Urology focuses on the diagnosis and treatment of conditions affecting the urinary tract system, including the kidneys, ureters, bladder, and urethra. For males, the practice also encompasses the entire reproductive system, including the penis, testes, and prostate gland. A urologist is a medical doctor trained in both medicine and surgery, making them uniquely qualified to manage a broad spectrum of genitourinary disorders. This specialization covers everything from common infections to complex cancers and reconstructive procedures.
Common Urinary Tract Conditions
Urologists manage conditions that interfere with the production, storage, or elimination of urine. A common issue is kidney stones, which are hard deposits of minerals and salts that form inside the kidneys and can cause severe flank or groin pain as they move. Urologists manage acute stone episodes with pain control and use non-invasive techniques like shock wave lithotripsy to break stones into smaller fragments. They also perform procedures, such as ureteroscopy, to remove stones using a scope inserted through the urethra.
Benign prostatic hyperplasia (BPH), prevalent in older males, occurs when the prostate gland enlarges and compresses the urethra. This enlargement leads to lower urinary tract symptoms (LUTS), such as a weak stream, frequent urination, and difficulty fully emptying the bladder. Treatment ranges from prescription medications that relax the bladder neck or shrink the prostate to surgical options like a transurethral resection of the prostate (TURP) that removes excess tissue.
Urologists also treat male urinary tract infections (UTIs), which may signal an underlying problem in the urinary system. They address voiding dysfunction and incontinence, which involves the involuntary loss of urine. Managing these issues requires a detailed evaluation to determine the cause, which can include nerve problems or bladder muscle weakness, leading to personalized treatment plans.
Male Reproductive and Sexual Function
Urologists are the primary specialists for disorders of the male reproductive system, covering sexual function and fertility. Erectile dysfunction (ED), the inability to achieve or maintain an erection firm enough for sexual intercourse, is a frequent reason for consultation. Urologists diagnose ED, which can often be an indicator of systemic health issues like diabetes or cardiovascular disease, and offer treatments from oral medications to penile injections and surgical implants.
The evaluation and treatment of male factor infertility also falls under urology, involving detailed assessments of sperm production and delivery. Urologists may perform semen analysis and hormonal assessments to identify causes like varicocele, a condition involving enlarged veins within the scrotum, which they can surgically correct. For men seeking permanent contraception, the urologist performs a vasectomy, a procedure that blocks the vas deferens to prevent sperm from entering the semen.
Other male-specific conditions include testicular pain and the evaluation of masses or lumps within the scrotum, which require prompt assessment. Urologists also manage low testosterone, providing hormone replacement therapy when appropriate to address symptoms like reduced energy and decreased libido. Furthermore, they treat Peyronie’s disease, a condition characterized by the development of scar tissue that causes a curvature in the penis.
Cancer Diagnosis and Management
Urologists diagnose and treat cancers affecting the genitourinary system, including the prostate, bladder, kidney, and testicles. Prostate cancer is one of the most common cancers in men, and urologists manage care starting with screening. Screening involves the prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE).
If screening suggests a risk, the urologist performs a biopsy to confirm the presence of cancer, often using advanced imaging like MRI fusion to target suspicious areas. Treatment options for localized prostate cancer include active surveillance, radiation therapy, or surgical removal of the prostate (radical prostatectomy), which can be performed using minimally invasive or robotic techniques. The choice of treatment is highly individualized, depending on the cancer’s aggressiveness and the patient’s overall health.
Urologists also treat bladder cancer, which often presents with blood in the urine, and diagnose it using cystoscopy, a procedure where a thin scope is inserted into the bladder. Early-stage bladder cancer can be treated by surgically removing the tumor through the urethra, while more advanced cases may require partial or total removal of the bladder (cystectomy). For kidney cancer, urologists typically perform a nephrectomy, which can involve removing the entire kidney or just the tumor while sparing healthy tissue. Testicular cancer, though relatively rare, is highly curable when caught early, and the urologist manages its diagnosis, staging, and surgical treatment.
When to Seek Urological Care
Men should seek urological care if they experience persistent or concerning symptoms related to their urinary or reproductive health. Specific warning signs include seeing blood in the urine, as well as pain or burning during urination. A urologist should also be consulted for any sudden or worsening changes in urination, such as difficulty starting a stream, a need to urinate frequently or urgently, or waking up multiple times at night to void.
Acute, severe pain in the flank or groin area may indicate a kidney stone and requires prompt evaluation. Any palpable lumps, masses, or persistent pain in the testicles should also be assessed by a urologist. Furthermore, men experiencing sudden or significant erectile dysfunction, or those with concerns about fertility, should consult a specialist.
General screening for prostate cancer, involving the PSA test, often begins around age 50 for men at average risk. Earlier screening may be recommended for those with a family history or other risk factors.