Narayana Health Care

• What does a urologist do?

Urology is the field of medicine that is associated with the diseases and disorders of the male and female urinary tract. Urologists are doctors who specialize in the treatment of diseases and conditions affecting the urinary system, including the bladder, kidney, ureter, urethra, and adrenal glands. In men, they treat all ailments concerning the penis, prostate, epididymis, seminal vesicles, and the testes.

They also perform surgeries if needed to remove cancer or a blockage in the urinary tract.

• When should you consult a urologist?

You can consult a urologist for all mild urinary problems like urinary tract infections (UTI) to severe ailments like cancer. In most cases, your primary doctor refers you to a urologist if your symptoms persist for long durations or don’t improve.

Symptoms of Urological Problems

Below mentioned is a list of symptoms that indicate that you have a problem in the urinary tract and need to visit a urologist.

• Presence of blood in the urine, a condition also called hematuria
• A recurring need to urinate urgently
• Burning sensation or pain during urination
• Difficulty urinating
• If you experience pain in your lower back, pelvis, or sides
• Urine leakage
• Weak urine flow, dribbling

If you are a man and have the following symptoms, you must visit a urologist.

• A decrease in sexual desires
• A lump in one of the testicles
• Trouble getting and keeping an erection

• What to expect from your consultation?

Usually, the urologist will have notes regarding your condition from the referring doctor, but they will still do an examination of the patient’s medical history and conduct a physical examination. Some of the tests your urologist might perform are:

• The first thing to do is to locate the problem. It is done by imaging tests like MRI scans, ultrasound, or CT scans.
• Cystoscopy, a medical imaging procedure that enables your doctor to examine the inside of the urinary tract by a cystoscope. The cystoscopy can also be used to collect tissue samples for testing.
• A basic urine test to check for the presence of bacteria or other signs of disease.
• Biopsy
• Urodynamic testing to determine how fast urine leaves the body, the amount of urine that stays in the bladder after urinating, and the pressure in the bladder.

After the diagnosis, different treatment methods can be employed depending on the condition. It can be medical management and surgery, as well. Your urologist will prescribe the following medications for treatment.

• Antibiotics to treat infections
• Hormone treatment for prostate cancer
• Drugs to act on the smooth muscle of the bladder for urinary incontinence
• Chemotherapy drugs for cancer
• PDE5 inhibitors like Cialis or Tadalafil for erectile dysfunction

The surgical treatments that may be performed are open surgery, laparoscopic, and laser therapy. Surgical procedures are carried out to remove tumors, kidney stones, parts of the kidney, strictures in the urethra, and kidney transplant. Urologists are also responsible for carrying out vasectomy, a surgical procedure for permanent contraception in men.

Common diseases treated by a urologist

There are many urologic diseases and disorders that urologists treat. These diseases can affect anyone, regardless of age. Generally, urologic diseases affect the urinary tract and reproductive organs in males, and the urinary tract in females.

In men, urologists treat:

• Cancers of the prostate, kidneys, bladder, penis, testicles, and adrenal glands
• Enlarged prostate gland or prostatitis
• Erectile dysfunction
• Infertility
• Painful bladder syndrome or interstitial cystitis
• Kidney diseases and kidney stones
• Urinary tract infections (UTIs)
• Varicoceles, or enlarged veins in the scrotum
• Peyronie’s disease – In this disease, a fibrous layer of scar tissue forms under the skin of the penis leading to bending or curving of the organ.

Some conditions specific to women that urologists treat are:

• Bladder prolapse, a condition in which the bladder bulges into the vagina. It occurs when the supportive tissue between the bladder and vaginal wall weakens and stretches.
• Cancers of the bladder, kidneys, and adrenal glands
• Urinary incontinence. Though the condition affects both genders, it is more common among women.
• It is another condition that women are more prone to developing. UTIs are infections that can affect any part of the urinary system, such as the bladder, kidneys, or the urethra.

Other common conditions include interstitial cystitis, kidney stones, and overactive bladder.

In the case of children, urologists treat bed-wetting, undescended testicles, blockages, and other issues with the urinary tract.

• How to find the right urologist?

In most cases, your primary care doctor will refer you to a good urologist. A good urologist will treat the disease as well as guide you through what needs to be done to ensure a healthy urinary tract. Therefore, you must find the one who’s best for you. Here are some factors that you need to consider.

1) Start with getting referrals

Your primary care doctor will refer you to a urologist depending on your condition. They should be able to inform you about the best urologists in your area or someone they have previously known and worked with. Besides, talking to your family and friends about it can be helpful as well. Having a lot of recommendations can help you decide which one will fit you right.

2) Find out about their credentials

Once you have prepared a list of urologists, you must try to research about them. Find out about their experience and skills. A vital factor to consider before selecting any urologist is their board certification.

It gives you an idea about the training they have undergone, and whether they have the expertise to provide urologic care. It is also essential to confirm that the urologist has never been involved in any malpractice claims or disciplinary actions. You can also do deeper research about their medical school and training hospital as well.

3) Consider the urologist’s experience

While choosing a urologist, considering their experience is essential. A well-experienced urologist will ensure that the procedure followed to treat a condition yields the desired result.

You can ask them questions about the number of patients they have treated with your conditions. If they tell you about a particular procedure that they will conduct for the treatment, you may ask them about the safety and complication rates associated with it. Your urologist should be able to explain to you in detail if they had come across any complications and risks with their past patients. Experienced urologists can prevent surgical complications by promptly identifying them and managing them.

4) Considering the gender of your urologist might be useful

Your urologist needs to understand your condition thoroughly. So, you will have to discuss your personal information with them openly. As urologists may specialize in conditions that are specific to men and women, you can make a choice based on that. It’s better to ask the urologist about their training and experience related to your condition and gender.

5) Find out about the quality of care provided at the hospital

A hospital that provides quality care to its patients has fewer chances of complications. Therefore, checking the quality of the hospital where your urologist treats their patients is vital.

After your treatment, you may have to visit the location for follow-ups and post-treatment check-ups. So, it’s better to choose a hospital that is located close to you. The distance shouldn’t discourage you from visiting your urologist when necessary.

6) Evaluate their communication style

Select a urologist with whom you can talk comfortably about your conditions. Your urologist should be able to inform you about everything you need to know about the condition, its pre-treatment and post-treatment procedures, and prevention.

When you meet a urologist, ask them questions and see if they welcome your queries. Also, notice if they offer answers that you can understand. Find a urologist who is genuinely interested in understanding you and your condition, who will consider your treatment preferences, and respect your decisions.

7) Go through patient satisfaction surveys

Nowadays, it is quite easy to find reviews about doctors. Many websites can help you check the reviews of the urologists on your list as well as how they have been rated. You will have better insights into how the specific urologist practices medicine.

You can find many patient satisfaction surveys, where people talk about their experience with booking appointments, waiting time, office environment, and staff friendliness. Reading what other people have to say will give you an idea about how much trust the patients put on the doctor, the time they spend with their patients, and how well they answer questions.

8) Insurance coverage

It’s a good idea to check with your doctor regarding the insurance plan they accept. Your insurance coverage is a practical matter. To receive the best insurance benefits and pay the least out of your pocket for your care, you may need to choose a urologist who participates in your plan. You should still consider credentials, experience, outcomes, and hospital quality as you select a urologist for your plan.

There is a good chance that your urologist doesn’t accept all types of insurance. Therefore, you must check which plans they take before you get any further in your search. If you have a long list of doctors, this could be an excellent way to narrow it down. Moreover, if you are not sure about the kind of coverage you have, it’s better to get the details from your insurance company.

Dr. Champai Saren, Senior Consultant – Urology, Brahmananda Narayana Multispeciality Hospital, Jamshedpur