Urology in Tunisia

Urology is a branch of medicine that deals with the diseases of the female and male urinary tract (kidneys, ureters, bladder, and urethra). This branch of medicine also deals with male reproductive organs (testes, epididymis, vas deferens, seminal vesicles, prostate, and penis).

Urology has a number of sub-disciplines, including:

• Endourology – this sub-discipline of urology deals with the closed manipulation of the urinary tract. It includes all minimally invasive urologic surgical procedures, such as prostate surgery and stone removal surgery.
• Urologic oncology – this focuses on the treatment of malignant genitourinary diseases, such as cancer of the bladder, prostate, kidney, ureters, adrenal glands, testicles, or penis.
• Neurourology – this deals with the treatment of conditions involving the nervous control of the genitourinary system or abnormal urination.
• Pediatric urology – this focuses on urologic disorders in children, such as congenital abnormalities of the genitourinary tract, cryptorchidism (undescended testes), underdeveloped genitalia, enuresis, and vesicoureteral reflux.
• Andrology – this deals with disorders of the male reproductive system, such as ejaculatory disorders, erectile dysfunction, vasectomy reversal, and infertility.
• Reconstructive urology – this is a highly specialized field of male urology that deals with the reconstruction of both the structure and function of the genitourinary tract.
• Female urology – this deals with conditions of a woman’s reproductive and urinary tract, such as pelvic organ prolapse, overactive bladder, and urinary incontinence.

Medical professionals specializing in the field of urology are called urologists. Urologists can diagnose and treat diseases of the urinary tract in both women and men, as well as diagnosing and treating any problems in men’s reproductive tract. In some cases, urologists may also perform surgery. In the case of certain conditions, urologists may need to work in conjunction with medical professionals who specializes in other fields, such as oncologist, radiotherapists, nephrologist, and gynecologist.

Urologists can treat the following conditions:

In men:

• Prostate gland enlargement
• Cancers of the penis, bladder, testicles, kidneys, and adrenal and prostate glands
• Erectile dysfunction
• Infertility
• Kidney diseases
• Kidney stones
• Interstitial cystitis, also known as painful bladder syndrome
• Prostatitis
• Varicoceles, or enlarged veins in the scrotum
• Urinary tract infections (UTIs)

In women:

• Cancer of the kidneys, bladder, and adrenal glands
• Bladder prolapse, or a condition in which the bladder drops into the vagina
• Kidney stones
• Interstitial cystitis
• Overactive bladder
• Urinary incontinence
• UTIs

In children:

• Blockages and other problems with the urinary tract structure
• Bed-wetting
• Undescended testicles

What does Urology Involve?

During your first appointment, your urologist may ask you questions about your health history, any medicines you take, and your current symptoms. Your urologist may do a physical exam that includes a rectal and genital exam. They may also do some tests, such as:

• Imaging tests, such as MRI scans, CT scans, or ultrasound to help them locate the problem.
• A urine test to check for bacteria or other signs of disease.
• A cystoscope (a long, thin tube with a camera on its end) to see inside the urinary tract and take a sample of tissue for testing.
• A biopsy to check for cancer and other disorders.
• Urodynamic testing to check how fast the urine leaves your body, how much pressure there is in your bladder, and how much urine remains in your bladder after urinating.

After your urologist makes a diagnosis, the treatment will depend on your specific condition. It may include the use of medications and surgery.

Types of medication include:

• Hormone treatment for prostate cancer
• Antibiotics for infections
• Phosphodiesterase 5 (PDE5) inhibitors for erectile dysfunction
• Chemotherapy drugs for cancer
• Drugs that act on the smooth muscle of the bladder to help reduce urinary incontinence.

Some of the most common types of surgery include:

• A cystectomy, which is a procedure to remove the bladder. This procedure is used to treat cancer.
• A kidney transplant, which involves replacing a damaged or diseased kidney with a healthy one.
• Extracorporeal shock-wave lithotripsy, which is used to break up kidney stones so they can be removed more easily.
• A repair of damage to the urinary tract due to injury.
• A procedure to open a blockage.
• A repair of urinary organs that are not well-formed.
• A prostatectomy, which is used to remove all or part of the prostate gland. This procedure is performed to treat prostate cancer.
• Transurethral needle ablation of the prostate, which removes excess tissue from an enlarged prostate.
• Transurethral resection of the prostate, which involves the removal of excess tissue from an enlarged prostate.
• A sling procedure, which uses strips of mesh in order to support the urethra and keep it closed. This procedure can treat urinary incontinence.
• A ureteroscopy, which involves the removal of stones in the kidneys and ureter using a scope.
• A vasectomy, which is a procedure to cut and tie the vas deferens, or the tubes that carry sperm. This is done to prevent pregnancy.
• A nephrectomy, which involves removing a kidney to treat cancer.

The surgery can be performed in one of two ways: open through a large incision, laparoscopically through several tiny incisions. Both methods are usually performed under general anesthesia. In some cases, local anesthetic may be used instead.

How Long Should I Stay in Tunisia?

Depending on the procedure you will have, you may be able to leave the hospital on the same day or you will have to stay for up to 5 days. In general, it is highly advisable that you stay in Tunisia for several days following your procedure for initial recovery and to attend scheduled follow-up checkups. For surgical procedures, you may need to stay in the country for at least 10 to 14 days.

What's the Recovery Time?

The recovery time varies, depending on the procedure you have, the reason why you need the procedure, and your overall health. For surgical procedures, it may take about one to six weeks until you can go back to your full activity. For non-surgical procedures, you may be allowed to go back to your normal routine within several days. Your urologist will give you a detailed recovery timeline, which includes the time you can go back to work, normal activity, and strenuous activities, such as exercise and heavy lifting.

What About Aftercare?

Your urologist will give you a set of instructions for your aftercare. The instruction may include a diet plan, exercise, restrictions, and medication to take, and wound care. It is important that you follow every instruction closely. After surgery, you will be encouraged to do some light exercise, such as walking, to help your healing process. You may also need to eat easily digestible food until you are recovered.

Depending on your specific condition, you may need to attend regular checkups following your treatment. For instance, if you had cancer treatment, your doctor will suggest you attend a checkup once or twice a year to ensure that cancer has not come back.

What's the Success Rate?

The field of urology is at the forefront of research and innovation. Due to its constant advancement, the procedures are becoming more effective and safer. Each urological treatment is also known to offer high success rates. However, any procedure comes with risks, such as infection, bleeding, and damage to nearby organs. Therefore, it is important that you choose a skilled and experienced urologist.

Are there Alternatives to Urology?

If you have any injury or disease in your urinary tract and/or reproductive organ (for men), there is no other alternative besides visiting a urology department. However, if your disease is found to be caused by other problems, the doctor will refer you to a relevant doctor.

Urology in and around Tunisia

About Tunisia

Tunisia is one of the few countries which can cater to everyone and it manages to combine climate, golden beaches, history, and shopping for an “all-around” experience. It has a high standard of healthcare and an excellent reputation for cosmetic surgery. Cosmetic and plastic surgeons are regulated by the Tunisian Ministry of Health and the private clinics have state-of-the-art equipment and English-speaking staff. Tunisia welcomes an ever-increasing number of medical tourists each year, many of whom travel for Urology procedures. Medical Tourists travel from all across the globe, particularly from Europe and neighboring African countries with an inferior healthcare system. Popular medical tourism destinations outside of the capital, Tunis, include Sousse and Mahdia

Popular Parts of Tunisia

• Tunis, the country’s capital, is overflowing with a history that dates from the 4th Century BC. The city is divided into two parts, the old city known as the medina and the new city (or Ville nouvelle in French). Many tourists visit Tunis to see the Archaeological Site of Carthage which is also a UNESCO World Heritage Site. The beautiful Islamic architecture in medina also attracts many tourists to the city.
• Tozeur is known as a home to an enchanting desert oasis, which was a place to rest and refuel for caravans crossing the Sahara. Another main attraction in the city is the medina, where tourists can find lines of beautiful brick-patterned traditional dessert houses. Chott el Djerid, Sahara’s largest salt pan, is a popular day-trip destination.
• Sousse is located on the coast of the Mediterranean Sea. It offers good beaches with a clear blue sea. The city has been fought over by the Romans, Arabs, and Europeans, giving it a colorful history and culture. Sousse Archeological Museum is one of the most visited sites in the country; it has the second largest collection of mosaics in the world.
• Hammamet is the country’s original tourism resort. The city has beautiful gardens filled with oranges, lemons, and other citrus plants. It also has wonderful sandy beaches with crystal clear water. Just like any other city in Tunisia, this city is also brimming with interesting histories. Sites such as The Gafsa Museum and Bardo Museum will give insights about the Islamic faith and culture.
• Douz, also known as “the gateway to the Sahara.” Tourists who want to experience the Sahara Desert come to this city. Take a camel trip or a 4-wheel-drive into the Sahara or see the Museum of the Sahara that has an interesting collection portraying traditional Saharan life.

Weather and Climate in Tunisia

The North of Tunisia has a subtropical Mediterranean climate with mild rainy winters and hot summers. The South and inland areas have a tropical desert climate.

The weather is relatively comfortable throughout the year. Summer starts in June and lasts until August. The average temperature is between 28 °C to 32 °C with July and August being the hottest months. The heat is not as bad on the coast because of the seaside breeze. Be aware that July to September is the jellyfish season.

The heat decreases in autumn and the weather is somewhat more comfortable. There are occasional rain showers in September. The temperature in October can be like summer during day time, but cold at night. October has more rain than September. The season lasts for three months from September to November with an average temperature of around 19 °C to 29 °C.

The weather in winter can be uncertain. The average temperature is between 16 °C and 18 °C, but it can drop to 7 °C at night and below 0 °C in highlands and deserts and a clear sky is rare during this season.

Spring comes in March and the temperature can rise to 20 °C. Mornings and nights are cold; there is still a high probability of rains and thunderstorms at the end of this season.  

Getting Around in Tunisia

Tunisia has several international airports. The main airport is Tunic-Carthage International Airport. It has international connections with major European countries and the Middle East. The airport is the hub for Tunisair, Tunisair Express, and Nouvelair. Other airports that have international flights are Enfidha-Hammamet, Monastir Habib Bourguiba, Djerba-Zarzis, and Tabarka-Aïn Draham.

Taxis and buses are available to get to the city center from Tunis Airport. The SNT bus line departs every 30 minutes from the airport, the ticket costs less than 1 TND. There is also the TUT bus which departs every 15 minutes and is more luxurious and expensive.

Airport taxis are available at the airport taxi stand and are usually metered. Always make sure that the driver turns the meter on before riding the taxis. A journey to the city should cost around 5 TND. An extra cost will be added if you have baggage.

Getting around in Tunisia can be done by several transportation modes. Tunisair Express provides domestic flights between Tunis, Tozeur, Djerba, and Gabes. The Train is also available and the national train company in the country is SNCFT that runs modern and comfortable trains from Tunis to Sousse, Sfax, and Monastir. There are three classes of service that tourists can choose. The fare from Tunis to Sousse is between 6 to 10 TND. The long-distance bus is an economical option to travel between big cities such as Tunis, Hammamet, and Nabeul. The buses usually depart every 30 minutes.

Tourist Visas in Tunisia

Citizens of 97 countries (including Australia, China Singapore, the United States, and Russia) can visit and stay in Tunisia for up to 90 days without a visa. Other nationalities are advised to check with their local Tunisia embassy. Tunisia provides an online visa application for nationalities that needs a visa to enter. The eVisa will simplify the process of obtaining travel authorization to enter the country.

Additional Information

1. Local Currency: the local currency is the Tunisian dinar (TND). 1 USD converts to 2.61 TND.

2. Money & Payments: ATMs can be found in most cities and in all tourist areas. Many ATMs have withdrawal limits of 400 TND. Credit cards (MasterCard and Visa) are accepted in major cities and tourist areas. They can be used for shops, car hire, or top-end accommodation. Always make sure to carry cash if you want to travel outside major cities. Tipping is not necessary but will be appreciated.

3. Local Language: Arabic is the official language of Tunisia. French is very common due to the country’s former status as a French protectorate. English is still very limited except in the tourist areas and expensive hotels.

4. Local Culture and Religion: Islam is the major religion with 98% of the population identified as Muslim. There is a small group of Christian and Jews. Since most of the population is Muslim, always remember that the dress code is important in Tunisia.

5. Public Holidays: Tunisia celebrates major Islam holidays. The country hosts several annual festivals throughout the year such as The International Festival of the Sahara, Yasmine Hammamet Festival, and the International Festival of Carthage.