What is a urologist? What do urologists do?
by Nhan Nguyen Nam Chaga A urologist is a physician who specializes in diseases of the
urinary tract and the male reproductive system. This can include
diseases affecting the bladder, urethra, Mất ngủ là biểu hiện của bệnh gì
ureters, kidneys, and adrenal glands, along with the epididymis, penis,
prostate, seminal vesicles and testes specifically in men.1
Urology
is commonly regarded as a surgical specialty. There are a wide variety
of different procedures that urologists carry out, such is the scope of
urology as a field.
In 2013, there were an estimated 9,500 urologists in the US. This number has been projected to fall to 7,500 by 2020. It is considered to be an aging specialty; in 2012, 44% of urologists were aged above 55, 18% were aged above 65, and 8% were aged above 70.2
In a 2012 survey of 29,025 physicians representing 25 different medical specialties, however, urologists were found to be the third happiest with their lives outside of work, chua benh mat ngu cho nguoi gia behind physicians practicing rheumatology and dermatology. Urologists reported an average happiness rating of 4.04 on a scale of 1-5, with 1 meaning "very unhappy" and 5 meaning "very happy."3
Contents of this article:
What is urology?
Urologist qualifications
Common conditions treated
Common procedures performed
When to see a urologist
What is urology?4,5
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.
The American Urological Association (AUA) have identified seven subspecialties that comprise the field of urology:
view of male urogenital anatomy
Urologists treat conditions that affect the urinary tract in men and women, as well as the male reproductive system.
Calculi: the management of stones that form within the kidneys and move into the ureters.
Female urology: pelvic outlet relaxation disorders and urinary incontinence.
Male infertility: primarily surgical correction of acquired and congenital obstructions within the male genitals.
Neurourology: includes erectile dysfunction and impotence, urodynamic evaluation of patients and voiding disorders.
Pediatric urology: treatment of urological chua benh mat ngu cho nguoi trung nien problems within children that are too complex for non-specialized pediatricians or urologists.
Renal transplantation: kidney transplants may be required following kidney failure.
Urologic oncology: treatment of cancers such as bladder cancer and prostate cancer.
Urology
is a constantly changing specialty, primarily due to advances made to
technology. Refinements to endoscopic procedures and the utilization of
the surgical microscope have greatly increased urologists' options.
Laparoscopic surgery and chemotherapy are altering how treatment is
administered, and laser therapy promises to become an important part of
future urologic practice.
Urologist qualifications1
To become a urologist in the US, candidates will graduate from an approved medical school and complete a urology residency program that takes a minimum of 5 years to complete, accredited by the Accreditation Council for Graduate Medical Education (ACGME).
During this residency program, 1 year must be spent in general surgery and 3 years must be spent in clinical urology. A minimum of 6 months can be allocated to general surgery, urology or another discipline that is relevant to the study of urology. During the final year of training, candidates will be posted as a senior/chief resident in urology, being given supervised clinical responsibility.
Surgeons may apply for certification from the
American Board of Urology (ABU) following the completion of their
graduation. In order to attain certification, they must complete and
pass a qualifying examination and a certifying examination.
Common conditions treated6
The following list of conditions are commonly treated by urologists. Please note that this list is by no means exhaustive:
picture of kidney stones post-lithotripsy
Kidney stones are hard deposits found in the kidneys and ureters, comprised of mineral and acid salt deposits.
Bladder prolapse: when the tissues and muscles of the pelvic floor are
no longer able to support the organs in the pelvis, the organs can drop
from their usual position. As well as the bladder, this can affect the
urethra, rectum, cervix, vagina and uterus. This condition is more
common in women than men, and crosses over into the field of gynecology
and a further subspecialty called urogynecology.7
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.8
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.10
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.11
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.12
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.13
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.14
Kidney and
ureteral stones: small, hard deposits made from mineral and acid salts
form in the kidneys but can pass through into the ureters.14 Stones can
affect urination and cause pain, nausea and vomiting.16
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.17
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.18
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.19
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.20
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.21
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