What Do Urologists Treat?

What is a urologist?

A urologist is a doctor who specializes in urinary tract disorders, including disorders of the external genital organs. Urologists also treat both males and females, contrary to popular belief that they only treat males. They treat any disorders that affect the kidneys, bladder, ureters, urethra, prostate, and penis. Urologists also perform related surgical procedures involving the adrenal glands, which are situated above the kidneys. 

Conditions Treated by Urologists

There are a number of reasons why people may need to see a urologist. The following are some of the common disorders and illnesses that urologists treat:

1. Recurrent Urinary Tract Infections (UTIs)

Females are more prone to having recurrent UTIs due to a shorter urethra. Having a shorter urethra enables bacteria to easily enter the bladder and cause an infection. There are also several factors that make females more susceptible to recurrent UTIs. They include:

• Frequent sexual intercourse
• Changes in the level of estrogen during menopause
• Bladder or kidney stones
• Genetic predisposition (inherited risk of having bladder infections)
• Abnormalities in the function and shape of the urinary bladder

People who have had more than two cultures that document recurrent urinary tract infections within a six-month period are often referred to a urologist. A urologist may recommend the following tests to figure out what is causing the recurrent infections:

• Urine culture of a urine sample collected via catheter
• Cystoscopy (endoscopy of the urinary bladder)
• CT scan of the urinary tract

2. Urinary Incontinence

Urinary incontinence or loss of bladder control is not a disease, but a symptom of a number of conditions. Some cases of urinary incontinence are short-term, which tend to resolve on their own, while others tend to be more serious, which require medical treatment. The following are some of the most common causes of urinary incontinence:

• Urinary tract infection
• Vaginal infection
• Diabetic neuropathy
• Sphincter problems (more common in women during and after pregnancy) 
• Overactive bladder muscles
• Neurological disorders (multiple sclerosis, spinal cord injury, cervical spondylosis)
• Physical and mobility impairments
• Depression and other psychological issues

3. Renal Calculi (Kidney Stones)

Kidney stones are solid crystalline masses that are formed within the kidneys or other parts of the urinary tract, such as the bladder, ureters, and urethra. The most common symptoms of kidney stones are hematuria (blood in the urine) and severe pain in the groin, flank, or abdomen. Aside from pain, they can also affect a person's urination along with causing nausea and vomiting.

Individuals who have small kidney stones can be treated by their primary care physician. However, those with large kidney stones with other symptoms of kidney problems and severe pain may be referred to a urologist or nephrologist for further evaluation and treatment. 

4. Prostatitis

Prostatitis occurs in men if their prostate gland becomes inflamed, swollen, and tender. It usually causes difficult and painful urination in men. Men with prostate problems are usually referred to a urologist for further evaluation and testing. Tests may include:

• Transrectal Ultrasound - To get a closer look at the prostate gland, an ultrasound probe is put into the rectum. 

• Urine and Expressed Prostatic Excretion (EPS) Testing - To check for any signs of infection and inflammation. 

• Semen Testing - To look for the presence of white blood cells, bacteria, and other signs of infection. 

• Blood Test - A blood test may be ordered to check the level of your prostate specific antigen (PSA), especially if you are at risk for cancer. 

• Cystoscopy - A procedure that allows urologists to look inside the urethra, bladder, and prostate by using a cystoscope (a long and thin tube with a light and camera at the end). 

• Urodynamic Testing (Urodynamics) - Urine flow studies can help urologists measure the strength of urine flow and can detect any blockage caused by the pelvic muscles, urethra, or prostate. 

5. Male Infertility

Urologists conduct comprehensive examinations and testing of male infertility. In most cases, male infertility has underlying problems, and when these problems are treated, infertility can be corrected. In other cases, male infertility is treated using more advanced techniques or surgery to correct the problem. 

6. Kidney Tumors or Masses

People who have kidney tumors or masses should be seen and evaluated by a urologist. In the past, when a mass is found on a kidney, doctors simply order a biopsy of the lesion. However, this diagnostic test can miss the cancer and may even cause the spread of cancer cells. 

Nowadays, urologists are capable of identifying different types of masses through a number of non-invasive tests, including the removal of the kidney or lesion when needed. Kidney cancer care has also been revolutionized by the advances in both laparoscopic and robotic surgery. 

7. Urinary Tract Cancers

Cancers of the urinary tract include bladder, kidney, penile, testicular, and prostate cancer. Among these types of cancer, the predominant one is bladder cancer. Early detection and regular follow-up of these conditions are very important because a delayed diagnosis is often associated with a poor prognosis. 

Pediatric Urology

Aside from the above-mentioned conditions, urologists also treat the following conditions in children:

• Undescended Testicles - When baby boys are still inside their mother's womb, their testicles are formed inside their abdomen and then descend or move down into their scrotum soon after they are born. However, in some cases, the testicles do not move down, and the baby is born with one or two undescended testicles. 

• Urinary Tract Obstruction - Blockages and other obstructions within children's urinary system. 

• Bed-wetting - Also called as nocturnal enuresis or nighttime incontinence, bed-wetting occurs when children have bladder control problems while they are asleep. Most children at the age of 4 are able to control their bladder during daytime as well as nighttime. However, approximately 10 percent of children ages 6-7 years old still have problems controlling their bladder, which results in either daytime or nighttime accidents. If your child is older than 7 years old and experiences this problem during sleep, a visit to a pediatric urologist is often recommended. 

Other pediatric urologic conditions also include:

• Antenatal Hydronephrosis (enlarged kidneys in utero)
• Hypospadias (a congenital defect in boys characterized by an abnormally situated urethral opening)
• Vesicoureteral Reflux (incorrect flow of urine)
• Ureteropelvic Junction (UPJ) Obstruction (may lead to kidney damage)