“We rarely find that the name and designation of a branch of medicine bears as little relation to its content, concept, and extent, as is the case in urology. For the original meaning of the word urology gives no inkling that it applies to one of the most important special fields of medicine.”
-Dr. Max Neuburger
The field of urology has existed in one form or another for thousands of years. Early on, the “field” was primarily defined by (and was named after) the process of examining the urine to detect abnormal qualities. The practice, known as uroscopy, was used by physicians as far back as the ancient Egyptians to infer from urine color and contents the state of a person’s overall bodily health.
In modern times, however, urology has become defined as the branch of medicine that deals with diseases of the male and female urinary tract system and the male reproductive system. Practitioners are known as urologists, and they have specialized training in the function of related organs such as the adrenal glands, kidneys, ureters, urethra, bladder, and the male reproductive organs.
Due to their proximity to other important body systems, a urologist’s focus on the urinary and reproductive systems (together referred to as the genitourinary system) often requires close collaboration with other medical disciplines like gastroenterology, gynecology, and nephrology. This cross-discipline collaboration requires a multidimensional skillset for would-be urologists, and for this reason, the training is quite extensive.
What Kind of Training Does a Urologist Have?
As with every other branch of medicine, those seeking to become urologists typically start by completing undergraduate education, usually majoring in a pre-med program or biological science. From there, students move on to medical school; these programs are typically four years and include a variety of classroom and hands-on clinical training. Medical schools are highly competitive, and thus only the best and brightest are able to make it all the way through to graduation.
Usually, in the final year of medical school, students begin to contemplate their specialty. With well over 100 specialties and subspecialties available for further study, students have an overwhelming number of options to consider. Once they have compiled their list of preferences, those lists are fed into a computer system and a mathematical algorithm matches students with specialty programs all over the country.
This matching process is called the National Resident Matching Program (NRMP), and its purpose is to match qualified candidates with appropriate programs. Urologists have a unique path amongst all the specialties because their matching procedure is independently run by the American Urological Association (AUA).
Once medical school graduates are matched with a urology specialty program, their residency program can be from three to seven years long. During this time they are given extensive, supervised, hands-on training that is necessary to become licensed and certified by the American Board of Urology (ABU). This training includes working alongside experienced urologists in a variety of healthcare settings; the primary goal is to expose the new doctors to as much real-life experience as possible.
The urologists who have become licensed and board-certified, after making their way through the gauntlet of vigorous training, coursework, and long hours of practicing techniques, are finally able to find coveted positions in hospitals or medical practices. Licensing is handled on a state-by-state basis, so a doctor can only practice in a state where he or she has been licensed. Moreover, specialty boards like the ABU require regular recertification and continuing education in order to ensure that each urologist is continually up to speed on new procedures.
Why Would You See a Urologist?
Knowing that your doctor has been through such an elaborate and sophisticated education and training process is comforting for most patients. This seems particularly true in the field of urology, where the potential conditions are usually related to organs that people feel especially sensitive about.
Some of the common reasons you might need to see a urologist include:
- Urinary Tract Infections (UTIs): Mostly affecting women, UTIs are bacterial infections of the urinary system. The majority of infections affect the lower urinary tract, which involves the bladder and urethra.
- Kidney Disease: Also known as renal disease or nephropathy, this condition involves damage to the kidneys or loss of function due to disease. It is the importance of the kidneys in the formation of urine that makes kidney disease a condition regularly treated by urologists.
- Kidney Transplants: Renal failure that stems from kidney disease will require a kidney transplant.
- Ureteral or Kidney Stones: Sometimes small deposits of mineral and acid salts can form in the kidneys; when they pass through the ureters, it can cause tremendous pain as well as nausea and vomiting.
- Urinary Incontinence: The loss of bladder control that can arise from numerous underlying conditions. For women, this can occur during pregnancy if the pelvic muscles become weak.
- Bladder Prolapse: This can also occur when the pelvic muscles weaken; in this case, the pelvic organs sink down from their normal positions.
- Interstitial Cystitis: Also known as painful bladder syndrome, this is a chronic condition that involves the painful inflammation of the bladder.
- Kidney Cancer: Various cancers of the kidneys, bladder, or the male reproductive system.
- Urethral Stricture: Sometimes when the urinary tract has been infected or injured, the urethra can become scarred; when this happens, the narrowed urethra can negatively affect the passage of urine from the bladder, causing painful urination.
There are also a variety of possible conditions that only affect men:
- Infertility: Male infertility can arise because of damage to the reproductive tract or any number of other problems with sperm.
- Erectile Dysfunction: Often a symptom of an underlying medical problem, this condition is defined by an inability of the penis to become sufficiently rigid in order to engage in sexual intercourse.
- Enlarged Prostate: Technically referred to as benign prostatic hyperplasia (BPH), this condition routinely affects men over 50 years old. The prostate gland grows too large and causes the urethra to constrict; this, in turn, results in urination problems.
- Prostatitis: Also involving the prostate gland, this condition occurs when the prostate becomes inflamed or infected.
- Undescended Testes: An undescended testicle is almost always a condition which affects infant boys; the testes normally descend right before birth, but in some boys, one testicle remains outside the scrotum.
- Peyronie’s Disease: This connective tissue disorder involves the growth of scar tissue under the skin of the penis; this often causes abnormal curving of the penis and can lead to painful erections and difficulties participating in sexual intercourse.
What Treatments Can a Urologist Offer?
Urologists have a wide range of treatment options at their disposal. Apart from prescribing medications to treat particular urologic conditions, there are several common diagnostic and therapeutic procedures that might be used in an office visit:
- Ureteroscopy: An examination with a type of endoscope used to look inside the ureters and kidneys.
- Cystoscopy: Similar to ureteroscopy but with a focus on the bladder and urethra.
- Vasectomy: A surgical procedure used to render a male infertile; involves the tying off of the vas deferens in order to prevent the passage of sperm.
- Prostate Biopsy: For men with enlarged prostates, this diagnostic procedure removes a small tissue sample to determine whether or not the patient has prostate cancer.
- Nephrectomy: The surgical removal of a kidney, usually due to the presence of cancer.
What Can I Expect in a Visit?
An initial appointment with a urologist is unlikely to be significantly different from a typical visit to a primary care physician. The urologist will inquire about your relevant health information: your medical history, your family’s health history, and your current medications. A physical exam will then allow the doctor to determine what further steps are necessary. Urologists are dedicated healthcare providers that had to go through extensive study and training.
If you’re looking for a clinic with qualified professionals who are passionate about providing excellent urology care, contact the Mississippi Urology Clinic today to make an appointment.