What is urology, and who are urologists?
Urology is the medical field that focuses on the health and disorders of the urinary tract in both men and women. It also deals with problems in the male reproductive system. Urologists are medical professionals specializing in treating diseases affecting the urinary system.
The urinary system filters and eliminates waste products from the body. The organs that make up the urinary system include kidneys, ureters, urinary bladder, and urethra. The male reproductive system's function is to produce, maintain, and transport sperm and semen (protective and lubricating fluid for the sperms) to initiate human reproduction. The male reproductive system's organs are located inside and outside the body; the internal organs are the vas deferens, urethra, and prostate, while the external organs are the scrotum, testicles, and penis.
Students interested in practicing as urologists in the U.S. must undergo close to 14 to 15 years of education and training in the field. First, they must earn a four-year undergraduate degree in a related science field. After graduation, students enroll in an accredited medical school to complete four years of their medical degree. The medical school is followed by four to five years of residency, focusing on urology. During residency, they work under expert supervision and learn how to diagnose and treat urological conditions. They also train in surgical processes used in the management of urologic issues.
While finishing a urology residency is enough to qualify a doctor to practice in the United States, some urologists train further for one or two more years. Fellowships offer medical practitioners additional training and research opportunities in a particular subspecialty. The fellowship program in urology focuses on specific areas such as female urology, children's urology, male infertility, kidney stones, reconstructive urology, or urologic oncology.
All urologists in the United States must clear the certification examination conducted by the American Board of Urology to become board-certified in their field.
What common disorders do urologists specialize in treating?
In men, urologists can prevent, diagnose, and treat diseases such as urinary tract infections (UTIs), painful bladder syndrome (also known as interstitial cystitis), erectile dysfunction, kidney stones, infertility, enlargement of the prostate gland, and cancers in organs such as kidneys, urinary bladder, penis, testicles, and adrenal and prostate glands.
In women, urologists can treat and manage UTIs, cancers found in the urinary bladder, kidneys, and adrenal glands, bladder prolapse (when the urinary bladder falls and bulges out into the front wall of the vagina), interstitial cystitis, and kidney stones.
Urologists can also manage specific disorders in children, such as bed-wetting habits, undescended testicles, and problems with the formation of the urinary tract.
Infections in certain parts of the urinary system are known as UTIs. The organs that mostly catch urinary infections are the ones in the lower urinary tract, the urinary bladder, and the urethra. The urinary system is designed to fend off bacterial invasions, but when the defenses fail, the bacteria grow in large numbers and cause infections.
Infections in the bladder, known as cystitis, happen due to a high bacterial load in the gastrointestinal tract, which travels into the urinary bladder and leads to infections. Infections in the urethra, known as urethritis, happen when gastrointestinal bacteria travel from the anus to the urethra.
Which doctor should you consult for UTIs?
Family physicians can treat most infections in the urinary tract. However, when the infections recur and are very frequent, you must consult a urologist near you who specializes in urinary disorders, or you may also visit a kidney disorder specialist (nephrologist).
What are the common symptoms of a UTI?
The signs and symptoms of UTIs depend on the part of the urinary system affected. Infection in the urinary bladder usually begins as pain during urination and an intense and frequent urge to urinate, with very little urine. Discomfort in the lower abdominal region and a feeling of pressure in the pelvis is sometimes accompanied by blood in the urine or cloudy or dark-colored urine. When the infection is in the urethra, patients feel a burning sensation while urinating and observe increased discharge. When the infection is in the kidneys (also known as acute pyelonephritis), the symptoms are nausea and vomiting, high fever, chills, malaise (feeling tired and unwell), and back and flank region pain.
Who is at risk of UTIs?
Women, in general, carry a higher risk of developing UTIs due to the specific anatomy of the urinary system. Sexually active women who use diaphragms and spermicidal agents for birth control and those who have had menopause are more vulnerable to UTIs. Several other factors are responsible for increasing the risk of contracting UTIs, such as abnormalities in the structure of the urinary tract, blockages in the urinary tract due to bladder or kidney stones, and enlarged prostate gland. Others include impairment of the body's immune or defense system, people who continuously use urinary catheters, and patients with a recent history of urinary tract surgery.
Why are UTIs more common in women?
The anatomy of the urinary tract in women makes them more vulnerable to bacterial infections in this region. Not only do women have shorter urethras when compared to men, but the distance between the urethral opening to the urinary bladder and the anus is very short. So, it's a comparatively shorter distance that the bacteria need to travel and invade the organs in the urinary system, leading to women being at high risk for UTIs and other sexually transmitted infections.
What are the complications arising from UTIs?
Recurrent and untreated UTIs can have serious consequences, such as permanent kidney damage and an increased risk of pregnant women having premature deliveries. It may also lead to permanent narrowing of the urethral opening in men and sepsis (a life-threatening condition when the body's defense system damages its tissues).
What tests will a urologist perform to diagnose UTIs?
After recording a thorough medical and medication history and asking detailed questions about your symptoms, urologists begin by taking and testing your urine sample. In chronic infections, imaging tests such as CT, ultrasound, and MRI scans help form the diagnosis. Urologists sometimes use a cystoscope (a long, flexible tube that goes into the urethra) to explore the urethra and urinary bladder.
How long does it take for UTIs to clear up, and how can you prevent reinfection?
Most UTI symptoms clear up within a few days of antibiotic treatment. However, you should take an entire course of antibiotics to prevent another infection from developing.
Some time-tested ways to prevent UTIs from recurring are:
- Emptying the bladder at the first sensation of urination
- Consuming a lot of fluids and water
- Cleaning the body with showers as opposed to baths
- Wiping from front to back in women after using the restroom
- Avoiding feminine products such as scented douches, hygiene sprays, and other bath products
- Urinating and cleaning the genital area immediately post-coitus
- Refraining from using diaphragms, spermicidal jelly, or unlubricated condoms for birth control as they increase the bacterial load and irritate the urinary bladder
- Keeping the genital area dry by using cotton underwear
Some studies show that cranberry juice can reduce UTIs because the proanthocyanidins in cranberries prevent the bacteria that cause UTIs from attaching to the urinary tract walls.
What other tests and surgical procedures can urologists perform?
Urologists may recommend one or multiple tests, ranging from blood tests to biopsies, to understand the root cause of your symptoms. They may choose to practice with or without surgery.
Typically, a urologist can perform the following diagnostic and surgical procedures:
- Minimally invasive urological surgery: In this type of surgery, urologists utilize various techniques like laparoscopic and robotic surgical techniques to treat certain conditions without doing open surgery, i.e., making large incisions into the body. A minimally invasive urological procedure can be done to treat many conditions, including kidney stones, bladder cancer, prostate cancer, kidney cysts, and chronic kidney disease. Examples of some minimally invasive urological surgeries include radical nephrectomy (to remove an entire kidney), radical cystectomy (to remove the bladder), and a robotic or laparoscopic pyeloplasty (to cut the narrowed or poorly functioning section of the ureter and reconstruct it).
- Prostate biopsy: The prostate gland found in males is walnut-shaped and responsible for producing a fluid (semen) that transports and nourishes sperm. It can be affected by cancer. The urologist may perform a prostate biopsy to detect prostate cancer. This test is usually recommended if the urologist finds that a patient has elevated or high prostate-specific antigen (PSA) levels. It may also be performed if the urologist finds abnormalities during a digital rectal exam. During a prostate biopsy, a needle will be used to collect a tissue sample from the prostate gland. These tissues are then examined for cell abnormalities and to check the possibility of cancer.
- Vasectomy: This is a minor procedure that prevents the sperm from reaching the semen. Vasectomies are usually performed in a urologist's office and are the best method to avoid pregnancy (apart from abstinence). A urologist may perform one of two types of vasectomies - a conventional vasectomy or a no-scalpel vasectomy. Vasectomies are safe procedures with little to no risk. Minor pain may occur after the treatment, which can be easily managed with pain medication. A vasectomy can also be reversed if a patient decides to have children in the future.
- Ablation therapy: Minimally invasive ablation treatment is a relatively new procedure done to treat prostate cancer. The procedure involves radiofrequency, high-intensity focused ultrasound (HIFU), or cryotherapy (treatment carried out using frigid temperatures) to destroy part or all of the prostate. This eliminates the cancer.
What should you expect at your urologist appointment, and how should you prepare?
You can visit a urologist directly or get referred to one by speaking to your primary care physician first. During your first visit, you will be expected to inform your doctor about your personal health history, family history, medications you are taking, and if you have any pre-existing chronic conditions. Ensure you carry a list of your drugs (including over-the-counter medicines and supplements), previous tests, and surgeries done. This information will help your urologist understand your symptoms better and diagnose your condition accurately. Bring a diary with a record of your current symptoms, their frequency, and duration.
For instance, if you have issues like incontinence, you can keep a bladder diary that tracks how often you experience leaks, what you were doing at the time of the leaks, and what you have been eating recently. A detailed record of your symptoms can enable your urologist to get a complete picture and determine the underlying cause of your condition. You must also be prepared to answer questions about your sexual health history.
After understanding your basic medical history, your urologist may recommend further diagnostic investigations involving imaging studies. These studies may include an ultrasound of the kidneys, abdomen, and bladder. A CT scan evaluates kidney stones, and nuclear medicine studies are used to see if kidneys are obstructed. An MRI scan or magnetic resonance imaging imaging may be recommended for more complex urologic problems. An MRI scan of the prostate can reveal the possibility of a mass or suspicious tissue; this is a new addition to the prostate screening process and has been found to eliminate unnecessary prostate biopsies.
Depending on your symptoms, your urologist may also want to perform a physical examination. In the case of males, a urologist focuses on checking the genitourinary system. They may perform a genital exam followed by a digital rectal exam (DRE) to evaluate the prostate for abnormalities. For women, a limited physical and pelvic examination may be performed. For children, you can expect a urologist to perform a gentle and minimally invasive physical exam focusing on your child's abdomen and pelvis area.
Your urologist may also order tests that require samples of urine, blood, or semen. To be prepared for a urinalysis, you must consume water before your appointment if asked to give a urine sample. Additionally, the urologist may perform a cough test if you are experiencing urinary incontinence. A cough test is typically used to search for leakage from the urethra.
After your doctor has reviewed your test results and given you a diagnosis, they will discuss your treatment plan with you. Depending on your diagnosis, this may involve medications, surgery, or a combination of both.
Find the best urologist near you in Miami, Florida
UTIs can be uncomfortable and painful and, when left untreated, can become severe and deadly. Therefore, finding the right urologist to help you understand and manage your condition is imperative. With Zocdoc, your search for the best urologists in Miami, Florida, becomes much more accessible.
On the Zocdoc website, type in your condition, location, preferred date, and insurance carrier to be directed to the top-rated urologists in Miami. You can also refine your search with the available filters. All practitioners on Zocdoc have dedicated profiles with details about their education, training, specialty, affiliations, accepted insurances, location, working hours, and even the languages they speak! Moreover, you can also view the verified patient reviews to select the best practitioner.
If you wish to book an appointment with an in-network urologist, you can do so by manually entering your insurance plan on the website or app and filtering your search results. If you need help finding your particular health plan, you can upload a photo of your insurance card. Once you upload a photo, Zocdoc will scan the image of your card and show you a plan that best matches your card. Note that this option is available for medical insurance cards only. Dental and vision are excluded. If you need help uploading your insurance card, contact Zocdoc's service team, which is available 365 days a year to answer all your queries. You can also visit Zocdoc's patient help center for answers to other insurance-related questions.
On Zocdoc, you can make in-person and online appointments with urologists near you on the same day or within 24 hours, morning or evening, depending on their availability.
All appointment bookings on Zocdoc are fast, free, and secure!
Urological statistics in Florida
According to a report published by the Florida Agency for Health Care Administration, between 2019 and 2021, there were about 83.6 visits to the emergency department for UTIs for every 100,000 people over 18 years old in Miami-Dade County, Florida. The highest numbers were reported from the 18-24 and 85+ age groups.
A report published by the Centers for Disease Control and Prevention (CDC) stated that there had not been a significant decrease in the number of catheter-associated UTIs in Florida between 2021 and 2022. The data collected from 226 acute care hospitals in the state reported that nearly 2% of patients had a worse standardized infection ratio than the national average.
According to the 2023 estimates presented by the Cancer Statistics Center, there will be about 24,000 new cases of prostate cancer, 5,670 kidney cancer, and 7,210 urinary bladder cancer in Florida. The report also predicted that during this year, 2,650 people would die from prostate cancer, 1,490 from urinary bladder cancer, and 1,090 from kidney cancer in the state.
Sources
Urology Care Foundation[1]
Urology Care Foundation[2]
Mayo Clinic[1]
Mayo Clinic[2]
Miami Matters
WebMD
Healthline
Centers for Disease Control and Prevention
American Cancer Society
National Association for Continence
Cleveland Clinic[1]
Cleveland Clinic[2]
Northwell Health
University of Florida
Community Hospital and Wellness Centers
Cincinnati Children's Hospital Medical Center
NYU Langone Health
