Overview

The urinary system performs several significant roles, including managing, regulating, and eliminating urine wastes. Just like the other body organs and systems, the urinary system is also susceptible to a range of problems. Regardless of gender, age, and lifestyle, everyone can suffer from acute to chronic disorders. 

Luckily urology is a specialized medical branch that helps with conditions of the urinary system. It deals with the functionality of the system and associated organs in both males and females. It also provides various treatment options, including surgical procedures, to address the conditions and ease associated symptoms. 

What is Urology?

Urology is a branch of medical science concerned with the study of the diseases of the male and the female urinary tract. The urinary tract is made up of the kidneys, bladder, urethra, and ureter. Besides, urology deals with the male reproductive organs, including the penis, testes, epididymis, seminal vesicles, vas deferens, and prostate. 

The urinary tract's main components are the kidneys, ureters, and bladder. The urinary tract is your body's pee drainage system. Urine is a waste and water mixture. All bodily components in the urinary tract must function together for urination to occur regularly and without difficulties.

Urologists thus are medical professionals who diagnose and cure urinary tract disorders in either men or women. They usually operate in different settings, such as general hospitals, urology centers, and private facilities or clinics. Sometimes, urologists conduct surgical operations to remove cancer or treat a blockage in the urinary tract. 

Urology Subspecialties 

Urology is a medical and surgical specialty that deals with genitourinary tract and adrenal gland problems. Specialists in this field must have knowledge, ability, and comprehension of the basic medical sciences related to the genitourinary tract and the adrenal glands.

Urology is typically a wide field that deals with a range of disorders of the kidneys, bladder, urethra, and ureter. As such, it’s further categorized into several subspecialties, including; 

Urologic Oncology

It’s concerned with cancer of the urinary system such as the prostate, kidneys, testicles, adrenal glands, penis, and the bladder. 

Neurourology

 It’s concerned with the treatment and management of various disorders affecting the genitourinary system's nerve control or causing abnormal urination. The neurological disorders that may cause these conditions are multiple sclerosis, spinal cord injuries, Parkinson’s disease, and stroke. 

Pediatric Urology

Deals with treatment and management of urinary disorders in infants, young children, and young adults. It includes undescended testicles, vesicoureteral reflux, and underdeveloped genitalia. 

Female and Reconstructive Urology

Deals with diagnosis and treatment of the conditions affecting the reproductive system and the urinary tract in women. It also deals with neurological conditions, including multiple sclerosis and spine injury in both males and females.

Male Infertility

Focuses on the illness that inhibit men from conceiving a child with the partner 

Male infertility is most commonly caused by issues in producing healthy sperm. Sperm that is immature, irregularly shaped, or unable to swim are all possibilities. You may not have enough sperm in various instances. Alternatively, you might not be able to produce any sperm. Many distinct circumstances might cause this issue, including:

• Infections or inflammatory diseases are also possible causes. Infection with the mumps virus after puberty is one case.
• Problems with the pituitary gland or hormones
• Immune disorders in which antibodies are produced against your own sperm
• Environmental and behavioral variables are both important. Tobacco usage, severe alcohol use, marijuana or steroid use, or exposure to pollutants are all examples.
• Cystic fibrosis and hemochromatosis are examples of genetic illnesses.

Endourology

 It deals with bladder, kidney, and prostate disorders using minimally invasive surgical procedures. These procedures are normally done using an endoscope, which is inserted through the urinary tract. Examples of such procedures are stone removal surgery, prostate surgery, or simple urethral surgical operation. 

• Procedures

Endourology differs from standard urology in that all treatments are performed inside, without the need for large incisions. Endourology is sometimes known as laparoscopic surgery or minimally invasive urologic surgery.

Small kidney stones, for example, can be located and removed using endourology. Small devices put into the body through the urethra, bladder, ureter, and kidney can be used to remove or fracture stones. In addition to therapy, doctors can assist in determining the cause of kidney stones and identifying measures to prevent new stones from developing. Lasers, graspers, micro stone retrieval baskets, specific scalpels, and cautery are examples of thin, flexible equipment that can be used to do surgery without making any incisions. Almost all endoscopic treatments may be performed as an outpatient procedure.

Endourological procedures include:

• Urethroscopy is a procedure that is used to treat urethral strictures or obstructions.

• Cystoscopy is a procedure that is used to treat bladder stones and tumors. This method can also be used to remove obstructive prostate tissue (a treatment known as "TURP"). Stents are flexible plastic tubes that may be passed up the ureter using cystoscopy and x-rays to alleviate ureter obstruction.

• Ureteroscopy is a procedure that is used to treat ureter stones and malignancies.
• Nephroscopy is a procedure that is used to treat kidney stones and malignancies.

Andrology

This sub-branch is concerned with the health issues of the male reproductive system. It includes ejaculation disorders, vasectomy reversal, erectile malfunction, and infertility. 

Urologic Health Conditions 

There are various conditions that affect the urinary system and the reproductive system in the male. Generally, women, men, and children are susceptible to a range of urology problems such as; 

• Cancer: The kidney, bladder, adrenal glands, testicles, and prostate glands are prone to cancer. This condition can highly affect the urinary system and sometimes the reproductive system in men. 
• Bladder prolapse: Occurs when the pelvic floor's muscles and tissues fail to support the pelvis organs. This makes the bladder and other organs to droops out of the normal position. 
• Kidney and ureteral stones: Occur when small hard deposits of acid salt and minerals develop on the kidneys and moves to the ureters. This usually alters urination and causes severe pain. 
• Interstitial cystitis: This condition is also known as painful bladder syndrome. It’s a severe inflammatory bladder disorder that causes mild to chronic pain and discomfort. 
• Urinary incontinence: This is a malfunction of the urinary system that causes involuntary loss of bladder control. This disorder can weaken the muscles of the pelvic floor, especially for pregnant women. 
• Urinary tract infections (UTIs): Affects both men and women. It mainly develops when the bacteria move from the digestive tract towards the urethra, causing abnormal urination, incontinence, and pain. 
• Prostate gland enlargement: This is a condition that affects most men who are 50 years and above. It occurs when cell overgrowth in the prostate glands constricts the urethra, causing urination problems. 
• Erection disorders: This is a male disorder that occurs when the penis cannot get or maintain an erection during sexual intercourse. Erection dysfunction can sometimes indicate an underlying condition. 
• Prostatitis: This is an infection or inflammation of the prostate gland that causes pain when ejaculating and urinating. Prostatitis is either a mild or a chronic condition affecting men. 
• Varicoceles: This is an enlargement of the veins of the scrotum. It occurs due to non-functional or poorly functioning valves located in the veins or sometimes vein compression by the surrounding structure. 
• Male infertility: This occurs when the male reproductive tract is damaged or if you have sperm disorders. Varicocele is the main cause of male infertility (an enlargement of the vein in the sac below the penis).
• Kidney diseases: This is chronic damage to the kidneys that causes swelling in the ankles or hands and high blood pressure. 
• Undescended testicles: This is where the testicles form and develop in the fetus's abdomen and descend to the scrotum before delivery. This alters sperm production and can also trigger other health complications or risks. 

Signs and Symptoms of a Urologic Disorder 

The primary care doctor can address mild urological health concerns. However, he or she can refer you to a professional urologist if the condition is more intense and the symptoms don’t show any sign of improvement. 

Some of these symptoms that may indicate a severe urologic condition include;

• Frequent urge to urinate 
• Blood in the urine 
• Pain and burning when urinating 
• Mild to chronic pain in the lower back, the pelvis, or sometimes both 
• Difficulty passing out urine 
• Weak flow of urine 
• Urine leakage 
• Lump in the testicle 
• Decreased sexual desire in men 

What you can expect during your visit to a urologist?

When you schedule an appointment with a urologist or your primary care provider refers you to one, be prepared to explain why you're there. It may be beneficial for you to bring a list of questions or symptoms relating to the reason for your consultation. You should also be prepared to answer questions about your medical history and current drugs.

Your urologist will most likely prescribe tests to identify your illness and establish the best course of treatment for you.

Some of these tests may include:

• Examination of the body. These will differ between men and women. If you are a guy, your doctor may do a rectal exam on you. A pelvic exam may be required if you are a woman.
• Urinalysis, blood tests, and sperm samples are all required. You must give urine, blood, and sperm samples for these examinations. (You should drink some water before going to your appointment since you may be requested to provide a urine sample.)
• Ultrasound or computed tomography (CT) scans are examples of imaging testing.

Urology Treatment Procedures 

Urologists are trained to assess and treat a wide range of urologic conditions. They are responsible for performing a range of urology procedures to determine and cure complex urologic disorders. Some of the common procedures include; 

• Vasectomy 

Vasectomy is the most common procedure among the male. It’s a surgery used as permanent birth control in men. 

Vasectomy is typically a brief procedure that usually takes 10 to 30 minutes. It involves cutting the sperm supply to the urethra by cutting or disconnecting the vas deferens and sealing them. Vas deferens is a vessel that transports sperms from the testicles. 

• Vasectomy reversal procedure 

Vasectomy reversal procedure is designed for men who had a vasectomy but want to get the partner pregnant. It involves reconnecting the vas deferens tubes transporting sperms from the testicles towards the urethra. 

• Prostate procedures 

Urologists often conduct several diagnostic procedures to treat and manage prostate conditions. These procedures include;

• Biopsy: This is a procedure conducted to extract samples of prostate tissues for more testing and examination in the laboratory. 
• Transurethral resection of the prostate (TURP): This is a minimally invasive procedure that utilizes a tool known as a resectoscope. It trims and seals the prostate tissue in a situation where the prostate gland is enlarged and poses difficulties when urinating. 
• Transurethral needle ablation (TUNA): Involves the use of radiofrequency ablation to shrink the prostate tissue pressing the urethra and triggering urinary symptoms. 
• Transurethral incision of the prostate (TUIP): This is a procedure to address benign prostatic hyperplasia using an endoscope inserted into the urethra. 
• UroLift: This is a minimally invasive procedure to treat and manage mild and moderate prostate gland enlargement. 
• Ureteroscopy 

This is a procedure to diagnose and address kidney stones. It involves the use of a specialized tool known as a ureteroscope. This is a long tiny tube attached to a camera and light. Ureteroscope is usually guided via the urethra, bladder, and ureter to the area where kidney stones are situated. 

Urologists can remove the small stones as a whole; however, large stones have to be broken first before extraction. 

• Cystoscopy 

This is a procedure that urologists use to check the linings of the urethra and bladder and diagnose or treat conditions. It’s done by inserting a special instrument known as the cystoscope into the urethra and guiding it to the bladder. A cystoscope is a long tiny tube that has a light and a small camera at the tip. 

• Lithotripsy

Lithotripsy involves using a laser or shock waves to break down large stones in the bladder, ureter, or kidney. This enables the stones to pass through the urinary system easily. 

Difference between urology and nephrology

Make an appointment with a nephrologist if you wish to visit a specialist who solely specializes on kidneys. Nephrology is a specialization, however it is one of internal medicine rather than urology. That is, nephrologists are not surgeons. Nephrologists must also be able to handle illnesses that occur elsewhere in the body and cause or are caused by renal disorders, such as excessive blood pressure. Urologists, on the other hand, are surgical specialists.

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.

Conclusion 

Urology is a medical field concerned with diagnosing and treating problems affecting the male and female urinary tract. It’s also concerned with male reproductive organs, the functions, and conditions that often affect these organs.