority of the surgeries consist of hip and knee joint endoprosthesis but we also perform shoulder, elbow and finger joint replacement surgeries.

Surgery Clinic, Orthopaedic Centre

Arthroscopic surgery (excluding meniscus, resection, free body)

Arthroscopy is a form of surgery which has been developed for the diagnosis and treatment of intra-articular problems.

Surgery Clinic, Orthopaedic Centre

Bone tumours

Our centre performs diagnosis and treatment for benign and malignant skin growths on limbs.

Surgery Clinic, Orthopaedic Centre jäsemed

Correction of deformities

At our centre, we perform corrective surgeries for thigh and shinbones in case of either congenital or acquired deformities.

Surgery Clinic, Orthopaedic Centre deformatsioonid

Different foot problems

We perform corrective surgeries for foot deformities.

Surgery Clinic, Orthopaedic Centre labajalg

Orthopaedic nurse's appointment

Traumatological-orthopedic patients are advised by orthopedic nurses. Pre-operation consultation we shall refer you to physiotherapy where you can learn to walk with crutches and perform exercises to increase muscle strength.

Surgery Clinic, Orthopaedic Centre

Orthopaedist's appointment

A referral letter from a specialist or a general practitioner is needed for the appointment of a orthopaedist at East Tallinn Central Hospital. Appointments take place on all working days at the Orthopaedic Department. In addition to doctors, orthopaedic nurses also provide independent appointments and counselling. Courses of action:

Surgery Clinic, Orthopaedic Centre ortopeed

Appointment with a consultant rheumatologist

A consultative outpatient appointment with a rheumatologist outside working hours.

Clinic of Internal Medicine, Centre of Rheumatology

Appointment with a rheumatology nurse

During their appointment with a rheumatology nurse we offer individual information to patients regarding the nature of their illness, teaching the patient how to cope with treatment and care. We provide support in adapting to changes resulting from the illness, including teaching patients receiving biological treatment how to give themselves injections.

Clinic of Internal Medicine, Centre of Rheumatology

Bone density measurement

The osteoporosis office deals with the diagnosis and treatment of osteoporosis, i.e. thinning of the bones. For diagnosis, a measurement of bone density is performed with a DEXA type densitometer. A referral from one’s family physician or specialist physician is required for the appointment.

Clinic of Internal Medicine, Centre of Rheumatology

Early arthritis office

The goal of the early arthritis office is the early diagnosis and commencing of treatment of autoimmune joint inflammations. Adequate treatment, commenced in the early stage of the disease, is important for achieving a positive treatment effect and preventing the person from becoming disabled. Patients whose arthritis symptoms have been ongoing for fewer than 12 weeks are welcome.

Clinic of Internal Medicine, Centre of Rheumatology

Foot treatment/medical pedicure

Foot treatment is a complex service which includes the following procedures, as required:

Clinic of Internal Medicine, Centre of Rheumatology

Joint injection

The rheumatologist punctures the joint, extracts the inflammatory joint fluid (if present) and injects the medication (glucocorticoid, a derivative of hyaluronic acid).

Clinic of Internal Medicine, Centre of Rheumatology

Joint injection under ultrasound guidance

The rheumatologist punctures the joint under ultrasound guidance, extracts the inflammatory joint fluid (if present) and injects the medication, if necessary (glucocorticoid, a derivative of hyaluronic acid). Joints located deeper (hip joints) within the body or with a more complex structure (shoulder-arm joint) must be injected under ultrasound guidance.

Clinic of Internal Medicine, Centre of Rheumatology

Kapillaroskoopia

Kapillaroskoopia on protseduur, mille käigus uuritakse kapillaroskoobi abil patsiendi mõlema käe 2.–5. sõrme küünevalli väikeseid veresooni. Parema kontakti ja nähtavuse saavutamiseks pannakse igale uuritavale küünevallile tilk taimeõli. Uuringut tehakse patsientidele, kellel on kaebuseks sõrmede muutumine valgeks või siniseks külma toimel ehk Raynaud’ sündroom. Eesmärgiks on eristada primaarset ja sekundaarset Raynaud’ fenomeni.

Clinic of Internal Medicine, Centre of Rheumatology

Therapeutic plasma exchange

Under the conditions of day treatment in the Rheumatology Centre, a certain amount of blood plasma will be removed from the patient’s blood circulation using a modern plasma separator. The procedure’s effect treats many diseases, since various disease-causing structures, such as autoantibodies, are removed from blood circulation with the plasma.

Clinic of Internal Medicine, Centre of Rheumatology

Anterior segment surgery

Surgical treatment of the pathologies of the anterior part of the eye. This includes surgeries on the eyelids and the eye mucous membrane, cornea. Corneal transplantation and the transfer of the different layers of the cornea, iris surgeries. Operations on the artificial lens, implanting, removing and replacing an artificial lens.

Eye Clinic, Centre of Eye Surgery

Artificial iris implantation

Artificial iris transplantation in case of eye traumas and oncological diseases.

Eye Clinic, Centre of Eye Surgery

Cataract surgery

Cataract removal with ultrasound technology and the implantation of an artificial lens.

Eye Clinic, Centre of Eye Surgery hallkae operatsioon

Corneal transplantation

Transplantation of donor cornea in case of different corneal diseases and traumas.

Eye Clinic, Centre of Eye Surgery

Divergent strabismus surgery

Strabismus treatment with a surgery that adjusts the strength of the muscles that move the eyeball. During the surgery, one or several muscles shall be tensed or loosened, as a result of which strabismus is reduced.

Eye Clinic, Centre of Eye Surgery

Glaucoma surgery

Operations that reduce eye pressure. Depending on the glaucoma stage and the eye pressure, different methods of surgery could be implemented: tabeculectomy, deep sclerectomy, and the use of different implants. In case of children’s congenital glaucoma, the surgical treatment involves surgery of the anterior corner of the eye.

Eye Clinic, Centre of Eye Surgery

Intraocular oncological surgery

Radiation treatment and surgery of malign eye tumours.

Eye Clinic, Centre of Eye Surgery

Vitreoretinal surgery

The surgical treatment of different vitreous and retinal diseases with microsurgery. This method of surgery can be used to operate in case of several different diseases, e.g. vitreous bruise, diabetic retinopathy, macular hole, epimacular membrane, retinal detachment, locked lenses, and artificial lenses.

Eye Clinic, Centre of Eye Surgery

Tear duct surgery

Operations used to treat tear duct pathologies. If there is an obstruction in the tear ducts, different methods of surgery are used. Tear duct probing, intubation with a silicone tube, external or endoscopic dacrocystorostomy.

Eye Clinic, Centre of Eye Surgery

Appointment with a thrombosis nurse

Patients prescribed anticoagulant therapy, i.e. treatment preventing blood clotting, or for whom it is planned, are welcome at the office of the thrombosis nurse.

Clinic of Internal Medicine, Centre of Internal Medicine

Appointment with pulmonology nurses

Independent reception by a pulmonology nurse is open on a daily basis. The main activities taking place are the training of patients regarding asthma and COPD, instruction in inhalation techniques, and monitoring. Sleep apnoea nurses also provide independent consultation daily regarding treatment of sleep apnoea and monitor CPAP therapy.

Clinic of Internal Medicine, Centre of Internal Medicine

Bronchoscopy

Bronchoscopy is a procedure which allows for a visual assessment of the condition of airways. The bronchoscope is an endoscopic instrument which is guided orally through the throat into the windpipe, i.e. trachea, and bronchi.

Clinic of Internal Medicine, Centre of Internal Medicine

Counselling for smoking cessation

Smoking is one of the leading causes of lung cancer. People living with smokers are also much more likely to develop lung cancer. We run a smoke-free hospital. We choose non-smoking; we recognise non-smokers and protect them from the risks of passive smoking.

Clinic of Internal Medicine, Centre of Internal Medicine

Diagnosing sleep apnoea

Sleep apnoea, i.e. obstructive sleep apnoea syndrome, is the most common sleep breathing disorder, characterised by constriction or closure of the upper airways, pauses in breathing during sleep, often accompanied by a decrease in blood oxygen saturation and sleep disorders.

Clinic of Internal Medicine, Centre of Internal Medicine

Lung diffusing capacity test

The diffusion of gas from alveolar air into pulmonary circulation is measured using different gases (such as helium, carbon monoxide). Typically, lung diffusing capacity decreases with the reduction of diffusion area, for example, in the case of emphysema concomitant with chronic obstructive pulmonary disease (COPD).

Clinic of Internal Medicine, Centre of Internal Medicine

Lung plethysmography

The test allows for the assessment of the obstruction and resistance of airways. The total capacity and residual capacity of lungs is assessed. In addition, lung resistance is also assessed, which is required for diagnosing restrictive lung diseases and determining their severity.

Clinic of Internal Medicine, Centre of Internal Medicine

Methacholine challenge test

The methacholine challenge test is used to evaluate the hyperactivity of airways. The methacholine challenge test is, in essence, a provocation test – it is used to try to provoke a bronchospasm. A positive result indicates hyperactivity of the bronchi, which may be characteristic of asthma; a negative result, however, very likely rules out asthma.

Clinic of Internal Medicine, Centre of Internal Medicine

Outpatient appointment with a thrombosis office physician

A physician from the thrombosis office deals with treating patients suffering from deep vein and pulmonary artery thrombosis, and performs additional tests, if required.

Clinic of Internal Medicine, Centre of Internal Medicine

Outpatient appointment with an internist

A family physician will refer the patient to an appointment with an internist using a referral, or the patient will be invited on the basis of the e-consultation decision ordered by their family physician. Internists welcome patients with an unclear diagnosis to their appointments. We deal with patients suffering from anaemia and an increase in inflammatory markers, diagnostics of patients with a suspected tumour, patients with multiple diseases.

Clinic of Internal Medicine, Centre of Internal Medicine

Pulmonologist’s appointment

A pulmonologist is a specialist in the study, treatment, and prevention of lung and respiratory diseases. You can come to the appointment with a general or special physician’s referral.

Clinic of Internal Medicine, Centre of Internal Medicine köha

Appointment with a cardiologist

There is reason to come to an appointment with a cardiologist if a heart-related disease is suspected – ischaemic heart disease, prior myocardial infarction, heart failure, cardiomyopathies, valve failures, arrhythmias, issues related to blood pressure disease, high risk of heart diseases in the family history (high cholesterol in family history, early onset of heart diseases, sudden death in the family), pregnant women with heart issues.

Clinic of Internal Medicine, Centre of Cardiology

Appointment with a nurse in the field of cardiology (heart failure)

The cardiology nurse teaches the patient and their loved ones to monitor for signs of disease. If necessary, they will also organise outpatient monitoring. The following are topics covered during cardiac insufficiency consultations: • nutritional and lifestyle consultation

Clinic of Internal Medicine, Centre of Cardiology

Funktsionaaldiagnostika uuringud

Funktsionaaldiagnostika osakonnas tehakse diagnostilisi uuringuid südametöö ja selle seisundi hindamiseks.

Clinic of Internal Medicine, Centre of Cardiology

Implantation, programming and follow-up of a cardic pacemaker

A permanent cardiac pacemaker is implanted for treating disturbances in the heart’s action potential and conduction. A cardiologist or another physician, after consulting with the cardiologist, will decide on the indication for implanting the pacemaker and schedule a time for it. We perform:

Clinic of Internal Medicine, Centre of Cardiology

One-day cardiological health audit (4 hours)

The health audit is a compact programme of tests, where the aim of the health tests is to be simple and convenient – referral letters to different physicians are not required, the condition of the organism is evaluated at one location and all at once. The health audit provides a great overview of the health condition, enables to prevent issues or prescribe a treatment at an early stage. The one-day health audit takes 4 hours (and does not require hospitalisation).

Clinic of Internal Medicine, Centre of Cardiology

Pediatrician appointment

Neonatal screening; newborn hearing testing; immunization of newborns; follow-up and monitoring of premature infants; recommendations for child care at home

Women's Clinic, Sünnitusmaja-perinataalkeskus

Midwife appointment

A midwife is an independent specialist who helps, instructs, monitors and advises women throughout their fertile life – before pregnancy, during pregnancy, in childbirth and in the postpartum period, they assist in breastfeeding, prepare women for the parental role, give advice on sex education and family planning and take part in prevention work related to the gynaecological field.

Women's Clinic, Sünnitusmaja-perinataalkeskus

Tervisetõendid

Tervisekontroll on vajalik isiku tervisliku seisundi ja selle sobivuse tõendamiseks vastaval erialal töötamiseks. Väljastame järgimisi tervisetõendeid:

Clinic of Internal Medicine, Centre of Occupational Health

Töötervishoiuarsti tervisekontroll ettevõtetele

Pakume töötervishoiuteenuseid eri suurusega ettevõtetele: suurettevõtted, keskmise suurusega ja väikeettevõtted, mikroettevõtted. Ettevõtte töötajate tervisekontrolli maksumus koostatakse individuaalselt (ei ole paketipõhine) ning töökeskkonna riskianalüüsi ja töötajate töökeskkonna ohutegureid arvesse võttes.

Clinic of Internal Medicine, Centre of Occupational Health

Vaktsineerimine

Vaktsineerimine aitab ennetada raskeid nakkushaigusi. ITKs pakume järgmisi vaktsineerimisi:

Clinic of Internal Medicine, Centre of Occupational Health

3D endoscopic/laparoscopic radical prostatectomy

The advantage of this method is better visualization during surgery through the use of multiple magnification, smaller scars, less pain after surgery, and the faster activation and recovery of the patient. Magnification and 3D technology enable better manipulation of tissues as well as faster operations, and are the best method for the preservation of nerves, which ensures the patient a higher post-operative quality of life.

Surgery Clinic, Centre of Urology eesnääre laproskoopia prostatektoomia

Cystolithotripsy (CLT)

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Surgery Clinic, Centre of Urology

Surgical treatment of benign prostatic hyperplasia

The frequency of benign prostatic hyperplasia increases with age. More than 50% of 70-year-old men have benign prostatic hyperplasia and every third patient at that age suffers from difficulties with urination. If conservative treatment is unsuccessful or if prostatic hyperplasia causes complications, the preferred method of treatment is surgery – either endoscopic or open surgery.

Surgery Clinic, Centre of Urology eesnääre eesnäärme healoomuline suurenemine healoomuline

Invasive prostate cancer diagnostics: a combined method of mpMRI and US or fusion guided biopsy

In March 2017, the Centre of Urology at East Tallinn Central Hospital was the first in Estonia to begin using a new method for obtaining tissue samples from the prostate. The method includes the combining or fusion of magnetic resonance imaging (MRI) and ultrasonography. The method enables a very precise tissue sample to be collected from a suspicious lesion in the prostate discovered during an MRI, which greatly improves the diagnostic value when looking for prostate cancer.

Surgery Clinic, Centre of Urology

Fibre-ureterorenoscopy i.e. retrograde intrarenal surgery (FURS/RIRS)

When an elastic/flexible fibre uretero-renoscope is used, it is possible to reach stones in the renal pelvis and calyces, crushing them with a laser and removing them.

Surgery Clinic, Centre of Urology

Independent appointments of urology nurses

A nurse’s independent appointment is an outpatient nursing care service that includes: epicystostomy replacement and teaching its care counselling a patient with a urostomy wound care, dressing, suture removal

Surgery Clinic, Centre of Urology

Surgical treatment of urogenital cancers

We provide surgical treatment for cancers of the kidney, adrenal gland, prostate, bladder and the genitals.

Surgery Clinic, Centre of Urology

Ureteroscopic Lithotripsy (URSL)

What is ureteroscopy? Ureteroscopy (URS) is a preferred method for the treatment of small- to medium-sized kidney stones located in any part of the urinary tract. Procedure The procedure is typically performed with the patient under general anaesthesia (asleep).

Surgery Clinic, Centre of Urology

Surgical treatment of urinary incontinence in women and men

Treatment of urinary incontinence in men using an AMS sling system One of the side effects of surgical treatment for prostate cancer, which has a significant impact on the quality of life, is urinary incontinence after radical prostatectomy. For the treatment of urinary incontinence in men we use a male AMS sling system, which permits the use of a surgical technique to successfully restore urinary continence in men with light to moderate urinary incontinence.

Surgery Clinic, Centre of Urology uriinipidamatus

Surgical treatment of bladder cancer

In non-muscle invasive bladder cancer, transurethral resection of the bladder (TURB) with photodynamic diagnosis (PDD) are used. In muscle-invasive cancers, complete removal of the bladder or radical cystectomy with bladder substitution using ileum or urinary diversion is usually indicated.

Surgery Clinic, Centre of Urology

Removal of kidney stones

The Centre of Urology at East Tallinn Central Hospital has, over the years, performed >30% of all kidney stone removal procedures in Estonia. Thanks to the universal training of our staff and smooth teamwork, patient handling is fast and standardised. This allows for the removal of the patient’s kidney or ureteral stone on the day of hospitalization, with the patient being discharged on the following day.

Surgery Clinic, Centre of Urology kuseteede kivid

Laparoscopic removal of adrenal tumours

We provide mini-invasive laparoscopic surgery of adrenal tumours, cooperating closely with the Centre of Endocrinology of the ETCH. Our endocrinologists always examine and prepare patients before surgery, thus ensuring maximum patient safety.

Surgery Clinic, Centre of Urology

Testicular biopsy

We have co-operated with our Centre for Infertility Treatment for many years and successfully helped hundreds of infertile couples. In outpatient surgery, we perform testicular biopsies for tissue examinations and for the histological evaluation of the perspective of infertility treatment, as well as Sperm cryopreservation, to permit IVF procedures in the future.

Surgery Clinic, Centre of Urology

Percutaneous Nephrolithotomy (PCNL)

PCNL is used most often when kidney stones are too difficult to reach, too large, too numerous, or too dense to be treated by shock wave lithotripsy or ureteroscopy.

Surgery Clinic, Centre of Urology neerukivid

Reconstructive urological surgeries

As a complication of different factors (inflammation, trauma, and previous surgical interventions), narrowing or stricture of the urethra might develop and cause difficulties with urination. Often the treatment of choice is an endoscopic minimally invasive method. In case of stricture recurrence, the treatment of choice is open surgery.

Surgery Clinic, Centre of Urology

Transurethral resection of the prostate (TURP)

Transurethral resection of the prostate (TURP) is one of the most common minimally invasive surgical treatment methods, in which a special camera-equipped instrument – a resectoscope – is advanced to the prostate and used to remove the part of the prostatic tissue which causes difficulties with urination. Thanks to the TURP operation, urination shall recover or the urination pressure shall improve.

Surgery Clinic, Centre of Urology

Urologist’s appointment

Urology focuses on kidney and urinary tract and prostate gland inflammations, different kinds of urinary disorders in both men and women, benign and malign tumours, including kidney, bladder, prostate gland, penis, and testicle tumours, as well as on patients who have kidney-urinary tract stones.

Surgery Clinic, Centre of Urology

Appointment with a midwife by a woman planning infertility treatment

For women who have an infertility diagnosis by an infertility doctor and who wish to start with infertility treatment are referred to the appointment of a midwife to determine and take tests. A midwife who has been trained in infertility treatment: