A urologist is a doctor who specializes in the urinary tract and male reproductive system. They diagnose and treat conditions affecting the kidneys, bladder, ureters (the tubes connecting kidneys to the bladder), urethra, and, in men, the prostate, penis, and testicles. Unlike many other specialists, urologists are trained as surgeons, which means they can manage problems both with medication and with operations when needed.
What a Urologist Treats
Urologists handle a wide range of conditions in both men and women. Some of the most common include urinary tract infections, kidney stones, bladder control problems, and prostate issues like enlargement or inflammation. They also treat blood in the urine, chronic bladder pain, urinary retention (when you can’t fully empty your bladder), and pelvic organ prolapse in women.
On the male reproductive side, urologists are the go-to specialists for erectile dysfunction, infertility, penile curvature, and testicular problems. They also perform vasectomies. In children, urologists treat bedwetting, urinary reflux (where urine flows backward toward the kidneys), and congenital conditions like hydronephrosis in newborns.
Cancer is another major part of the field. Urologists diagnose and treat cancers of the kidney, bladder, prostate, testicles, and adrenal glands. Urology is sometimes referred to as genitourinary surgery precisely because so much of the specialty involves both medical and surgical care.
How Urologists Differ From Nephrologists
People sometimes confuse urologists with nephrologists, since both deal with the kidneys. The key difference is surgical training. Nephrologists are internal medicine doctors who manage kidney diseases with medication and monitoring. They handle conditions like chronic kidney disease, electrolyte imbalances, and kidney failure requiring dialysis. Urologists step in when a kidney problem may require an operation, such as kidney stones that won’t pass on their own or kidney cancer that needs to be removed. If your issue is structural or surgical, you’ll likely see a urologist. If it’s a disease of kidney function, a nephrologist is the right fit.
Training and Education
Becoming a urologist takes a long time. After completing medical school, a urologist must finish a minimum of five clinical years of postgraduate training, according to the American Board of Urology. This residency covers general surgical skills along with specialized urology training. After residency, urologists can pursue board certification by passing exams administered by the American Board of Urology.
Some urologists go even further with subspecialty training. The American Board of Urology offers additional certification in pediatric urology (for those whose practice is at least 75% focused on children) and in urogynecology and reconstructive pelvic surgery, a subspecialty focused on pelvic floor disorders in women. Other common areas of focus include urologic oncology (cancer), male infertility and sexual medicine, and kidney stone disease, though not all of these carry formal board subspecialty certification.
Common Tests and Procedures
A visit to the urologist often starts simply. Urine collection and blood tests are typically the first steps in screening for urological conditions. From there, your urologist may order imaging like an ultrasound, CT scan, or a specialized X-ray of the urinary tract to look for blockages, tumors, or other structural problems. Functional tests, like cystometry (which measures bladder pressure) and urine flow studies, help assess whether your bladder and urethra are working normally.
On the procedural side, urologists perform everything from minimally invasive office procedures to major surgeries. A cystoscopy, where a thin camera is inserted through the urethra to examine the bladder, is one of the most common diagnostic tools. For kidney stones, they may use shock wave therapy to break stones apart from outside the body, or pass a small scope up through the urinary tract to remove them directly. Prostate biopsies, vasectomies, and surgeries for cancer, incontinence, or prolapse all fall within a urologist’s scope.
Signs You Should See a Urologist
Your primary care doctor may refer you, or you can seek out a urologist on your own if you’re experiencing certain symptoms. These include:
- Changes in urination: trouble starting, a weak stream, pain while peeing, cloudy urine, blood in your urine, going more frequently than usual, or sudden strong urges you can’t control
- Erectile dysfunction: difficulty getting or maintaining an erection
- Infertility: trouble conceiving, particularly on the male side
- Pelvic heaviness or prolapse: a feeling that something is dropping or bulging in the vaginal area
- Chronic pelvic pain: ongoing discomfort in the lower abdomen or groin without a clear cause
Blood in the urine deserves special attention. Even a single episode, particularly if painless, can signal something serious like bladder or kidney cancer. It doesn’t always mean something dangerous is happening, but it warrants evaluation.
Urologists Treat Women Too
Many people assume urologists only treat men, but that’s not the case. Women commonly see urologists for recurrent urinary tract infections, overactive bladder, stress incontinence (leaking urine when you cough or sneeze), interstitial cystitis (chronic bladder pain), kidney stones, and pelvic organ prolapse. Some urologists subspecialize in female pelvic medicine and reconstructive surgery specifically to address these conditions. If your symptoms involve the urinary tract rather than the reproductive organs, a urologist is often the right specialist regardless of your sex.