What is a Urologist?

An urologist is a physician who specializes in diseases of the urinary tract (men and women) and the male reproductive system. This can include diseases affecting the bladder, urethra, ureters, kidneys, and adrenal glands in sexes and the epididymis, penis, prostate, seminal vesicles and testes specifically in men.

In 2013, there were an estimated 9,500 urologists in the US. This number has been projected to fall to 7,500 by 2020

What is urology?

Urology, the study of conditions of the urinary tract and male reproductive system, is a broad field. Although it is generally classified as a surgical specialty, urologists require knowledge of other specialties such as gynecology and internal medicine due to the wide variety of clinical problems that they have to deal with.

Urologist qualifications

To become a urologist in the US, candidates graduate from an approved medical school and complete a urology residency program that takes a minimum of 5 (generally 6) years to complete, accredited by the Accreditation Council for Graduate Medical Education (ACGME). After completion of the residency, urologist are examined and certified by the American Board of Urology.

Common conditions treated

• Cancer (bladder, kidney, prostate, testicular): prostate cancer is the second most common cancer in the US, with 233,000 new cases and 29,480 deaths estimated for 2014. Bladder cancer is the sixth most common cancer in the US, with 74,690 new cases and 15,580 deaths estimated for 2014. Urologists also treat cancers of other organs that fall under the scope of urology.
• Enlarged prostate: also referred to as benign prostatic hyperplasia (BPH). BPH affects around one-third of men over 50.⁹ The prostate is a male gland located just below the bladder, surrounding the urethra. In BPH, an overgrowth of cells in the central portion of the gland causes the urethra to constrict, hindering urination and making it difficult for the bladder to be emptied.
• Erectile dysfunction: when the penis is unable to attain sufficient rigidity to fully participate in sexual intercourse. Frequently, erectile dysfunction is a symptom of a further underlying problem. Between 15 million and 30 million Americans are estimated to have erectile dysfunction.
• Incontinence: an involuntary loss of bladder control caused by part of the urinary system malfunctioning. Close to 20 million Americans are believed to experience urinary incontinence – 85% of whom are women.
• Infertility: while infertility in women is normally treated by gynecologists, male infertility is treated by urologists. Male partners are estimated to contribute to 40% of cases of infertility within couples. The condition can be caused by damage to the male reproductive tract and a variety of sperm disorders. A third of cases are caused by varicoceles – an enlarged vein in the sac beneath the penis.
• Interstitial cystitis/Painful bladder syndrome: a chronic inflammatory bladder condition producing discomfort at varying levels and frequencies. Although the cause is unknown, it is believed that a breakdown in the bladder’s lining could be related to the disease.
• Kidney and ureteral stones: small, hard deposits made from mineral and acid salts form in the kidneys but can pass through into the ureters. Stones can affect urination and cause pain, nausea and vomiting.
• Peyronie’s disease: a disorder whereby a fibrous layer of scar tissue develops beneath the skin of the penis. This growth affects the erectile tissue, leading to bending or curving in the penis during erection that can cause pain and lead to difficulties with sexual intercourse.
• Prostatitis: infection or inflammation of the prostate (as opposed to overgrowth as in BPH) can cause painful urination or ejaculation. Prostatitis is the most common urologic condition in men under 50. Cases can be acute or chronic.
• Undescended testes: also referred to as cryptorchidism, undescended testicle is the most common genital abnormality in men. Around 4% of males are born with the condition. In normal development, testicles form inside the abdomen and descend into the scrotum before birth. If one or both do not descend, sperm production can be impaired and the risk of injury is much higher.
• Urethral stricture: whereby scarring of the urethra can narrow or block the path of urine flowing from the bladder. Urethral stricture can be caused by infection, inflammation or injury, leading to urinary symptoms such as painful urination and reduced output. Complications include other urologic conditions such as prostatitis and urinary tract infections.
• Urinary tract infections (UTIs): a common complaint in women, whose lifetime risk is more than 50%. UTIs are frequently caused by the migration of bacteria from the digestive tract to the urethra. Common symptoms include abnormal urination, pain, incontinence, nausea, vomiting, fevers and chills.

When to see a urologist?

Patients are advised to seek the advice of a urologist if they experience any problems affecting their urinary system. Male patients should also contact a urologist regarding problems with their reproductive system, annual prostate health checks or if they wish to have a vasectomy.