What is urology, and who are urologists?
Back in the days of ancient Egyptians and Greeks, doctors used to study urine to learn about a person's health. They looked at urine's color, smell, and texture and checked for things like bubbles or blood, which could indicate signs of illness. Nowadays, a whole branch of medicine is dedicated to the health of the urinary system, called urology.
Urologists specialize in understanding and treating issues related to the urinary system. They use advanced methods and technology to help keep our urinary systems healthy and address any problems that may arise.
The urinary system is an integral part of our bodies as it helps eliminate toxins and waste. It comprises the adrenal glands, kidneys, ureters, urinary bladder, penis, testes, and prostate.
What kind of education and training do urologists receive?
In the United States, these specialists undergo four years of medical school and four or five years of residency training at a hospital. While all urologists can diagnose and treat the urinary and male reproductive tract with this training, some may specialize in one care area. During this one or two-year additional training called a fellowship, urologists gain skills in a subspecialty. Some of these subspecialties are:
- Female urology: Focuses on the female reproductive and urinary tract.
- Pediatric urology: Focuses on urinary problems among children.
- Urologic oncology: Focuses on urinary system cancers, including the kidneys and bladder.
- Neurourology: Focuses on urinary issues due to conditions of the nervous system.
- Male infertility: Focuses on issues preventing a male from conceiving a baby with his partner.
At the end of their training, urologists also earn a board certification from the American Board of Urology.
What conditions do urologists treat?
In men, urologists treat various conditions that affect the urinary and reproductive systems as listed below:
- Urinary issues, including kidney diseases, kidney stones, and urinary tract infections
- Reproductive problems, such as infertility, erectile dysfunction (difficulty getting or keeping an erection), prostate gland enlargement, and varicoceles (enlarged veins in the scrotum)
- Cancers of the bladder, kidneys, testicles, penis, adrenal, and prostate glands
In women, urologists only focus on the urinary system, including the following:
- Urinary tract infections
- Urinary incontinence
- Kidney stones
- Overactive bladder
- Bladder prolapse (dropping of bladder into the vagina)
In children, urologists treat issues such as:
- Bed-wetting
- Undescended testicles
- Blockages and other problems with the urinary tract
What procedures do urologists perform?
When you see a urologist near you, they'll conduct various tests to determine your condition. Here are some standard surgical procedures and tests done by urologists.
Surgical procedures
- Cystectomy removes the bladder for cancer treatment.
- Shock-wave lithotripsy breaks up kidney stones for easier removal.
- Kidney transplant involves using a healthy kidney to replace a diseased one.
- Biopsies of the bladder, kidneys, or prostate
- Surgeries open blockages, repair injuries, or address malformed urinary organs.
- Procedures for prostate issues include prostatectomy, transurethral resection, and needle ablation.
- Sling procedures use mesh to support the urethra and treat incontinence.
- Ureteroscopy involves using a scope to remove kidney and ureter stones.
- Vasectomy, cutting and tying the vas deferens, is performed to prevent pregnancy.
Tests
- Imaging tests like CT scans, MRIs, and ultrasounds are used to examine the urinary tract.
- A cystogram involves X-ray images of the bladder.
- Cystoscopy utilizes a cystoscope to inspect the urethra and bladder.
- Post-void residual urine test measures urine speed and the remaining amount in the bladder.
- Urine samples are checked for bacteria-causing infections.
- Urodynamic testing assesses pressure and volume inside the bladder.
What can cause bladder control problems?
Loss of urinary bladder control, also known as urinary bladder incontinence, can affect men and women. This condition is more common in older people and women who have experienced pregnancy, childbirth, and menopause, which weaken the pelvic muscles. Bladder control problems in men and women manifest differently and can have varying causes.
Changes in health and lifestyle are the primary causes of bladder conditions. Congenital disabilities, aging, diabetes, being obese or overweight, and a blocked urinary tract due to kidney stones or a tumor can lead to bladder diseases. Constipation, chronic cough, and genitourinary fistulas can also result in bladder control loss. Nerve damage can confuse the brain and prevent it from sending messages to the bladder.
Similarly, lifestyle choices can interfere with the body's ability to regulate the bladder. For instance, poor eating and drinking habits can result in constipation. Certain medications, smoking, and being physically inactive often cause constipation and affect the normal functioning of the bladder. Other reasons people develop incontinence are injury or trauma due to sexual assault, pelvic organ prolapse, prostate cancer, or other conditions. Some of these conditions cause temporary incontinence, which is resolved by treating the root cause.
How do urologists treat bladder incontinence?
After conducting the necessary diagnostic tests, your urologist can suggest treatments and medications for bladder incontinence. You may have to bring about lifestyle changes such as starting an exercise routine if you don't have one, drinking the necessary amounts of fluids each day, and maintaining a healthy weight. Staying hydrated and including plenty of fiber in your diet can help avoid constipation, one of the causes of urinary tract problems. Your medical practitioner may ask you to maintain a bladder schedule to help you empty your bladder regularly. They might suggest pelvic floor exercises to help strengthen the muscles that contain your urine. Pelvic floor exercises can benefit both women and men.
If these are not viable options in your case, the urologist is likely to prescribe medicines. Pills, patches, and liquids are available to help with the treatment. Botox injections to the bladder can help cure incontinence by relaxing the bladder. When medications do not work, urologists use medical devices to administer the drug. Catheters, pessary, and bulking agents are some commonly used devices. Other options include electrical nerve stimulation, surgery, and an artificial urinary sphincter implant.
When should you get screened for prostate cancer?
If you are a man between 55 and 69 years of age, your urologist may suggest regular prostate cancer screenings. Frequent testing is necessary if you have a family history of prostate cancer. The two tests used for this purpose are digital rectal examination (DRE) and prostate-specific antigen (PSA).
In a DRE, the doctor would use gloves and insert a finger into the rectum. The feel of the prostate will help them determine if you need further tests. The PSA is a blood test to check the level of PSA, a substance made by the prostate, in the blood. Higher levels of PSA indicate the possibility of prostate cancer. However, other factors such as specific medications, medical procedures, infection, and an enlarged prostate can also cause elevated PSA levels. A biopsy can help your doctor arrive at a conclusive diagnosis. If they think something is abnormal, additional tests may follow.
What is Benign Prostatic Hyperplasia (BPH)?
BPH is when a man's prostate gets bigger, but it's not cancer. It usually happens as men get older. Remember, BPH doesn't mean you have prostate cancer.
When the prostate grows, it can press on the tube that transports pee from your bladder, causing some problems. If you have BPH, you might feel like you need to pee a lot, and when you do, it might be hard to start, and your pee stream might be weak. You could also feel like your bladder doesn't empty.
If your urologist suspects you have BPH, they might monitor it or prescribe you medicines to help. In more severe cases, they might suggest surgery to fix the problem.
Urinary tract infections
Urinary tract infection (UTI) can occur in any organ of the urinary system. However, most infections happen in the lower urinary tract, involving the urethra and bladder. They occur when bacteria near the rectum enter the urethra and infect the urinary tract. These infections can also affect multiple organs in the urinary system. Bladder infection is the most prevalent type of UTI. Kidney infection or pyelonephritis is less common but more severe than bladder infections.
Risk factors
UTIs can affect anyone at any age. Women are more susceptible to such infections than men. Their urethra is smaller and much closer to the rectum, making it easy for the bacteria to enter the urinary tract. Factors that increase the chances of UTIs include the following:
- Sexual activity
- History of UTI
- Bacterial changes in the vaginal area or vaginal flora due to spermicide use or menopause
- Pregnancy
- Poor hygiene
- Structural abnormalities such as enlarged prostate
- Age (Young children and older adults are more susceptible to UTIs)
Symptoms
The various signs or symptoms include the following:
- Burning sensation while urinating
- Strong urge to urinate despite an empty bladder
- Cloudy urine
- Frequent urination and passing small quantities of urine
- Strong smelling urine
- Urine appears bright pink or red - signs of blood in the urine
- Pelvic pain around the pubic bone among women
See a urologist immediately if you experience any of the above symptoms. If untreated, UTIs could cause severe health complications.
Prevention
UTIs are preventable. Here are a few recommendations:
- Drink plenty of water and stay hydrated
- Urinate after sexual activity
- Keep your private parts clean and dry
- Teach young children good hygiene practices during potty training
- Minimize the use of powders, sprays, or douches in the genital area
How do you find an experienced urologist near you in Seattle?
Discussing urinary or bladder problems can be challenging, even with a medical professional. While there are various treatment options to help you, an early diagnosis is always helpful. An ideal urologist will always diagnose and treat you in an understanding and non-judgmental manner. Our extensive database of medical practitioners can help you find a urologist that meets your preferences.
At Zocdoc, we use an advanced algorithm to match you with doctors using location, specialty, and insurance network filters. You can click on each doctor's profile in the list to learn about the doctor's educational qualifications, experience, hospital affiliations, awards, and accreditations. You can also find verified reviews and ratings from past patients to learn more about the specialist. You can also find out their gender, the languages they speak, and whether they treat children.
If you want to know your insurance plan, upload an image of your insurance card to your Zocdoc account, and we will find and display information regarding your insurance plan (this facility is not available for vision or dental plans). You can even contact the Zocdoc service team if you need help uploading a photo of your card. You can also check out Zocdoc's patient help center for more information and solutions related to insurance.
Feel free to view and compare profiles at your convenience and book an appointment only when ready. Depending on the urologist's availability, you can book appointments before, during, and after office hours. If the urologist's schedule permits, you can also book appointments on weekends and holidays.
Booking appointments with urologists near you through Zocdoc is free, secure, and quick.
Statistics on urological problems in Washington
Across the United States, urological disorders continue to rise, with prostate cancer becoming the second-most common cancer among American men. According to the Washington State Department of Health, the incidence rate of prostate cancer in King County is 124.6 at 100,000, higher than the state average of 100.2. Moreover, roughly 6 per 100,000 men have cancer of the testes. About 20.9 per 100,000 men and women are diagnosed with bladder cancer. The corresponding statistics for these two diseases in the state are 6.3 and 20.6, almost on par with the figures for King County.
Urologists also treat children for issues like bed-wetting, which is a distressing experience for children and parents. According to Cleveland Clinic, bed-wetting occurs in roughly 30% of children at age 7, about 5% at age 10, and about 1-2% of 15-year-olds in the United States. A report published by the National Institutes of Health studied the effectiveness of parental strategies for bed-wetting in children. The study found that limiting liquids before sleep and wearing protective trousers did not lower the likelihood of bed-wetting over two years. Bed-wetting can even lead to self-esteem concerns for many children. Parents must seek professional help from a urologist.
According to the American Urological Association, about 12,660 urologists are practicing in the United States. Of those, roughly 293 are practicing in Washington state. The urologist-to-population ratio was about 3.96 per 100,000 population in 2018.
Sources
Cleveland Clinic[1]
Cleveland Clinic[2]
Cleveland Clinic[3]
National Institute of Diabetes and Digestive and Kidney Diseases[1]
National Institute of Diabetes and Digestive and Kidney Diseases[2]
University of California, San Francisco
U.S. Centers for Disease Control and Prevention[1]
U.S. Centers for Disease Control and Prevention[2]
Mayo Clinic
American Cancer Society
Washington State Department of Health
Healthline[1]
Healthline[2]
WebMD
National Institutes of Health
American Urological Association
