A urologist diagnoses and treats conditions affecting the urinary tract in both men and women, as well as the male reproductive system. This includes the kidneys, bladder, ureters (the tubes connecting kidneys to the bladder), urethra, and, in men, the prostate, testes, and penis. Many people assume urologists only treat men, but a significant portion of urology practice involves conditions that affect women and children too.
Prostate and Male Reproductive Conditions
The prostate is one of the most common reasons men end up in a urologist’s office. Benign prostatic hyperplasia, or an enlarged prostate, causes a frustratingly weak urine stream, frequent nighttime trips to the bathroom, and the feeling that your bladder never fully empties. It becomes increasingly common after age 50. Urologists manage it with medications that relax or shrink the prostate tissue, and when those stop working, minimally invasive procedures can open the blocked pathway.
Prostatitis, an inflammation of the prostate, is a separate issue that can strike younger men too. It causes pelvic pain, burning during urination, and sometimes flu-like symptoms. Some cases involve a bacterial infection that responds to antibiotics, while chronic prostatitis can be harder to pin down and requires longer-term management.
Erectile dysfunction and male infertility also fall under the urologist’s scope. For erectile dysfunction, a urologist evaluates whether the cause is vascular, hormonal, neurological, or a combination, then tailors treatment accordingly. Male infertility workups typically involve semen analysis and hormone testing to identify issues like low sperm production or blockages in the reproductive tract.
Kidney Stones and Bladder Stones
Kidney stones are one of the most painful conditions urologists treat. Small stones, generally under 5 millimeters (about the size of a pencil eraser), can often pass on their own with fluids and pain management. Larger stones that block urine flow or cause severe pain typically need intervention.
The most common procedure for stones that won’t pass is shock wave lithotripsy, which uses focused sound waves from outside the body to break a stone into smaller fragments you can pass naturally. Factors like stone size, location, your body type, and other health conditions determine whether this approach is right for you. For stones that are too large or in a difficult position for shock waves, urologists may use ureteroscopy, where a thin scope is threaded through the urinary tract to reach and remove or break apart the stone directly. Some patients need a second procedure if fragments remain after the first.
Bladder Control Problems
Urinary incontinence, the involuntary leaking of urine, brings both men and women to a urologist. In women, this often relates to weakened pelvic floor muscles after childbirth or hormonal changes after menopause. In men, it frequently follows prostate surgery. Urologists use specialized testing that measures how well your bladder fills, stores, and releases urine, helping pinpoint exactly where the problem lies.
Overactive bladder, a related condition, causes a sudden and hard-to-control urge to urinate, sometimes dozens of times a day. Neurogenic bladder is another category, where nerve damage from conditions like diabetes, spinal cord injuries, or multiple sclerosis disrupts the signals between the brain and bladder. Pelvic organ prolapse, in which the bladder, uterus, or rectum drops from its normal position, is a condition urologists treat in women, sometimes alongside gynecologists.
Urinary Tract Infections
Most simple UTIs are handled by a primary care doctor. Urologists get involved when infections keep coming back. Recurrent UTIs are generally defined as two or more episodes within six months. At that point, a urologist can investigate whether an underlying structural issue is fueling the cycle, using a cystoscope (a small camera inserted through the urethra) to look for abnormalities like bladder pouches, scar tissue from prior surgery, or foreign material such as surgical mesh.
For prevention, urologists may recommend cranberry supplements, increased water intake (especially if you drink less than about 50 ounces a day), or low-dose antibiotic prophylaxis. For perimenopausal and postmenopausal women, vaginal estrogen therapy is one of the more effective strategies for reducing recurrent infections. When infection-related stones are found, complete removal is necessary to fully clear the infection.
Urologic Cancers
Urologists diagnose and treat cancers throughout the urinary and male reproductive systems. The main types include bladder cancer and kidney cancer, which affect both sexes, and prostate cancer, testicular cancer, and penile cancer, which are specific to men. Prostate cancer is by far the most common of the group and is often first suspected after a routine blood test or physical exam.
Visible blood in your urine is one of the most important red flags that can prompt a cancer evaluation. Even microscopic blood (detected on a routine urine test) may warrant further investigation depending on your risk profile. The American Urological Association identifies several factors that raise concern: a history of smoking (especially heavy, long-term use), a family history of urologic cancers, irritative urinary symptoms like urgency or burning, and age over 60. If you fall into a higher-risk category, your urologist will typically perform a cystoscopy and imaging of the upper urinary tract to rule out malignancy.
Women’s Urology Conditions
Beyond incontinence and UTIs, urologists treat several conditions specific to or more common in women. Interstitial cystitis, also called painful bladder syndrome, causes chronic bladder pressure and pelvic pain that can mimic a UTI but shows no infection on testing. Urethral diverticulum, a pouch that forms along the urethra, can cause recurrent infections, pain during sex, and dribbling after urination. Vesicovaginal fistula, an abnormal connection between the bladder and vagina, causes continuous urine leakage and typically requires surgical repair.
Pediatric Urology
Children are born with urologic conditions more often than many parents realize. Undescended testicles are the most common urinary tract abnormality in boys. During pregnancy, the testicles normally descend from the abdomen into the scrotum, but sometimes one or both fail to make the trip. This usually requires surgical correction in the first year of life to protect future fertility and reduce cancer risk.
Hypospadias is another condition present at birth, where the opening of the urethra develops on the underside of the penis rather than at the tip. It ranges from mild to severe and is corrected surgically. In girls, vesicoureteral reflux is one of the most common urinary abnormalities. Normally, urine flows one way: from the kidneys down to the bladder. With reflux, urine backs up toward the kidneys, raising the risk of kidney infections and potential kidney damage. Mild cases may resolve on their own as the child grows, while more significant reflux often needs surgical repair.
Diagnostic Tools Urologists Use
A urologist’s evaluation often goes well beyond a physical exam and blood work. Cystoscopy, where a thin camera is passed through the urethra to visually inspect the bladder lining, is one of the most frequently performed office procedures. It’s used to investigate blood in the urine, recurrent infections, bladder pain, and suspected tumors. Urodynamic testing measures how your bladder and urethra are functioning during filling and emptying, which is essential for diagnosing complex incontinence or voiding problems. Prostate biopsies, guided by ultrasound or MRI, are performed when cancer is suspected. Many of these procedures are done in the office rather than an operating room, with results often available the same day.