What is a Urologist? When to See One and What They Treat

Urology is a medical speciality that focuses on diagnosing and treating conditions affecting the urinary tract in both men and women, as well as the male reproductive system. This branch of medicine encompasses a wide range of issues, from common urinary infections and kidney stones to more complex surgical interventions for cancers, congenital abnormalities, and pelvic floor disorders. Urologists often work closely with other specialists, such as nephrologists, oncologists, and gynaecologists, to provide comprehensive care for patients with interconnected urinary and reproductive health concerns. To better understand the role of a urologist, let’s take a closer look at what they do and how they can help you maintain optimal urinary and reproductive health.

What Is a Urologist?

A urologist is a doctor who specialises in the diagnosis and treatment of diseases and disorders related to the urinary system and male reproductive organs. They are trained to manage both non-surgical conditions, such as urinary tract infections (UTIs), overactive bladder, and benign prostatic hyperplasia (BPH), as well as surgical treatments for cancers of the prostate, bladder, and kidneys. Urologists also perform procedures to address urinary obstructions, congenital defects, and reconstructive surgeries for pelvic organ prolapse or trauma.

In addition to their surgical expertise, urologists are well-versed in the management of adrenal gland disorders, male infertility, erectile dysfunction, and gender-affirming surgeries. Unlike nephrologists, who focus solely on kidney function and related medical conditions, urologists are trained surgeons capable of addressing structural and functional abnormalities across the entire genitourinary system.

What Does a Urologist Do?

Urologists are highly trained medical specialists who diagnose and treat conditions affecting the urinary tract (kidneys, ureters, bladder, and urethra) and the male reproductive system. They perform a wide range of diagnostic procedures to identify the root cause of urological issues. These may include cystoscopy, which involves inserting a lighted scope into the bladder to visualise the inner lining, and urodynamic testing to assess bladder function and identify any abnormalities. Imaging studies such as ultrasound and CT scans are also commonly used by urologists to identify structural issues within the urinary tract.

When it comes to treatment, urologists are skilled in performing minimally invasive surgeries such as ureteroscopy for removing kidney stones, lithotripsy (using laser or shockwaves to fragment stones), and various prostate procedures like biopsies, UroLift, or transurethral resection (TURP). They also manage catheter placements, urinary diversions, and more complex oncologic surgeries such as cystectomy (removal of the bladder). While urologists are highly skilled in surgical interventions, they also play a crucial role in identifying when a patient should seek their expertise.

When Should You See a Urologist?

There are several symptoms and conditions that warrant a visit to a urologist. These include:

• Urinary Symptoms: If you experience frequent urination, painful urination, blood in your urine, or incontinence, it’s important to consult a urologist to identify the underlying cause.
• Kidney Issues: Recurrent kidney stones, flank pain, or urinary obstruction may indicate a more serious problem that requires urological evaluation.
• Prostate Concerns: If you have an enlarged prostate (BPH) causing symptoms such as a weak urinary stream, frequent nighttime urination (nocturia), or urinary retention, a urologist can help.
• Male Reproductive Health: Issues such as erectile dysfunction, infertility, testicular pain or lumps, or hormonal imbalances should be addressed by a urologist.
• Suspected Cancers: If you have symptoms suggestive of bladder, kidney, prostate, or testicular cancer (such as blood in the urine or an elevated PSA), prompt urological evaluation is crucial.
• Congenital Abnormalities: Conditions such as undescended testes (which may require orchiopexy) or hypospadias often necessitate urological intervention.

Common Conditions Treated by Urologists

Urologists treat a diverse array of conditions related to the urinary tract and male reproductive system, including:

• Urinary tract infections (UTIs) that affect the kidneys, bladder, or urethra.
• Kidney stones, which are hard mineral deposits that can cause severe pain and obstruct urine flow.
• Erectile dysfunction (ED), characterised by difficulty achieving or maintaining an erection, often due to underlying health issues.
• Prostate issues, such as enlargement, cancer, or prostatitis (inflammation).
• Bladder control problems, including overactive bladder, stress incontinence, and urge incontinence.
• Cancer of the urinary tract, including kidney, bladder, prostate, and testicular cancers.
• Benign prostatic hyperplasia (BPH), which is the non-cancerous enlargement of the prostate gland.

Diagnostic Procedures in Urology

Urologists use various diagnostic procedures to identify and evaluate conditions affecting the urinary tract and reproductive system. Some common tests include:

• Cystoscopy: A thin, flexible tube with a camera (cystoscope) is inserted through the urethra into the bladder, allowing the urologist to visually inspect the bladder and urethra for any abnormalities or signs of disease.
• Uroflowmetry: This non-invasive test measures the flow rate and volume of urine during urination. It helps assess how well the bladder and urethra are functioning and can identify issues such as obstruction or bladder dysfunction.
• Imaging Studies: Urologists may use ultrasound, CT scans, or MRI to obtain detailed images of the urinary tract. These imaging techniques help diagnose conditions like kidney stones, tumours, or structural abnormalities in the kidneys, bladder, or prostate.
• Urodynamic Studies: These tests evaluate the function of the bladder and urethra during the filling and emptying process. Procedures like cystometry measure pressures inside the bladder, while pressure-flow studies assess the bladder and urethra during urination. Urodynamic studies help diagnose conditions such as overactive bladder or urinary incontinence.

These diagnostic procedures provide valuable information that guides urologists in determining the most appropriate treatment options for each patient.

Treatment Options Offered by Urologists

Urologists offer a wide range of treatment options tailored to address specific urological conditions and meet individual patient needs. The main categories of treatments include:

• Medical Treatments: Urologists may prescribe medications to manage various urological conditions. For example, antibiotics are used to treat urinary tract infections, while alpha-blockers or 5-alpha reductase inhibitors are prescribed for benign prostatic hyperplasia (BPH) to improve urinary symptoms.
• Surgical Treatments: In some cases, surgical intervention may be necessary to treat urological conditions. Urologists perform surgeries for kidney stones, tumours, or significant prostate enlargement. With advancements in technology, many procedures can now be performed using minimally invasive techniques, such as robotic-assisted surgeries, which offer increased precision and faster recovery times.
• Minimally Invasive Treatments: Urologists also offer minimally invasive procedures that provide effective treatment with less discomfort and shorter recovery periods compared to traditional surgeries. Examples include shockwave lithotripsy, to break up kidney stones, and transurethral resection of the prostate (TURP) for BPH, where the enlarged prostate tissue is removed through the urethra. Ureteral stenting is another minimally invasive procedure that involves placing a small tube in the ureter to ensure proper urine flow from the kidney to the bladder.

Urologists work closely with patients to develop personalised treatment plans that consider the specific condition, severity, and individual preferences to achieve the best possible outcomes.

Subspecialties Within Urology

Urology is a diverse field that encompasses several subspecialties, each focusing on specific aspects of urological health. Paediatric urology is dedicated to treating congenital and acquired urinary tract disorders in children, such as undescended testes or congenital abnormalities. Urogynecology, also known as female pelvic medicine, concentrates on pelvic floor dysfunction, urinary incontinence, and pelvic organ prolapse in women. Urologic oncology specialises in the management of cancers affecting the urinary system, including the bladder and kidneys, as well as male reproductive organs, utilising surgical techniques and advanced therapies like robotic surgery. When seeking urological care, it’s essential to consider the expertise of the specialist and their experience in treating your specific condition.

How to Choose the Right Urologist?

When choosing a urologist, opt for a board-certified specialist with subspecialty training that matches your specific condition. For example, if you have a paediatric urological issue or a urologic cancer, seek out a urologist with certification in paediatric urology or urologic oncology, respectively. Verify the urologist’s experience in performing specific procedures relevant to your condition, such as robotic surgery or holmium laser enucleation of the prostate (HoLEP) for enlarged prostates. Prioritise providers affiliated with academic medical centres or recognised clinics, as they often offer access to advanced therapies and multidisciplinary care. Patient reviews and referrals from your family physician can further guide your decision in selecting the right urologist for your needs. Consulting with a qualified urologist is crucial for addressing urological health concerns effectively.

Conclusion

Urologists play a crucial role in diagnosing and treating a wide range of conditions affecting the urinary tract and male reproductive system, from common issues like kidney stones to more complex problems such as cancers. Timely consultation with a urologist ensures access to specialised care, which can improve outcomes for conditions like urinary incontinence, pelvic organ prolapse, or prostate disorders. Early intervention by a qualified urologist can prevent complications and enhance the overall quality of life for patients dealing with urological health issues.

Frequently Asked Question (FAQs)

References

1. https://www.healthdirect.gov.au/urologist
2. https://health.umms.org/2022/08/02/urology-health/
3. https://www.urologyhealth.org/healthy-living/urologyhealth-extra/magazine-archives/winter-2013/when-should-i-see-a-urologist
4. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/diagnosis-and-screening-of-urologic-conditions