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Urology in Germany covers the diagnosis and treatment of conditions of the kidneys, bladder, prostate and male genital organs in hospitals across the country, and it starts with an accurate diagnosis, not with an operation. Urological complaints are often put off out of embarrassment, so many people arrive with a report already in hand: a raised PSA (a blood test for a protein made by the prostate), a prostate nodule, a stone, blood in the urine or incontinence.
Urology in Germany is not only surgery: the doctor first weighs whether an intervention is needed at all and how continence and sexual function can be preserved. Below: what urology treats, diagnosis, the main fields of treatment, hospitals and doctors, and how AlenMed arranges the trip.
Urology in Germany: what patients come for
Patients see a urologist for conditions of the kidneys, ureters, bladder, prostate and male genital organs; women most often for bladder infections and incontinence. That covers stones, difficulty passing urine with an enlarged prostate, recurrent infections, blood in the urine, erection problems and male infertility. Urology in Germany also includes uro-oncology, the treatment of tumours of the prostate, bladder, kidney and testis, which urologists diagnose, operate on and treat with drugs together with oncologists.
International patients choose urology in Germany above all for the way decisions are made. The German Cancer Society (Deutsche Krebsgesellschaft) certifies prostate cancer centres and audits them every year: experts check on site how many patients a centre treats and whether it meets the quality requirements, as the certification system for prostate cancer centres sets out. A tumour board of urologist, oncologist, radiation oncologist, radiologist and pathologist agrees on the approach together, so an operation is less likely to be ordered out of habit where monitoring would be wiser. Many operations are gentle, done through the natural passages or small punctures.
Some situations need urgent help where you are, not a trip: acute urinary retention, when you cannot pass urine and the overfull bladder hurts; kidney colic with fever, as a stone may be blocking the outflow from an inflamed kidney; and sudden severe pain and swelling of a testicle, possibly a torsion, when hours count. Germany comes later, to find the cause and plan treatment.
Diagnosis first
In German urology an accurate diagnosis comes first, and treatment is discussed afterwards. The basis is blood and urine tests and ultrasound of the kidneys and bladder, including residual urine, the amount left after passing water, with CT or MRI where needed. With blood in the urine or a suspected bladder tumour, a cystoscopy is done: the doctor looks inside the bladder with a thin endoscope passed through the urethra.
Where prostate cancer is suspected, MRI comes before the biopsy, so that tissue is taken from the suspicious area in a targeted way rather than at random. The updated German prostate cancer guideline has strengthened the role of MRI: if the scan points to a very low probability of cancer, it advises against a biopsy. Cancer is diagnosed only by histology, the examination of the tissue itself under a microscope, so a raised PSA or a nodule is not yet a verdict. More on the methods: prostate cancer diagnosis in Germany.
For incontinence or difficulty passing urine there are function tests, above all urodynamics: the bladder is slowly filled through a thin catheter while pressure and volume are measured, showing why urine leaks or does not flow well. Bring existing CT and MRI scans on disc, not just the reports: a German doctor wants to see the images themselves.
Main fields of treatment
The main fields are prostate conditions, tumours, stones, incontinence and men’s health, each treated step by step, from medication to surgery. Benign prostate enlargement is first treated with tablets that ease the flow of urine or gradually shrink the gland; prostatitis, an inflammation of the prostate, is treated according to its form, the bacterial form with antibiotics. When medication is no longer enough, surgery through the urethra, without external incisions, is offered: TURP trims away excess tissue with an electric loop, and HoLEP, laser enucleation, removes the enlarged tissue with a laser. More: prostate treatment in Germany.
For prostate cancer there are several options. If the tumour is confined to the prostate and low-risk, the German guideline recommends active surveillance: no surgery or radiotherapy, but regular PSA tests, MRI and, where needed, repeat biopsies, so that treatment can start if the disease becomes more active. If treatment is needed, the options are radiotherapy or surgery, often with the da Vinci robot: the surgeon sees the operating field magnified in three dimensions and, where the extent of the tumour allows, preserves the nerve bundles on which erection depends and protects the muscles that hold urine. Bladder, kidney and testicular tumours have their own treatment plans. All the options: prostate cancer treatment in Germany.
Kidney and ureteral stones are mostly removed without incisions. Shock wave lithotripsy breaks the stone up from outside the body with focused shock waves that pass through the skin. In flexible ureteroscopy a thin endoscope is passed through the urethra and bladder to the stone, which is then broken up with a laser. Large kidney stones are removed percutaneously, through a small puncture in the lower back. More: kidney stone treatment.
Incontinence is also treated in steps: pelvic floor training and medication that calms an overactive bladder come first. If urine leaks on coughing or exertion despite this, a sling, a thin tape supporting the urethra, may be placed. Men with severe incontinence, for example after prostate removal, may be helped by an artificial sphincter: an implanted cuff that closes the urethra and opens when the patient presses a small pump. More: urinary incontinence treatment.
Erectile dysfunction and men’s health are the field of andrology, which also treats male infertility; proven methods include tablets, injections into the penis, vacuum devices and, if these fail, an implant. Cell-based methods such as stem cells or plasma injections are still under research and belong only in clinical studies.
Best urology hospital in Germany: what to look for
There is no official ranking, so the answer to «best urology hospital in Germany» is a set of criteria rather than a name. Instead of searching for the «best urologist doctor in Germany», check whether the hospital holds a certificate for the centre that treats your condition, how often it performs the specific operation you need, whether a tumour board discusses your case and whether the doctor is willing to talk about surveillance instead of surgery where that is reasonable.
A urology clinic in Germany with a single specialty is the Urologische Klinik München-Planegg, which specialises in diagnosing and treating urological conditions. Its uro-oncology centre is certified by the German Cancer Society for prostate, bladder, kidney and testicular cancer. According to the clinic, it performs more than 600 tumour operations a year with the da Vinci robot and now works with a second such robot. Prof. Martin Kriegmair, one of its chief physicians, was president of the German Society of Urology (DGU) in 2023; Dr Alexander Kaspin heads the clinic’s stone centre.
A urology hospital in Germany can also be a department of a private hospital with several specialties: at ISAR Klinikum in Munich, urology is directed by Prof. David Schilling, whose focus is robot-assisted and minimally invasive surgery and the treatment of prostate, kidney and bladder cancer.
In Hamburg, Prof. Michael Rink is chief physician of urology at the Catholic Marienkrankenhaus. He is deputy chair of the European Association of Urology guideline on muscle-invasive and metastatic bladder cancer, meaning cancer that has grown into the muscle layer of the bladder wall or has spread. In Frankfurt, Prof. Georg Bartsch is chief physician of urology at AGAPLESION Markus Krankenhaus and heads its interdisciplinary centre for robot-assisted surgery.
In Nuremberg, Prof. Sascha Pahernik is director of urology at Klinikum Nürnberg and also directs the hospital’s Interdisciplinary Oncology Centre.
Frequently asked questions
Is surgery always necessary in urology?
No, many urological conditions are treated without surgery. An enlarged prostate is first treated with tablets, small stones often pass on their own or are broken up with shock waves, low-risk prostate cancer is usually watched under active surveillance, and incontinence often improves with pelvic floor training and medication. Surgery is needed when these steps fail or the condition is dangerous.
Can urological operations be done without incisions?
Yes, many urological operations are now done without a conventional incision. Enlarged prostate tissue, bladder tumours and stones are removed through the urethra, the da Vinci robot works through a few small punctures, and shock waves break up stones from outside the body. Open surgery remains an option for particular cases, such as some large tumours.
Do urologists treat women?
Yes, urologists also treat women, above all for bladder and kidney conditions: recurrent cystitis, urinary incontinence, an overactive bladder, stones and tumours of the kidney and bladder. For incontinence and pelvic organ prolapse the urologist often works with a gynaecologist, and urodynamic testing shows which type of incontinence a woman has and which treatment suits her.
What documents does a urologist in Germany need?
A urologist needs recent results and everything earlier examinations have shown: PSA values over the past years where the prostate is concerned, urine and blood tests, ultrasound, CT and MRI reports with the images on disc, histology from any biopsy or operation, discharge letters and a list of medications. Translated into German, they let the urologist decide whether a trip is needed.
How AlenMed arranges urology treatment in Germany
AlenMed handles the preparation, the trip and contact with the urologist afterwards. Before the trip, AlenMed translates reports, scans and results, including PSA and histology, and sends them to a urologist, who says what is actually needed: further tests, a second opinion or surgery. If surgery has been proposed at home, a German urologist’s second opinion is a sensible start: it shows whether the images and reports confirm the need for surgery, and sometimes spares an operation or opens a gentler option.
AlenMed then books the consultation or operation and obtains the hospital’s estimate; payment goes directly to the hospital against its invoice. The patient receives a letter of invitation for the visa, AlenMed arranges transfer and accommodation, and an interpreter is present at consultations. AlenMed’s office is in Munich.
After returning home, the patient receives the reports in their own language, and AlenMed helps them stay in touch with the urologist: when to repeat PSA and other tests and what to do if a result changes.
This material is for information only and is not an offer. The treatment plan is decided by a doctor at an in-person consultation.
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