Dr. Himanshu Chaudhary

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UROLOGY

WHAT IS UROLOGY?

Urology is a medical specialty that focuses on the diagnosis and treatment of conditions and diseases related to the urinary tract and male reproductive system. Urologists are medical doctors who specialize in managing disorders and diseases that affect the kidneys, bladder, ureters, urethra, and the male reproductive organs (such as the testes, prostate, and penis).

Common conditions that urologists address include urinary tract infections, kidney stones, prostate issues (such as benign prostatic hyperplasia or prostate cancer), erectile dysfunction, infertility, and urinary incontinence. Urologists may use a variety of diagnostic tools, including imaging studies, laboratory tests, and specialized procedures, to evaluate and treat urological conditions.

Additionally, urologists may perform surgical procedures, ranging from minimally invasive techniques to more complex surgeries, to address urological issues. They play a crucial role in managing both medical and surgical aspects of urological disorders, and they may collaborate with other medical specialists as needed to provide comprehensive care.

UROLOGY SPECIALIST AREAS

Endourology

Endourology deals with the closed manipulation of the urinary tract. The field has grown to now include minimally invasive surgical procedures. Procedures are carried out using endoscopes inserted into the urinary tract and examples include prostate surgery, stone removal surgery and simple urethral or ureteral surgeries.

Urologic oncology

This deals with genitourinary malignancies such as cancers of the kidney, adrenal glands, prostate, bladder, ureters, testicles or penis.

Neurourology

Neururology concerns the management of conditions that involve the nervous control of the genitourinary system or abnormal urination. Examples of neurological conditions that may lead to these conditions include Parkinson’s disease, multiple sclerosis, stroke and spinal cord injuries.

Pediatric urology

This involves the correction of genitourinary problems arising in children such as undescended testes or cryptorchidism, underdeveloped genitalia and vesicoureteral reflux.

Andrology

Andrology focuses on disorders of the male reproductive system such as erectile dysfunction, ejaculatory disorders, infertility and vasectomy reversal.

Reasons you might see a urologist

You may make an appointment or get a referral to a urologist if you have:

  • Trouble urinating (peeing), including getting started or having a strong flow of urine, pain, cloudy urine or blood in the urine.
  • Changes in urination, like frequent urination or feeling like you always have to go.
  • Trouble getting or keeping an erection.
  • Infertility.
  • A feeling that something is falling down into your vagina or heaviness in that area.
  • Pelvic pain.
  • Urinating when you don’t want to, like at night or when you sneeze, laugh or exercise.

Urological symptoms

Urological symptoms can vary widely depending on the specific condition or issue affecting the urinary tract or male reproductive system. Here are some common urological symptoms that may indicate the need for a consultation with a urologist:

Pain or Discomfort:

  • Pain or burning sensation during urination.
  • Pain in the lower abdomen, pelvis, or lower back.
  • Pain in the testicles or penis.

Changes in Urinary Habits:

  • Frequent urination.
  • Urgency to urinate.
  • Difficulty initiating or maintaining a urine stream.
  • Weak or interrupted urine flow.

Blood in Urine:

  • Hematuria, or blood in the urine, which may be visible or microscopic.

Incontinence:

  • Urinary incontinence, which is the unintentional loss of urine.

Changes in Sexual Function:

  • Erectile dysfunction (difficulty achieving or maintaining an erection).
  • Pain during sexual activity.
  • Changes in libido (sex drive).

Prostate Issues:

  • Symptoms related to an enlarged prostate (benign prostatic hyperplasia, or BPH), such as increased frequency of urination, especially at night.

Testicular Symptoms:

  • Testicular pain or swelling.
  • Changes in the size or consistency of the testicles.

Recurrent Infections:

  • Frequent urinary tract infections.

It’s important to note that these symptoms can be associated with various urological conditions, and experiencing one or more of these symptoms may not necessarily mean a specific diagnosis. If you are experiencing any persistent or concerning urological symptoms, it is advisable to seek medical attention. A urologist can conduct a thorough evaluation, including a medical history, physical examination, and possibly additional diagnostic tests, to determine the underlying cause and recommend appropriate treatment. Early detection and intervention can often lead to more effective management of urological conditions.

10 Common Urology Procedures

Vasectomy

This is a common urology procedure that many men get. Vasectomy is a surgical procedure used for permanent male birth control. During the procedure, the doctor cuts off the supply of sperm to the semen by cutting and sealing the vas deferens, which carries sperm from the testicles. It is an out-patient procedure that only takes about 10-30 minutes.

Vasectomy Reversal

If a man who has had a vasectomy decides he wants to try and father children again, a vasectomy reversal can be performed. However, vasectomy reversal is not a guarantee the man can conceive a child. Certain factors are necessary for the reversal to be successful. Microsurgical techniques are used to repair the vas deferens.

Cystoscopy

A cystoscopy is a urology procedure that allows a urologist to examine the lining of the bladder and the urethra. An instrument called a cystoscope is inserted into the urethra and guided to the bladder. The cystoscope is made up of a long, thin tube with a light and a camera at the end. This procedure is commonly used to diagnose and treat bladder conditions. It can also be used to diagnose an enlarged prostate.

Prostate Procedures

Urologists may perform a number of procedures to diagnose and treat prostate conditions. These include: Prostate biopsy, UroLift, Transurethral needle ablation (TUNA), Transurethral resection of the prostate (TURP), Transurethral incision of the prostate (TUIP).

Ureteroscopy

Ureteroscopy is a procedure used to diagnose and treat kidney stones. A special instrument called a ureteroscope (a long, thin tube with a light and camera) is guided through the urethra and the bladder and up the ureter to where the kidney stone is located. Small stones can be removed whole, while larger stones need to be broken up. The procedure used to break up the stones is called lithotripsy.

Lithotripsy

Lithotripsy is a urology procedure that uses shock waves or a laser to break down stones in the kidney, bladder, or ureter. The laser or shock waves break up large stones so that they can pass through the urinary system.

Orchiopexy

Orchiopexy is a surgical procedure performed to repair an undescended testicle. During the procedure, the testicle is moved from the abdomen or groin area and into the scrotum. Then it is attached to the scrotum with a “tacking stitch.”

Penile Plication

Penile plication is a surgical urology procedure that is used to treat curvature of the penis caused by Peyronie’s disease. It is an outpatient procedure in which permanent sutures are placed on the opposite side of the scarring that causes the curvature.

Penile Implants & Prosthesis

Penile implants or prostheses are devices placed inside the penis to allow men with erectile dysfunction (ED) to get an erection. These devices are usually only recommended after other ED treatments fail. For instance, a penile prosthesis may be recommended for men with severe Peyronie’s disease who cannot get an erection due to the curvature of the penis.

Male circumcision

Circumcision is a surgical procedure in which the skin covering the tip of the penis (foreskin) is removed. It is a procedure commonly performed on newborn boys in different places around the world.

What does a urologist do?

A urologist can diagnose and treat many kinds of issues. Some urologists might practice without doing surgery, but all urologists are trained as surgeons.

There are subspecialties in urology, including:

  • Pediatric urology.
  • Urologic oncology.
  • Kidney transplantation.
  • Sexual medicine.
  • Male infertility.
  • Genitourinary reconstruction.
  • Minimally invasive surgery (robotic, laparoscopic and endoscopic surgery).