Doctors frequently checked the urine's colour, texture, and odour during ancient Egyptian and Greek times. They also examined the urine for blood, bubbles, and signs of other diseases in the urine. Today, a whole field in medicine is for urinary system health called Urology. Let us see when to see a urologist and what they do.
Who is A Urologist?
The urologist is the specialist of the urinary system in both men and women. They diagnose and cure diseases of the urinary tract. They also examine and fix things involved with the male reproductive tract. Sometimes, they may perform surgery to remove cancer or clear blockage in the urinary tract. You can visit a urologist in a hospital, private clinic or urology centre.
The urinary tract can be defined as the system responsible for creating, storing and removing urine from the body. A urologist can fix any part of this system, including:
- Adrenal glands: hormone-releasing glands located at the top of each kidney
- Bladder: hollow sac for urine storage
- Kidneys: filtering organs to remove waste from the blood and produce urine
- Ureters: the tube carrying urine from the kidney to the bladder
- Urethra: tube carrying the urine out of the body
Urologists also specialise in the male reproductive system, including:
- Prostate: fluid producing gland underneath bladder to make semen from sperm.
- Penis: organ releasing urine and sperm out of the body
- Testicles: testosterone and sperm-producing two oval organs inside the scrotum
What is Urology?
The field of medicine deals with the urinary tract and male reproductive tract ailments. There can be general urologists that deal with general urinary tract diseases or specialists in a specific type of urology like:
- Neurourology: deals with urinary tract issues due to nervous system conditions.
- Male fertility: deals with issues that make a man unable to have a baby with his partner.
- Female urology: deals with the problems of the female urinary tract and reproductive tract.
- Urologic oncology: deals with cancers of the urinary system, including the prostate, bladder, testicles, and kidneys.
- Pediatric urology: deals with children's urinary problems.
Difference Between Urology And Nephrology
You may make an appointment with a nephrologist if you want a doctor who solely focuses on the kidneys. Although nephrology is a subspecialty of urology, it is a subspecialty of internal medicine. As a result, nephrologists are not surgeons. Nephrologists must also be capable of managing illnesses that occur elsewhere in the body and cause or result from renal disorders, such as high blood pressure. On the other hand, urologists are surgeons who specialise in the male reproductive system.
Education And Training Requirements
The essential requirement to be a urologist is a four-year college degree and then four years of medical school. After graduation, you require 4-5 years of medical training at a hospital. This program is called residency, and you work with experienced urologists and acquire surgical skills.
Some people take additional training for a year or two called fellowship. Here you can acquire skills in a speciality area like female urology or urologic oncology. In the end, you have to pass the speciality certification exam for urologists. You receive a certificate from the American Board of Urology upon successful completion of the exam.
Conditions Treated by Urologists
There is a wide variety of diseases of the urinary system and male reproductive system that a urologist can treat.
In men, urologists cure:
- Kidney stones
- Prostatitis: an inflammation of the prostate gland
- Interstitial cystitis also called painful bladder syndrome
- Varicoceles, or enlarged veins in the scrotum
- Erectile dysfunction, or trouble achieving or keeping an erection
- Kidney diseases
- Cancers of the kidneys, bladder, penis, testicles, and adrenal and prostate glands
- Urinary tract infections (UTIs)
- Prostate gland enlargement
In women, urologists cure:
- Interstitial cystitis
- Urinary incontinence
- Bladder prolapse, or when the bladder drops into the vagina
- Kidney stones
- Overactive bladder
- Cancers of the kidneys, bladder, and adrenal glands
In children, urologists cure:
- Problems with the urinary tract structure and blockages
- Undescended testicles
Procedures Performed by Urologists
On your first visit to the urologist, he may ask you to get some of the following tests done:
- Urodynamic testing: measures the volume and pressure inside the bladder
- Post-void residual urine test: check the speed of urine leaving your body during urination. It also tells the amount of urine left in the bladder after urination.
- Urine sample test: to examine the urine for infection-causing bacteria
- Cystoscopy: done using a thin scope called a cystoscope; examines the inside of the bladder and urethra.
- Imaging tests: like MRI scan, ultrasound, CT scan to see the inside of the urinary tract
- Cystogram: gets the X-ray images of your bladder.
A urologist is trained to perform various surgeries like:
- Ureteroscopy: removes stones from the kidneys and ureter using a scope.
- Vasectomy: prevents pregnancy by cutting and tying the vas deferens, or the tube that carries sperm to produce semen
- Biopsies: of the bladder, prostate or kidneys
- Extracorporeal shock-wave lithotripsy breaks the kidney stones to remove them quickly.
- Cystectomy: removes the bladder to treat cancer
- Kidney transplant: replaces a diseased kidney with another healthy kidney
- Prostatectomy: treats prostate cancer by removing a part, or the whole prostate gland
- Transurethral Resection of the prostate: involves removing the excess tissue from an enlarged prostate
- Sling procedure: to treat urinary incontinence. Done by using mesh strips that support the urethra and keep it closed.
- Transurethral Needle Ablation of the prostate: removes excess tissue from an enlarged prostate
- Procedure to repair damage due to injury
- Open a blockage
- Repairing underdeveloped urinary organs
When to Visit a Urologist?
Your regular doctor can treat some mild urinary problems you have, like UTI. If they cannot cure your situation or the symptoms do not seem to improve, your doctor might refer you to a urologist. Sometimes you may have to see a urologist and another specialist doctor for some conditions. For example, someone with prostate cancer can consult an Oncologist - a cancer specialist, and a urologist.
These symptoms might be an indication of a urinary tract problem.
- Trouble urinating
- A frequent or urgent need to urinate
- Blood in the urine
- Urine leakage
- Pain or burning during urination
- Weak urine flow, dribbling
- Pain in your pelvis, lower back or sides
A man should see a urologist if they have any of the following symptoms:
- A lump in the testicle
- Trouble getting or keeping an erection
- A decreased sexual desire
A visit to the urologist: Prepare to explain why you're seeing a urologist when you schedule an appointment or when your health care practitioner refers you to one. Prepare to be questioned about your medical history and your current drugs. Bringing a list of questions or symptoms about why you arranged the appointment might benefit you.
Your urologist will most likely prescribe tests to diagnose your problem and determine the best course of action.
Among the tests that the doctor may perform are:
- Examination of the body. Males and females will have different requirements. If you're a man, the doctor may perform a rectal exam on you. A pelvic exam may be required if you are a woman.
- Urinalysis, blood testing, and sperm samples are all available. You must give urine, blood, and sperm samples for these examinations. (Before you go to your appointment, make sure you drink enough water because you may be required to provide a urine sample.)
- Ultrasound or computed tomography (CT) scans are examples of imaging tests.
There can be a wide variety of diseases under this category related to the filtration and travel of urine out of the body. Anybody of any age, any gender, can suffer from these diseases. These diseases only affect specific body parts, like the urinary tract in females and urinary and reproductive tracts in males.
Most Common Urological Diseases
Out of various urological conditions, the American Urological Association Foundation (AUAF) listed some as common diseases. Some of them are:
- Benign Prostatic Hyperplasia (BPH): It is a condition with an enlarged prostate. The size of the prostate gland increases if you are suffering from BPH. It has no direct connection with prostate cancer.
- The enlarged prostate pressurises the urethra, which leads to BPH symptoms. The urethra is the narrow tube carrying urine from the bladder out of the body.
- Man with BPH may have an urge to urinate frequently. The urine stream may be weak, and they may feel the bladder is not empty even after urination. Some severe cases may require surgery. Your doctor may either monitor the condition or prescribe you some medicines like alpha-blockers for treatment.
- Urinary Incontinence: This condition cause a loss of control over the bladder, resulting in unwanted urine leakage. This condition is quite common, although it can be inconvenient and embarrassing. The AUAF states that in the United States, more than 15 million people suffer from urinary incontinence.
- Several reasons can lead to urinary incontinence. Some of the common causes are:
- Overactive bladder
- Enlarged prostate
- Weak bladder muscles
- Pregnancy or childbirth
- Severe constipation
- Diseases like Parkinson's and multiple sclerosis
- Urinary tract infections
- Injury to the spinal cord
- Weak sphincter muscles (muscles supporting the urethra)
Some lifestyle changes like controlling your fluid intake can be enough to cure continence. If approaches like this do not work, your doctor may recommend surgery to correct underlying causes.
- Urinary Tract Infections (UTIs): When pathogenic bacteria or viruses enter the urinary tract and cause infection, that infection is a UTI. Men and women both can suffer from UTIs, but females are at a higher risk. The AUAF states that around 12% of males and 40% of females will suffer from UTIs with noticeable symptoms. The most common symptom of UTI is a burning sensation during urination. Other symptoms can be the urge to urinate frequently and the feeling that the bladder is not empty after urination. Usually, antibiotics can cure UTIs in 5-7 days.
- Kidney and Ureteral Stones: When the urine has some crystals, and small particles cover and collect on the crystals, it leads to stones in the kidneys. The stones that shift from the kidney to the ureter (the tube carrying urine to the bladder from the kidney ) are called Ureteral stones.
- These stones can be excruciating and can block the urine flow. But, the larger stones can cause blockage and will be problematic. People can often just expel the stones without any medical help.
- Sometimes, people may also require surgery to remove the larger stones. The most common technique is the Extracorporeal shock wave lithotripsy (ESWL), which breaks the stones into smaller pieces to make them easily leave the body.
- Other common urological conditions: Some other conditions are:
- Bladder prolapse
- Erectile dysfunction
- Overactive bladder
- Hematuria (blood in the urine)
- Bladder cancer
- Interstitial cystitis (painful bladder syndrome)
- Prostatitis (swelling of the prostate gland)
- Prostate cancer
Tips To Improve Overall Urological Health
The AUAF states various tips for better urological health in adults and children. These are:
- Limit fluid intake in the nighttime hours
- Teach young girls that they should use a front-to-back motion to wipe the genital area after going to the washroom
- Stay within a healthy weight range
- Limit the amount of salt and caffeine consumption
- Purchase athletic "cups" for your sons to help prevent injury
- Do Kegel exercises to toughen the muscles of the pelvic area
- Encourage children to urinate immediately before bed
- Drinking cranberry juice can help you prevent urinary tract infections (UTIs)
- Stay hydrated
- Choose a smoke-free lifestyle
Tips for Parents
The best advocate for your urological health is you. Regularly get yourself checked and always tell your doctor any concerning symptoms you observe. Taking care of your urinary system is easy as long you follow the above tips. Now you know what symptoms can be concerning and when you should visit a urologist. Slight changes in the current lifestyle can lead to a stress-free, disease-free life. So gear up and work out towards your health goal.
Urinary Tract Infection (UTI) Tests
A urinary tract infection (UTI) is an infection that affects the kidneys, bladder, ureters, and urethra. UTIs are one of the most often diagnosed infections, impacting around 150 million individuals worldwide. Most UTIs are caused by bacterial infections, although viruses or fungi cause some. UTIs are discussed on this page regarding their types, causes, symptoms, and therapy. Medical tests and home tests are also covered, and how to interpret the results.
Doctors divide UTIs into two categories: simple and complex. Individuals with no urinary tract anomalies are more likely to get uncomplicated UTIs. UTIs that are complicated are linked to circumstances that damage the urinary system, such as renal failure or pregnancy.
There are three forms of urinary tract infections, each of which affects a distinct section of the urinary tract:
- Urethritis: an infection that affects the urethra.
- Cystitis: When germs enter the urethra and move to the bladder, UTI occurs.
- Pyelonephritis: This kidney infection is caused by bacteria that migrate through the urethra.
Adults and children have different symptoms when it comes to UTIs.
The following are the most prevalent symptoms in adults:
- Urinary discomfort
- Urination frequently
- Being unable to urinate
- Urinary urgency that appears out of nowhere
A UTI can cause a child to have a high fever, feel ill, or wet themselves.
Tests at Home
An over-the-counter UTI dipstick test can be used by someone who suspects they have a UTI. These can be found in local drugstores and on the internet. At-home testing kits are beneficial since they are simple, affordable, and accurate. They examine the urine for white blood cells and germs to see if an infection is present.
Reading a Home Test
These tests use a test strip wetted with fresh urine, similar to a pregnancy test.
- The test strip will change colour after 1–2 minutes, showing whether a UTI is present. The colour of the test strip pads must correspond to the colour blocks on the foil pouch in the test kit.
- The majority of test strips look for leukocytes and nitrites. Some people additionally test their pH levels.
- Leukocytes are white blood cells that aid in the body's infection-fighting abilities. Nitrates are substances found in healthy urine that can change into nitrites if an infection is present. As a result, leukocytes or nitrites in the urine frequently indicate a urinary tract infection.
- Finally, You can use some pH strips at home. Urine, in good health, has a pH of 4.5–8.0, which is mildly acidic. A pH of 8.5 or 9 can suggest the existence of an infection and, as a result, a urinary tract infection.
- If any of these symptoms appear on a home test, the person has a UTI.
Tests by Doctors
A UTI is diagnosed by determining the bacteria that caused the infection. They do it by taking a midstream urine sample and running tests to determine the amount of bacteria present. Some people with recurrent UTIs may require an ultrasound, CT, or MRI scan. The doctor might use these imaging procedures to check for any abnormalities in the urinary tract. At-home testing is less reliable and informative than tests performed by professionals. They can, for example, aid in determining the severity of an illness and its transmission.
Treatment for UTIs eliminates the infection, relieves symptoms, and prevents a recurrence.
- A doctor can successfully treat most UTIs with antibiotics. However, it is critical to strictly adhere to the doctors' instructions, as any departure raises the likelihood of the infection.
- Antibiotics and minor, temporary lifestyle changes are commonly used to treat urethritis and cystitis. Drinking more water and peeing more frequently are two examples of these behaviours.
- Because kidney infections make individuals feel poorly, various treatment options may be required. Generally, antibiotics are used to treat pyelonephritis. If a person is too sick to take oral antibiotics, they may need to be admitted to the hospital and treated with intravenous antibiotics for a brief time.
There are currently no home cures that can heal UTIs.
- Drinking extra water and taking antibiotics are beneficial because it causes a person to urinate more frequently, which helps to clean out the urinary system.
- Although some people believe that cranberry juice or cranberries can aid in treating UTIs, there is little scientific evidence to back this up. Studies on the effects of cranberry juice and cranberries on UTIs have yielded inconsistent results, indicating that more research is needed.
- According to the American Urological Association (AUA), doctors can prescribe cranberry juice to those who have recurrent UTIs as a strategy to avoid them. Although this shows that this home cure could be a helpful preventive intervention, the American Urological Association (AUA) warns that there is little evidence to support this claim.
Causes of UTI Infection
A urinary tract infection (UTI) arises when a bacterial, viral, or fungal infection moves up the urinary tract. Females are more likely to have UTIs than males because their urethras are shorter, making it easier for bacteria to reach the bladder. Approximately 40–60% of females will get a UTI.
The following factors can also cause UTIs:
- Use of a catheter
- Urethral manipulation
- Having sexual relations
- Use of spermicides and diaphragms
- Receiving regular pelvic examinations
- Possessing several anatomical flaws
- After undergoing a kidney transplant
- Diabetic lifestyle
- Having a Weak Immune System
If you have bladder problems, pelvic pain, or sexual issues, your primary care provider may send you to a urologist, an expert in these areas. The urologist can prescribe tests to clarify the diagnosis and lead you in the right direction for therapy. Some people may feel ashamed to discuss urination, incontinence, or other "down there" difficulties. Still, those same people will be relieved to learn that these conditions are relatively common and successful treatment is available. It's critical to be honest, and transparent with your healthcare providers so that they can assist you in regaining your health and enjoying life again.