Urologists vs. nephrologists
The urinary tract is made up of the kidneys, bladder, ureters, and urethra. Urologists are surgeons trained in treating urinary tract diseases in women, children, and men. They also specialize in treating prostatic enlargements and testicular and penile disorders.
A nephrologist is a healthcare specialist who diagnoses and treats the diseases that affect the kidneys. Also known as renal medicine, nephrology is a subspecialty of internal medicine. Nephrologists must be board-certified by the American Board of Internal Medicine.
Nephrologists also train to manage conditions that occur in the kidneys due to other health issues and specific illnesses caused by kidney ailments. Common diseases include high blood pressure, electrolyte or mineral imbalances, and fluid retention. They oversee kidney dialysis treatments, kidney transplants, and any follow-up care. Urologists and nephrologists often collaborate when treating patients with kidney disease.
Education and training of urologists
After studying for four years, aspiring urologists must earn a college degree. Then, they must complete four years of medical school.
After graduation, they undergo a residency training program of about four or five years, during which they receive training at a hospital. During their residency, they work alongside experienced urologists and learn surgical skills.
Some urologists may also undergo fellowship for a year or two. They can choose to specialize in areas such as urologic oncology or female urology. After completing their training, they must also pass a specialty certification exam. Subspecialties of urology include male infertility, urologic oncology, pediatric urology, kidney transplantation, sexual medicine, and genitourinary reconstruction. Urologists must be certified by the American Board of Urology and are qualified to perform minimally invasive surgical procedures such as endoscopic, laparoscopic, and robotic surgery.
What are some of the subspecialties in urology?
Urology encompasses various specialized areas to address urinary and reproductive issues across all age groups.
- General urology: Treats many urinary and reproductive system issues in both men and women.
- Pediatric urology: Focuses on urinary and reproductive issues in children, including congenital abnormalities like undescended testicles.
- Urologic oncology: Specializes in treating cancers of the urinary and male reproductive systems, including prostate, bladder, and kidney cancers.
- Renal transplantation: Involves kidney transplants for patients with non-functioning kidneys, often in collaboration with a surgical team.
- Male infertility: Addresses reproductive issues in men, such as low sperm count or sperm blockage; includes procedures like vasectomy reversal.
- Calculi (kidney stones): Specializes in diagnosing, removing kidney stones, and preventing recurrence.
- Female urology: Deals with issues specific to women, such as urinary incontinence/pelvic floor disorders.
- Neurourology: Focuses on the nervous system’s role in urinary and reproductive functions, treating disorders ranging from spinal injuries to Parkinson’s disease.
Conditions treated by urologists
The urinary tract acts as a human drainage system by excreting urine, a collection of water and wastes. The urinary system of males differs from that of females, and some diseases are exclusive to both genders. Urologists treat both men and women for standard as well as rarer ailments. Some conditions treated by a urologist are:
- Urinary incontinence (not being able to control the urge to urinate)
- Recurrent urinary tract infection
- Bladder pain or interstitial cystitis
- Hematuria or blood in the urine
- Enlarged prostate or benign prostatic hyperplasia (BPH)
- Erectile dysfunction (ED)
- Kidney stones
- Cancer of the prostate, kidney, or bladder
- Urinary tract issues that are congenital
- Pelvic organ prolapse
Typically, one must visit a urologist if diagnosed with these conditions. You must also set an appointment with a urologist in case of trouble urinating, cloudy urine, frequent urge to pass urine, or a weak urine flow. Additionally, you might need to consult a specialist for pelvic pain, infertility, and involuntarily urinating when you cough or sneeze.
Children might need to see a urologist for bedwetting, bladder infections, hydronephrosis in newborns, and kidney stones.
Diagnostic procedures in urology
Urologists use various diagnostic techniques and tools to identify an issue. They begin with a detailed evaluation of any symptoms you might be experiencing. The urologist will physically examine you, focusing on the genitourinary system. They may also conduct a rectal or pelvic exam based on your concerns.
After this, blood tests and urine analysis are usually essential when diagnosing urological problems. You may also need to undergo kidney function tests and prostate-specific antigen (PSA) tests. If your urologist finds it necessary, they may order imaging tests to visualize the urinary tract internally. These tests can help them find blockages, structural abnormalities, and abnormal masses, including tumors.
Some other imaging tests include CT scan, ultrasound, pyelogram, renal angiogram, cystography, and prostate or rectal sonogram. Urine flow tests and cystometry can help your doctor pinpoint any abnormalities in urinary function. They may also perform a biopsy (removing a tissue or cell sample from your body) for suspected cancerous growths. Based on the outcome of the prescribed tests, your doctor will suggest a treatment plan with medication or surgical intervention.
When should you visit a urologist?
A primary care doctor can often treat mild urinary issues, like a urinary tract infection (UTI). However, if symptoms persist or if there’s a need for specialized treatment, they may refer you to a urologist. Urologists can handle conditions that require more focused care in the urinary tract.
For certain complex health issues, seeing both a urologist and another specialist may be necessary. For example, men diagnosed with prostate cancer might work with both an oncologist, a cancer specialist, and a urologist to address the condition effectively.
How can you tell when it’s time to see a urologist? Common more signs of urinary tract issues include pain in the lower back, pelvis, or sides, painful urination, urine leakage, or dribbling. Men experiencing reduced sexual desire or a lump in the testicle may also benefit from a urologist’s care.
How should one prepare for their urology appointment?
If you are going to visit a urologist near you for the first time, you may need clarification about how to best prepare for the appointment. Are there some do's and don'ts to follow? What should you bring to the consultation? Can you ask questions to the urologist? You can find answers to all your queries in the following helpful guidelines:
- Arrive at least 15 minutes early at the doctor's office with all the necessary documents to complete the initial paperwork, such as your proof of identification, insurance details, and referrals.
- Make a list of your medications and dosages. This list should include prescriptions, over-the-counter drugs, vitamins, and supplements.
- Have your medical records with you, including information about your past and current health conditions, diagnostic test results, and prior surgeries.
- Know your family history of urologic conditions.
- Bring complete information about your symptoms—when they first began, what triggers them, how they affect your daily life, and whether you have tried any previous treatments.
- Call the urologist's office to confirm if you should expect any tests during the appointment and how to prepare for them. For example, if you are going to have a urinalysis, you must not empty your bladder before the visit.
- List down questions you want to ask your provider. What caused my condition? Is my condition curable? What lifestyle changes should I make? What foods should I eat and avoid? Does the prescribed treatment have any side effects? How long before I can see positive results? Will I need to undergo surgery in the future? You can bring up any queries and concerns you want without hesitation.
- Have a loved one join you to make your urology visit more comfortable. Plus, having someone take down important doctor's notes during the appointment is always good.
What can you expect from a urologist visit?
When you schedule an appointment with a urologist or your primary care provider refers you to one, you will need to discuss why you are there.
Your urologist will likely order tests to diagnose your condition and determine your best treatment. These tests could include the following:
- Physical examinations: These will be different for men and women. The physician might perform a rectal exam for a man and a pelvic exam for a woman.
- Blood tests, urine analysis, and semen sample collections: The doctor will ask the patient to submit urine, blood, and sperm samples for these tests (they must drink enough water before the appointment if asked to provide a urine sample).
A urologist can conduct various procedures to determine the patient's health and diagnose any possible issues. They may perform one or more of these tests when you visit them:
- They may assess your urinary tract thanks to imaging tests like a CT scan, MRI scan, or ultrasound.
- They can request a cystogram, which involves taking X-ray pictures of your bladder.
- They can perform a cystoscopy. It entails looking inside your urethra and bladder using a tiny cystoscope device.
- They may perform a post-void residual urine test to determine how quickly urine leaves your body during urination. Additionally, this displays how much urine is still in your bladder after urinating.
- Using a urine sample, they can test your urine for bacteria that cause infections.
- They can perform urodynamic testing to determine the volume and pressure inside your bladder.
Find top-rated urologists near you in Philadelphia, PA
Urinary tract diseases require a urologist's consultation as these problems can be painful and impact the quality of your life. Such issues make it necessary to seek expert medical help at the earliest. Zocdoc's extensive database of medical practitioners nationwide can help you find a urologist with all the relevant experience and qualifications. Find all the information you need at the click of a button.
Zocdoc offers you specialty, location, and experience filters to develop a list of practitioners best suited to your needs. Each practitioner's profile includes comprehensive details, including education, certifications, location, and procedures performed. You can also read the verified patient reviews for the practitioner.
Our online patient help center is here to help you find urologists who accept your insurance. With Zocdoc, you can connect your medical, dental, and vision insurance plans to your account, though you can use only one plan per appointment.
If you have multiple insurance plans, you can add secondary insurance information in the appointment notes. Additionally, if your provider utilizes Zocdoc's Intake forms, you can enter your secondary insurance details directly there.
Once you are satisfied with your requirements, you can schedule an appointment with the chosen urologist near you. Certain practitioners also provide online video consultations.
Booking appointments with Zocdoc is simple, secure, and free!
Urological diseases in Philadelphia
Prostate cancer is the second-most common cancer affecting American men after skin cancer. According to the American Cancer Society, around 2,99,010 new prostate cancer cases were estimated in the country in 2024.
According to the Commonwealth of Pennsylvania, from 2017-21, in Philadelphia, the number of men detected with prostate cancer was nearly 125.8 per 100,000, significantly higher than the state average of about 104.6. For urinary bladder cancer in males, this number was 28, slightly lower than Pennsylvania's, i.e., about 36.5 per 100,000. Regarding urinary bladder cancer among women, the number stood at about 8.6, lower than the state average of around 9.4.
Sources
WebMD
Urology Health
Cleveland Clinic
National Institute of Diabetes and Digestive and Kidney Diseases
Mayo Clinic
Pennsylvania County Health Profiles
American Cancer Society
National Kidney Foundation
Journal of Clinical Urology
Healthline
Alliance Urology Specialists
Byram Healthcare
America's Best Care Plus, Inc.
University Urology Associates of New Jersey
Urologists.org
