Urology is a part of health care that deals with diseases of the male and female urinary tract. A urologist is a specialist surgeon who treats anyone with a problem with their kidneys, bladder, prostate or male reproductive organs. These include a wide range of conditions like cancer, kidney stones, infection, incontinence (loss of bladder control), sexual problems and pelvic floor problems. Operations can range from simple to highly detailed procedures. Urology also deals with some of the most sensitive parts of health, like sexual function, fertility and gender identity. For this reason, urologists are skilled in having tough, quality-of-life conversations and talking with patients and caregivers in a sensitive manner.
Education and Training to Become a Urologist
“Urologists attend medical school and, after they graduate, they attend a 5–6-year residency program typically in a hospital setting, where they learn about all aspects of urology from surgery to medications to talking with patients and caregivers,” says Kyle A. Richards, MD, FACS, a urologist at the University of Wisconsin.
“Some urologists choose to attend a urology fellowship for an extra 1-2 years where they can train within a urology subspecialty. After schooling is complete, we take our oral and written board exams from the American Board of Urology. We maintain certification and stay up to date with the latest treatment options with mandatory courses to further our education.”
Urology Subspecialties
Pediatric Urology –Diagnose, manage and treat urinary and genital conditions in children. They provide surgical reconstruction for urinary tract and genital abnormalities, correct hernias, undescended testes and other groin conditions and check and surgically manage conditions of the bladder, kidneys and testis.
Female Pelvic Medicine and Reconstructive Surgery –Training in both urology and gynecology. They focus on conditions of the urethra, bladder and pelvis. They diagnose and treat pelvic floor disorders like pelvic pain, overactive bladder (OAB), urinary incontinence and pelvic organ prolapse (POP).
Male Infertility – Focus on male infertility, diagnose and treat health issues that reduce a male’s chance of getting a female partner pregnant. Such issues may include illness, injuries and anatomical differences that impact the body’s ability to produce enough healthy sperm for conception.
Urologic Oncology – Diagnose and treat cancers that occur in the male and female urinary tract and those of the male reproductive organs. Prostate cancer, bladder cancer and kidney cancer are three urological cancers among the ten most commonly diagnosed cancers in the United States.
Renal Transplant – Focus on kidney transplants. Specialists help patients learn the benefits and risks of transplant surgery to help them make informed decisions about their condition and refer them to other clinicians for surgery and support.
Urology Workforce
“One of the biggest challenges facing urologists are workforce issues. We struggle with diversity within the field. For example, only 11.2% of urologists in 2022 were women. The number of women in urology is increasing. We are trying to recruit more underrepresented in medicine urologists to the field each year. Traditionally, urologists have been mostly male and Caucasian,” says Dr. Richards. “Diversity in the medical work force is important to improving patient results. When patients and their providers have something in common like gender or race, there can be better communication, decision-making and maintaining care plans.”
There is also a shortage of urologists in rural America. Many urologists choose to work in big cities and as a result, 62% of rural locations across the country do not have a practicing urologist. This means that patients have to travel farther for a visit or simply choose not to receive care. With a growing and aging population, this is placing a large burden on patients and urologists.
- About 20% of the U.S. population lives in a rural area (with a population of less than 50,000 people), yet only 10% of urologists practice in these areas.
- Rural urologists tend to be older and often delay retirement compared to urologists in big cities.
- As a result, there is an aging urology workforce mostly in rural areas while new members of the urology workforce appear to be drawn to larger cities.
Virtual visits with patients have helped bridge the gap, but there is a need for more urologists overall to solve the problem.
Urology Patients
Urology patients tend to suffer from health issues for many years before they seek care, and they can be very grateful when a urologist can help them maintain a robust sex life, relieve their pain or even help them not leak urine throughout the day. Maintaining urologic health is of great value as it covers so many of our body’s functions. And while both men and women are often embarrassed about having to see a urologist for problems such as incontinence and sexual issues, taking preventative measures when it comes to urologic health can help lower the risk for many urologic conditions.
If you are looking for a urologist, talk with your health care provider to help refer you to someone in your area and within your insurance network.
“What I enjoy the most about being a urologist is building long-term relationships with patients and their families – over the course of many years and sometimes decades. Urology deals with sensitive issues, and that is why it is important for us to build strong bonds with our patients and their families, so they trust us with their care,” says Dr. Richards. “As urologists, we diagnose and treat patients in medical situations that are incredibly personal and sometimes frightening, so we must have the ability to communicate with patients with a level of respect, patience, and transparency. I go to work every day to provide the best possible urologic care for my patients. Sometimes I treat life-threatening diseases like cancer, other times I can free a patient of pain and discomfort so they can live a better life. That is why I love what I do.”