A Urologist is a Surgeon who deals with diseases of the Urinary tract (including Kidney, Ureter, Urinary bladder, Prostate, Urethra) and male Reproductive organs (Testis, Penis) as well as the adrenal glands.
When to seek help from a Urologist?
1) Urinary difficulties: This could be frequent urination during day or night time, burning or pain while urinating, difficulty in initiation of urine, poor stream of urine or a sensation of incomplete voiding. There could be complete retention of urine with an inability to pass urine at all. Some people suffer from incontinence i.e loss of urinary control, either completely, associated with urgency or during laughing, coughing or sneezing. These urinary problems could be due to issues in urinary bladder, prostate or urethra.
2) Deranged PSA test results: Nowadays PSA (Prostate-specific antigen) test is frequently included as part of health packages and is on occasion clinically indicated. Deranged PSA test results should always be interpreted by a Urologist as raised PSA may not always indicate Prostate Cancer.
3) Blood in urine: This could be due to a variety of causes ranging from infections, stone disease, urologic cancer, etc. This has to be taken seriously and can present as bright red urine, pink urine or small clots in the urine. Sometimes it can only be detected on microscopic examination of urine.
4) Pain in the flanks or back: Kidney pain usually occurs in the flank and could be due to various causes like urinary stone, kidney infections, obstruction to urine outflow from kidney etc. This needs to be evaluated by a Urologist.
5) Urinary stone disease: This is a very common problem. Stones form in the kidney and sometimes descend downwards through the ureter and cause a lot of pain while doing so. The common symptoms are a dull pain in the flank, sharp shooting pain from the flanks radiating to the groin/testicles. Rarely stones may present with blood in the urine or no symptoms at all. Stones are usually detected on Ultrasound or CT scan of the abdomen.
6) Testicular swelling or pain: This can be acute or a chronic problem. A lump in the testis should never be ignored. It could be due to testicular cancer. Pain in the testis could be due to infection, dilated veins (varicocele) or a lump. Sudden pain in testis needs to be seen urgently as it may due to the twisting of the testicular blood supply (torsion).
7) Urinary tract infections: This could sometimes occur repeatedly when it is best evaluated by a Urologist to find the cause and rectify it.
8) Pain in the penis: This could be due to the inability to retract the foreskin (phimosis), pain while urinating or during erections. Sometimes a penile skin lesion or ulceration (wound) can occur which could be serious indicating penile cancer.
9) Sexual dysfunction: Inability to achieve or sustain an erection for sexual intercourse, premature ejaculation, pain during intercourse, bending of the penis during erection are some of the problems that could occur, which need evaluation by a Urologist.
10) Male infertility: Frequently there could be problems in the male partner which are found during the evaluation of infertility. This could be low sperm counts, absent sperm or non-motile sperm in the semen.
These are few of the common scenarios which require evaluation by a Urologist. Timely consultation can avoid complications and allay the anxieties of the patient and family members.
The writer, Dr. Ashwin Mallya, is a Consultant Urology and Kidney Transplant at, Narayana Superspeciality Hospital in Gurugram