WHAT IS UROLOGY?

Urology is the field of medicine that focuses on diseases of the urinary tract and the male reproductive tract. Some urologists treat general diseases of the urinary tract.

Others specialize in a particular type of urology, such as: 

  • Female urology - which focuses on conditions of a woman’s reproductive and urinary tract
  • Male infertility - which focuses on problems that prevent a man from conceiving a baby with his partner
  • Neurourology - which focuses on urinary problems due to conditions of the nervous system
  • Pediatric urology - which focuses on urinary problems in children
  • Urologic oncology - which focuses on cancers of the urinary system, including the bladder, kidneys, prostate, and testicles

Although it is generally classified as a surgical specialty, urologists require knowledge of other specialties such as gynecology and internal medicine due to the wide variety of clinical problems that they have to deal with.

WHICH CONDITIONS DO UROLOGISTS TREAT?

Urologists treat a wide variety of conditions that affect the urinary system and male reproductive system. 

In men, urologists treat:

  • Cancers of the bladder, kidneys, penis, testicles, and adrenal and prostate glands
  • Prostate gland enlargement
  • Erectile dysfunction, or trouble getting or keeping an erection
  • Infertility
  • Interstitial cystitis, also called painful bladder syndrome 
  • Kidney diseases
  • Kidney stones
  • Prostatitis, which is inflammation of the prostate gland 
  • Urinary tract infections (UTIs)
  • Varicoceles, or enlarged veins in the scrotum

In women, urologists treat:

  • Bladder prolapse, or the dropping of the bladder into the vagina
  • Cancers of the bladder, kidneys, and adrenal glands
  • Interstitial cystitis
  • Kidney stones
  • Overactive bladder
  • UTIs
  • Urinary incontinence

In children, urologists treat:

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

WHAT PROCEDURES DO UROLOGISTS PERFORM?

When you visit a urologist, they’ll start by doing one or more of these tests to find out what condition you have:

  • Imaging tests, such as a CT scan, MRI scan, or ultrasound, which allows them to see inside your urinary tract.
  • They can order a cystogram, which involves taking X-ray images of your bladder.
  • Your urologist can perform a cystoscopy. This involves using a thin scope called a cystoscope to see the inside of your urethra and bladder.
  • They can perform a post-void residual urine test to find out how fast urine leaves your body during urination. It also shows how much urine is left in your bladder after you urinate.
  • They can use a urine sample to check your urine for bacteria that cause infections.
  • They can perform urodynamic testing to measure the pressure and volume inside your bladder.

Urologists are also trained to perform different types of surgery. This may include performing:

  • Biopsies of the bladder, kidneys, or prostate
  • A cystectomy, which involves removing the bladder, to treat cancer
  • Extracorporeal shock-wave lithotripsy, which involves breaking up kidney stones so they can remove them more easily
  • A kidney transplant, which involves replacing a diseased kidney with a healthy one 
  • A procedure to open a blockage
  • A repair of damage due to injury
  • A repair of urinary organs that aren’t well-formed
  • A prostatectomy, which involves removing all or part of the prostate gland to treat prostate cancer
  • A sling procedure, which involves using strips of mesh to support the urethra and keep it closed to treat urinary incontinence
  • A transurethral resection of the prostate, which involves removing excess tissue from an enlarged prostate 
  • A transurethral needle ablation of the prostate, which involves removing excess tissue from an enlarged prostate
  • A ureteroscopy, which involves using a scope to remove stones in the kidneys and ureter
  • A vasectomy to prevent pregnancy, which involves cutting and tying the vas deferens, or the tube sperm travel through to produce semen 

WHEN SHOULD YOU SEE A UROLOGIST?

Your primary care doctor can treat you for mild urinary problems, such as a UTI. Your primary care doctor may refer you to a urologist if your symptoms don’t improve or if you have a condition that needs treatments they can’t provide.

You may need to see both a urologist and another specialist for certain conditions. For example, a man who has prostate cancer can see a cancer specialist called “an oncologist” and a urologist. 

How do you know when it’s time to see a urologist? Having any of these symptoms suggests you have a problem in the urinary tract:

  • Blood in your urine
  • A frequent or urgent need to urinate
  • Pain in your lower back, pelvis, or sides
  • Pain or burning during urination
  • Trouble urinating
  • Urine leakage
  • Weak urine flow, dribbling

You should also see a urologist if you’re a man and you’re experiencing these symptoms:

  • A decreased sexual desire
  • A lump in the testicle
  • Trouble getting or keeping an erection
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