Why and When You Might Want to See a Urologist

Andrew Siegel MD 12/18/2021

The urologists in our group:
Standing: Andrew Siegel, Vince Lanteri, Marty Goldstein, Chris Wright, Mutahar Ahmed 
Sitting: Mike Esposito, Greg Lovallo, Tom Christiano

Photo taken before our recent merger and hiring of our newest urologist, so missing are Dr. Daniel Lowe, Dr. Christine White-Cumarasamy, and Dr. Mubashir Shabil Billah

“Urology” (uro—urinary tract; logos—study of) is the branch of medicine that diagnoses and treats diseases of the urinary tract in males and females and the reproductive tract in males. The urinary organs under the domain of urology include the kidneys, the ureters (tubes connecting kidneys to urinary bladder), the urinary bladder, and the urethra (channel that conducts urine out from bladder).  These body parts are responsible for the production, storage and release of urine. The male reproductive organs that a urologist cares for are the testes, epididymis (structure above and behind the testicle where sperm mature and are stored), vas deferens (sperm ducts), seminal vesicles (structures that produce the bulk of semen), prostate gland, 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” surgeons.

Urology is a balanced specialty– we treat men and women and 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 are entering the urology workforce.

It takes extensive training to become a urologist.  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 training in pelvic medicine and reconstructive urology.  I started practicing at age 33.

Board certification 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. Every urologist in our New Jersey Urology practice is either board-certified or board-eligible.  Some, like myself, are double board-certified (in my case in general urology and pelvic medicine/reconstructive urology).

Urology is on the cutting edge of surgical advancements (no pun intended) with continued evolution into improved and less invasive techniques.  Urologists have at their disposal a host of minimally invasive technologies including fiber-optic scopes to view the entirety of the inside of the urinary tract, as well as ultrasound, lasers, laparoscopy and robotics. As a result, many procedures that used to be done on an inpatient basis are now performed on an outpatient basis.

New Jersey Urology has been at the forefront of robotic-assisted laparoscopic surgery that has largely replaced open surgery.  The urologist with a dedicated team of assistants harnesses the powers of the robot, an extraordinary example of human-machine symbiosis.  It affords numerous advantages including high quality 3D vision, motion scaling (the conversion of the surgeon’s large hand movements into smaller movements of the surgical instruments in the operative field) and enhancement of surgeon dexterity, which translates to numerous benefits and advantages to the patient.  Our practice (New Jersey Urology Maywood/Teaneck/Hackensack/Wallington) has the largest experience in robotic urology procedures in New Jersey, particularly cancer and reconstructive urological surgery. Single-port access– even more minimally-invasive than the conventional multi-port robotic technology– is the latest iteration and evolution and our practice has the largest clinical experience with this in the Northeastern United States. 

Clinical research is a vital part of urology and New Jersey Urology has numerous ongoing clinical trials in prostate cancer, bladder cancer, benign prostate hypertrophy, and overactive bladder.  Dr. Elan Diamond is a medical oncologist and the medical director of clinical research and the Center for Advanced Prostate Cancer Therapeutics that offers novel medications and immunotherapies in our Saddle Brook office. Radiation oncology is a key component of the treatment of many urological cancers and is provided in our Saddle Brook office with the department directed by radiation oncologist Dr. Glen Gejerman.

Urologists use genomic science to determine the molecular blueprint of cancers, the key to assessing their biological potential. Determining a cancer’s unique genetic profile provides the potential for “precision medicine,” individualized and customized treatment strategies with agents targeted against the specific mutations, a treatment based upon cancer biology and no longer only cancer histology.                                                                                                                               Although urology is a unique specialty, there is some overlap with other medical and surgical disciplines, including nephrology (specialists in medical diseases of the kidney); oncology (medical cancer specialists); radiation oncologists (radiation cancer specialists); radiology (imaging specialists); gynecology (female specialists); endocrinology (hormone specialists); and infectious disease (infection specialists).

Urologists are the male counterparts to gynecologists and the go-to physicians when it comes to expertise in male pelvic health.  Common reasons for referral to a urologist include: blood in the urine (whether visible or found on a urine test); an elevated 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).  Sexual dysfunction is a routine condition managed by the urologist—including erectile dysfunction, ejaculation problems, and testosterone issues. Urologists treat not only male infertility, but also create male infertility when it is desired by performing voluntary male sterilization (vasectomy). Testicular pain and swelling are the domain of urologists. 

Although gynecologists treat only females, urologists care for both genders. Providing healthcare to females is a routine part of urology and commonly treated female issues include recurrent urinary infections, urinary incontinence (stress incontinence and overactive bladder) and pelvic organ prolapse.

Urological surgery involves operating on patients with potentially life-threatening illnesses. Cancers of the genital and urinary tracts are common and a major part of urological practice.  These include prostate cancer, bladder cancer, and cancer of the kidney and renal pelvis (the inner part of the kidney that collects the urine).  Women with kidney and bladder cancer are also managed by urologists, although the prevalence of these cancers is much less in females. Urologists are the specialists who treat testicular, penile, and adrenal cancer.  After definitive urological cancer care, urologists provide the aftercare and necessary follow-up.

A large component of urology practice is the management of infections that may involve the bladder, kidneys, prostate, testicles and epididymis. Kidney stones are another key issue that keep urologists busy. To manage stones that fail to pass spontaneously, urologists have at their disposal minimally invasive outpatient techniques with new generation shockwave devices and miniaturized fiberoptic telescopes with laser technology.

When does one need urological care?  Although many of our patients are referred by their primary care physicians, others directly seek our care. Common reasons for visits include blood in the urine or semen, kidney stones, difficulty in emptying one’s bladder, urinary control issues, pelvic organ prolapse, frequent urination, urinary and sexually transmitted infections, elevated PSA, abnormal prostate exam, erectile and ejaculation issues, infertility and vasectomy consultations.

Men age 40 and older who have a life expectancy of 10 years or greater should be screened for prostate cancer, the most common male cancer (aside from skin cancer), whether the screening is done by their primary care physician or urologist. Screening is vital since prostate cancer does not cause symptoms until it progresses to advanced stages and screening aims to detect prostate cancer in its earliest and most curable states. Screening is as simple as an annual digital rectal examination and a PSA blood test.

Wishing you the best of health,

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro AreaInside 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. He is a urologist at New Jersey Urology, the largest urology practice in the United States.  He is the co-founder of PelvicRx and Private Gym.  His latest book is Prostate Cancer 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families. 

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Video trailer for Prostate Cancer 20/20

Preview of Prostate Cancer 20/20

Andrew Siegel MD Amazon author page

PROSTATE CANCER 20/20 is now available at Audible, iTunes and Amazon as an audiobook read by the author (just over 6 hours). 

Dr. Siegel’s other books:

FINDING YOUR OWN FOUNTAIN OF YOUTH: The Essential Guide to Maximizing Health, Wellness, Fitness and Longevity

PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food

MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health

THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health


2 Responses to “Why and When You Might Want to See a Urologist”

  1. Dennis Zambito Says:

    My experience has been first with Dr. Siegel , then with Dr. Lovallo.
    I could not be in better hands. I am truly blessed.

    Dennis Zambito

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