Andrew Siegel MD 8/5/17
I am a second-generation urologist. It is unlikely that there will be a third-generation urologist as my oldest child is a film-maker, my middle child works in tech marketing and my youngest is off to college later this month, intent on becoming a child psychologist. After she spent a day in the office with me, she told me that the experience caused her to have post-traumatic stress disorder!
As a youngster, I attended summer camp in New Hampshire at Camp Moosilauke . My friends made fun of my father’s profession, referring to him as a “pecker checker.” Today’s entry is a brief review of what urology really is and what urologists do for a living. One thing is for sure…sooner or later most everyone will need the service of a urologist.
“Urology” (uro—urinary tract and logos—study of) is the branch of medicine that deals with the diagnosis and treatment of diseases of the urinary tract in males and females and of the reproductive tract in males. The urinary organs under the “domain” of urology include the kidneys, the ureters (tubes connecting the kidneys to the urinary bladder), the urinary bladder, and the urethra (channel that conducts urine from the bladder to the outside). These body parts are responsible for the production, storage and release of urine.
The male reproductive organs under the “domain” of urology include the testes, epididymis (structures above and behind the testicle where sperm mature and are stored), vas deferens (sperm duct), seminal vesicles (structures that produce the bulk of semen), prostate gland and, of course, the scrotum and penis. These body parts are responsible for the production, storage and release of reproductive fluids. The reproductive and urinary tracts are closely connected, and disorders of one oftentimes affect the other…thus urologists are referred to as “genitourinary” specialists.
Urology is a balanced specialty– urologists treat men and women, young and old, from pediatric to geriatric. Whereas most physicians are either medical doctors or surgeons, a urologist is both, with time divided between a busy office practice and the operating room. Although most urologists are men, more and more women than every before have been entering the urological workforce.
Factoid: My pathway to urology was 4 years of college, 4 years of medical school, 2 years of general surgery residency, 4 years of urology residency and 1 year of specialty fellowship in pelvic medicine and reconstructive urology. I started practicing at age 33.
Factoid: Becoming board certified is the equivalent of a lawyer passing the bar exam. There are three possible board certifications in urology: general urology, pediatric urology, and female pelvic medicine and reconstructive surgery. Thereafter, one must maintain board certification by participating in continuing medical education and pass a recertification exam every ten years. I am dually certified in general urology as well as female pelvic medicine. The common problems I take care of in my female pelvic medicine practice are urinary incontinence (stress urinary incontinence and overactive bladder), pelvic organ prolapse and recurrent urinary tract infections.
Urologists are the male counterparts to gynecologists and the go-to physicians when it comes to expertise in male pelvic health. Urological surgery involves operating on patients with potentially life-threatening illnesses, particularly cancers of the genital and urinary tracts. In terms of new cancer cases per year in American men, prostate cancer is number one accounting for almost 30% of cases; bladder cancer is number four accounting for 6% of cases; and cancer of the kidney and renal pelvis (the inner part of the kidney that collects the urine) is number six accounting for 5% of cases. Urologists are also the specialists who treat testicular cancer. Urologists also treat women with kidney and bladder cancer, although the prevalence of these cancers is much less in women than in males.
Urology has always been on the cutting edge of surgical advancements (no pun intended) and urologists use minimally invasive technologies including fiber-optic scopes to view the entire inside of the urinary tract, as well as ultrasound, lasers, laparoscopy and robotics. There is overlap in what urologists do with other medical and surgical disciplines, including nephrology (doctors who specialize in medical diseases of the kidney); oncology (medical cancer specialists); radiation oncologists (radiation cancer specialists); radiology (imaging); gynecology (female specialists); and endocrinology (hormone specialists).
Common reasons for a referral to a urologist include: blood in the urine, whether it is visible or picked up on a urine test; an elevated or an accelerated PSA (Prostate Specific Antigen); prostate enlargement; irregularities of the prostate on digital rectal examination; and urinary difficulties ranging the gamut from urinary leakage to the inability to urinate (urinary retention).
Urologists manage a variety of other issues. Kidney stones, which can be extraordinarily painful, keep us very busy, especially during the hot summer months when dehydration is more common. Infections are a large part of our practice and can involve the bladder, kidneys, prostate, testicles and epididymis. Sexual dysfunction is a very common condition that occupies much of the time of the urologist—under this category are problems with obtaining and maintaining an erection, problems of ejaculation, and testosterone issues. Urologists treat not only male infertility, but also create male infertility when it is desired by performing voluntary male sterilization (vasectomy). Urologists are responsible for caring for scrotal issues including testicular pain and swelling. Many referrals are made to urologists for blood in the semen.
Wishing you the best of health,
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Dr. Andrew Siegel is a practicing physician and urological surgeon board-certified in urology as well as in female pelvic medicine and reconstructive surgery. Dr. Siegel serves as Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community that is in such dire need of bridging.
Author of MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health
Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health
Amazon page for Dr. Siegel’s books
Tags: Andrew Siegel MD, genital system, reproductive system, urinary system, urologist, urology
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