Why would I be referred to a urologist?
A urologist is a doctor who specializes in conditions that affect the urinary tract in men and women. A urologist also treats the male reproductive system and male fertility issues.
One common reason people see a urologist is because they have trouble with bladder control. There are a number of types of bladder control problems, or urinary incontinence. These include stress urinary incontinence (leaking urine when you are active) and overactive bladder, or OAB (a sudden strong urge to pass urine that you cannot control).
Other common reasons people are referred to a urologist include:
- Urinary tract infections (UTIs). Symptoms can include pain when passing urine, frequent need to pass urine and fever. A urologist can prescribe antibiotics and other treatments to help manage UTIs.
- Testicular pain. If you feel a pain or mass in your testicle(s), you should see a urologist right away. There is a small chance the pain could be testicular cancer, which needs to be treated right away.
- Erectile dysfunction. This common problem affects as many as 30 million men in the U.S.
- Kidney stones. Pain in the groin, lower stomach or side of the back may be symptoms of kidney stones.
- Blood in the urine. This could be a sign of something as simple as a urinary tract infection. It also could be a sign of something more serious, such as kidney or prostate cancer.
- Frequent urination. Going to the bathroom more often than normal could be a sign of many things. These include a urinary tract infection, enlarged prostate or an overactive bladder.
- Male infertility. If you and your partner are having trouble conceiving a child, a urologist can test for male-factor infertility. Based on the cause, male infertility may be treated with medical, surgical or assisted reproductive therapies.
Within the field of urology, pediatric urologists specialize in taking care of children with conditions that affect the genitourinary tract. Many of these conditions are present at birth and others are present during childhood. Also, pediatric urologists are in charge of treating patients until they reach adulthood and prepare them for that transition.
Dr. Nicolás Fernández, a pediatric urologist at Seattle Children’s Hospital, specializes in hypospadias, robotic minimally invasive surgery for complex reconstructions and complex kidney stone management in pediatric patients with severe comorbidities.
What should I expect at my first urology visit?
A urologist is a specialist who treats all genders for health concerns that relate to the urinary system and reproductive organs. Your urologist is an expert when it comes to the urinary system, which includes the kidneys, bladder, ureters (thin muscles that carry urine from kidneys into the bladder) and urethra (tube that drains urine out of the bladder).
If your primary care provider has referred you to a urologist, it is likely your doctor is seeking a second opinion about a health concern you're facing. Specialists are great for taking a deeper look into certain urological concerns and helping to provide specialty treatment options. While a referral to a specialist does not always mean something is urgent, it is of great value to take your visit with a urologist seriously. Come prepared with questions or concerns to make sure you get the most out of your visit so you can find the right treatment with your doctor.
During the visit, the urologist will perform a physical exam that may include the following:
- For people with prostate issues, the urologist might perform a digital rectal exam. This exam lets the doctor perform a physical exam of the prostate. Other tests may include a urine flow test to test for urinary tract blockage and blood work to check for prostate cancer.
- For people dealing with recurrent urinary tract infections (UTIs) or a painful bladder, a pelvic exam may be done along with a urinalysis. A urinalysis involves checking the color, concentration and content of urine. A urine culture is a follow up test during which the urine is stored for two to three days to see if any bacteria will grow.
- Testing for low sex drive almost always requires a blood panel to determine hormone levels.
- Those with loss of bladder control (urinary incontinence symptoms) will undergo a cough stress test to determine urine loss and often a bladder scan to make sure the bladder is emptying properly.
- Any other concerns around cancer will include blood work, imaging, relevant physical exams and in some cases, imaging and cystoscopy (looking into the urethra and bladder).
Once your doctor has examined you, they will talk about their findings and possible solutions. Based on your symptoms, your doctor may suggest treatments such as medications, lifestyle changes, physical therapy or surgery. Make notes when your doctor reviews a treatment plan with you. Now is the time to ask any questions about what you have just been told. If you remember a question after your visit, send a message or call your doctor to get your questions answered. You and your urologist will work together to decide what is right for you.
Dr. Ekene Enemchukwu, a urologist at Stanford University Medical Center, focuses on management of male and female pelvic floor conditions, pelvic organ prolapse, voiding function and urinary incontinence.
Do urologists do surgery too?
Urologists perform many types of surgery. These include:
- Vasectomy. This is a surgical procedure used for male birth control. The urologist cuts the tubes that carry spermto prevent pregnancy. If a man who has had a vasectomy decides he does want children, the procedure can be reversed. A vasectomy reversal does not guarantee the man can conceive a child.
- Prostate procedures. One common prostate procedure is a biopsy to remove samples of tissue from the prostate to look for cancer. There are also a number of procedures that treat prostate enlargement that causes problems with passing urine.
- Kidney stone procedures. One way urologists get rid of stones in the kidney, bladder or ureter (the tube that carries urine from the kidney to the bladder) is with lithotripsy. This uses shock waves or a laser to break down the stones so they can pass out of the body through urine.
- Penile implants. These are devices placed inside the penis to allow a man with erectile dysfunction to get an erection.
- Cystoscopy. This procedure lets the urologist look at the lining of the bladder and urethra (the tube that urine flows through from the bladder to the outside of the body). It looks for the cause of blood in the urine, or for the reason a person has trouble urinating. It can also be used to diagnose an enlarged prostate.
- Treating an undescended testicle. In this procedure, the testicle is moved from the abdomen or groin area and into the scrotum.
- Surgery to treat urinary incontinence. This includes a sling procedure. The urologist uses strips of mesh to support the urethra and keep it closed.
Dr. Ruchika Talwar, a urologist at Vanderbilt University Medical Center, specializes in urologic oncology.