Areas of treatment

01

Prostate and lower urinary tract

A weak urinary stream, getting up at night, burning and sudden urges, the feeling of a bladder that never empties, recurring infections, blood in the urine. I run the diagnosis in the office, non-invasively - ultrasound and uroflowmetry; where needed I order blood and urine tests. Treatment of benign prostatic hyperplasia (BPH) usually starts with medication; when the picture is unclear or the drugs stop working, I turn to flexible cystoscopy and urodynamic testing. Surgical treatment means HoLEP laser enucleation, and in selected cases the minimally invasive iTind and Rezum procedures, with no hospital stay.

A weaker urinary stream, getting up at night, the feeling of retained urine - these are symptoms worth coming in with earlier than men usually do. Periodic preventive check-ups matter just as much: it is worth starting them between the ages of 35 and 40, even with no symptoms at all. Diagnosis starts in the office: ultrasound, uroflowmetry, and where needed flexible cystoscopy or urodynamic testing. I match the treatment to the severity of the symptoms and the size of the gland - from medication to HoLEP laser enucleation, which removes the whole enlarged adenoma through the urethra, with no incision.

• HoLEP laser prostate treatment - endoscopic removal of the enlarged tissue with a holmium laser, through the urethra, regardless of how large the gland is.
• Urodynamic testing - measures how the bladder and urethra work. It answers whether the symptoms come from the prostate or from the bladder itself.
• Flexible cystoscopy - an assessment of the urethra and bladder from the inside, under local anaesthesia. The basic test when there is blood in the urine.

02

Urinary stone disease

Sudden pain in the flank, blood in the urine, recurring infections, fever with chills. Diagnosis usually means ultrasound and a CT scan - they establish the size, position and hardness of the stone, and the choice of method follows from that. I remove stones endoscopically - through the urethra or from a small puncture, without opening the abdominal wall. Fever and chills alongside kidney pain call for urgent assessment - best in hospital rather than outpatient conditions.

There are two ways people arrive at a urologist with stone disease: with an attack of renal colic, or with an incidental finding on imaging. Both call for a plan - a stone that does not hurt today can block the flow of urine at the least convenient moment. The endoscopic methods differ in the route of access: through the urethra (URS, RIRS) or through a small puncture of the skin (PCNL, ECIRS) - the choice depends on the size, position and hardness of the stone, not on one universal technique.

• Stone treatment - RIRS, URSL, PCNL - laser fragmentation and removal of the stone, with the technique matched to its size and position.

03

Male fertility

Trying for a child without success, an abnormal semen analysis, azoospermia. I run the diagnosis from the ground up and choose the treatment only once the cause is clear.

An abnormal semen analysis is the starting point for diagnosis, not a diagnosis in itself. I look for the cause - hormonal, anatomical, genetic - because it determines whether the treatment will be conservative, microsurgical, or shared with a fertility centre. I perform the microsurgical procedures - from varicocele repair to mTESE and vasectomy reversal - using an operating microscope, in ongoing cooperation with fertility centres in Kraków.

• Male infertility and mTESE - diagnosis, conservative treatment and microsurgical sperm retrieval from the testis when there are no sperm in the ejaculate.
• Varicocele of the spermatic cord - microsurgical repair using an operating microscope, sparing the artery and the lymphatic vessels - the technique recommended in the European Association of Urology (EAU) guidelines.

04

Sexual health

Weaker erections, a curvature that makes intercourse difficult, pain during erection. These are medical problems, not a matter of character - and most of them can be treated.

Erectile dysfunction and penile curvature are common and treatable - and yet men put the visit off for years. Although many find the subject embarrassing, treatment is often effective and can markedly improve quality of life and sexual satisfaction, and in most cases today's methods are minimally invasive and practically painless. The diagnosis is specific and the treatment is staged: from medication, through low-intensity shockwave therapy, to surgical treatment where it is genuinely needed. Erectile dysfunction can also be the first sign of cardiovascular disease - sometimes this visit settles more than one problem.

• Erectile dysfunction - diagnosis, drug treatment, low-intensity LI-ESWT shockwave therapy, injections; penile Doppler ultrasound in selected cases.
• Penile curvature - Peyronie's disease - conservative treatment, shockwave therapy and surgical correction of the curvature.

05

Outpatient procedures

Short procedures under local anaesthesia, performed in the office: vasectomy, phimosis surgery and circumcision, plasty of a short frenulum, laser removal of skin lesions in the intimate area - naevi, warts, condylomas and scars. You go home the same day, with no hospital stay.

Some procedures need neither a hospital nor general anaesthesia: vasectomy, phimosis surgery and circumcision, frenuloplasty, flexible cystoscopy, laser removal of skin lesions in the intimate area. I perform them on site, under local anaesthesia - you come in at a set time and go home the same day. Qualification takes place at an ordinary consultation, and if you have a referral from a specialist, the procedure can often be booked straight away.

• Vasectomy - permanent male contraception, no-scalpel technique, in under twenty minutes.
• Phimosis and circumcision - treatment of phimosis, classic and stapler circumcision, frenuloplasty.

06

Where I see and operate on patients in Kraków

Consultations, ultrasound diagnostics and outpatient procedures take place at my office: Andromeda Centrum Medyczne, ul. Mogilska 69A, 31-545 Kraków, Poland.

Endoscopic procedures and surgery under general anaesthesia - HoLEP, stone treatment, open surgery - are performed at Szpital na Klinach in Kraków. Andrological microsurgery takes place at the Kraków fertility centres KrakOvi and ARTVIMED.

Written and medically reviewed by Michał Swolkień, MD - urologist (FEBU), clinical andrologist (PTA). Last reviewed: 13 September 2026.