Urology

Urology is a surgical speciality that deals with the treatment of conditions involving the male urinary tract and the male reproductive organs. People specializing in the field of urology are called urologists, healthcare professionals who are trained to diagnose, detect and treat this group of disorders and diseases. The disorders that may be treated by urologists include those involving the kidneys, the ureters (tubes connecting the kidneys to the bladder), the adrenal glands, the bladder and the urethra (the tube that passes urine out of the body from the bladder). In males, a urologist may also treat conditions of the testes, epididymis, vas deferens, seminal vesicles, prostate and penis. The field of urology involves the medical management of conditions such as urinary tract infection and prostate enlargement through to the surgical management of conditions such as bladder cancer, prostate cancer, kidney stones and stress incontinence.

What urologists treat

A urologist is a physician who has specialized knowledge and skill regarding problems of the male and female urinary tract and the male reproductive organs. Because of the variety of clinical problems encountered, knowledge of internal medicine, pediatrics, gynecology, and other specialties is required of the urologist.

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

• 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
• varicoceles, or enlarged veins in the scrotum

Urology is a surgical speciality that deals with the treatment of conditions involving the male and female urinary tract and the male reproductive organs. People specializing in the field of urology are called urologists, healthcare professionals who are trained to diagnose, detect and treat this group of disorders and diseases. The disorders that may be treated by urologists include those involving the kidneys, the ureters (tubes connecting the kidneys to the bladder), the adrenal glands, the bladder and the urethra (the tube that passes urine out of the body from the bladder). In males, a urologist may also treat conditions of the testes, epididymis, vas deferens, seminal vesicles, prostate and penis. The field of urology involves the medical management of conditions such as urinary tract infection and prostate enlargement through to the surgical management of conditions such as bladder cancer, prostate cancer, kidney stones and stress incontinence. In the case of certain conditions such as cancer of the urinary tract, urologists may need to work in conjunction with oncologists or radiotherapists. They may also need to collaborate with nephrologists who deal with kidney conditions, gynaecologists who deal with the female reproductive system and endocrinologists who are concerned with conditions of the endocrine system and hormone disorders. Urologists may also collaborate with practitioners of pediatric surgery and colorectal surgery.

Urologists undergo post-graduate training for five years, completing 12 months in general surgery and 36 months in clinical urology. The remaining time is spent training in general surgery, clinical urology or a discipline that is relevant to urology. There are several specialist areas that can be practised after completion of a urology degree. Some of these include:

Endourology

Endourology deals with the closed manipulation of the urinary tract. The field has grown to now include minimally invasive surgical procedures. Procedures are carried out using endoscopes inserted into the urinary tract and examples include prostate surgery, stone removal surgery and simple urethral or ureteral surgeries.

Urologic oncology

This deals with genitourinary malignancies such as cancers of the kidney, adrenal glands, prostate, bladder, ureters, testicles or penis.

Neurourology

Neururology concerns the management of conditions that involve the nervous control of the genitourinary system or abnormal urination. Examples of neurological conditions that may lead to these conditions include Parkinson's disease, multiple sclerosis, stroke and spinal cord injuries.

Pediatric urology

This involves the correction of genitourinary problems arising in children such as undescended testes or cryptorchidism, underdeveloped genitalia and vesicoureteral reflux.

Andrology

Andrology focuses on disorders of the male reproductive system such as erectile dysfunction, ejaculatory disorders, infertility and vasectomy reversal.

What to do to maintain good urologic health?

Make sure you regularly empty your bladder and drink water instead of caffeine or juice. Avoid smoking and maintain a low-salt diet. These general rules can help to prevent a vast majority of common urologic issues.

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

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, allow 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