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Faces of Healthcare: What Is a Urologist?

Overview

what is a urologist

In the time of the ancient Egyptians and Greeks, doctors frequently examined urine’s color, odor, and texture. They also looked for bubbles, blood, and other signs of disease.

Today, an entire field of medicine focuses on the health of the urinary system. It’s called urology. Here’s a look at what urologists do and when you should consider seeing one of these specialists.

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Urologist

What is a urologist?

Urologists diagnose and treat diseases of the urinary tract in both men and women. They also diagnose and treat anything involving the reproductive tract in men.

In some cases, they may perform surgery. For example, they may remove cancer or open up a blockage in the urinary tract. Urologists work in a variety of settings, including hospitals, private clinics, and urology centers.

The urinary tract is the system that creates, stores, and removes urine from the body. Urologists can treat any part of this system. This includes the:

  • kidneys, which are the organs that filter waste out of the blood to produce urine
  • ureters, which are the tubes through which urine flows from the kidneys to the bladder
  • bladder, which is the hollow sac that stores urine
  • urethra, which is the tube through which urine travels from the bladder out of the body
  • adrenal glands, which are the glands located on top of each kidney that release hormones

Urologists also treat all parts of the male reproductive system. This system is made up of the:

  • penis, which is the organ that releases urine and carries sperm out of the body
  • prostate, which is the gland underneath the bladder that adds fluid to sperm to produce semen
  • testicles, which are the two oval organs inside the scrotum that make the hormone testosterone and produce sperm
Most patients come to me for issues that aren’t related to cancer, like kidney stones, voiding dysfunction, or urinary tract infections. However, many urologists will also take care of men with erectile dysfunction or prostate cancer, as well as men and women with a variety of bladder or kidney problems.
— Fara Bellows, M.D.

Urology

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
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Education

What are the education and training requirements?

You must earn a four-year college degree and then complete four years of medical school. Once you graduate from medical school, you must then go through four or five years of medical training at a hospital. During this program, which is called a residency, you work alongside experienced urologists and learn surgical skills.

Some urologists decide to do a year or two of additional training. This is called a fellowship. During this time, you gain skills in a specialty area. This can include urologic oncology or female urology.

At the end of their training, urologists must pass the specialty certification exam for urologists. The American Board of Urology certifies them upon successful completion of the exam.

Conditions

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

Check out: Tips to get your bladder under control »

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Procedures

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

Keep reading: Why it pays to get checked for prostate cancer »

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When to see a urologist

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 can I 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.

    - Fara Bellows, M.D.
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