What is urology?
Urology is the part of health care that specifically deals with disorders affecting the urinary
system and male reproductive organs. This includes:
- Male reproductive organs – testicles, scrotum, penis, prostate
1 in 2 of us will get a urology condition at some point in our lifetime (Urology Foundation).
Urology is a vast topic with many more conditions than the ones included in this guide. We will be focusing on some of the more common conditions which come under the heading of urology.
Kidneys are important in keeping the body functioning properly. Their main role is to clean the blood by removing any extra waste products. The waste is then passed out of the body as urine. Kidneys are also responsible for stabilising blood pressure and producing hormones that help to build strong bones and form red blood cells.
Around 1 in 8 people in the UK live with a chronic kidney disease.
Two of the most common conditions are:
Kidney Failure –
This happens when the kidneys aren’t filtering waste as they should. This goes on to cause a build-up and can happen very quickly (acute renal failure) or over a period of years (chronic kidney failure). Usually, a doctor can get a diagnosis using a patient’s symptoms, a physical examination
and blood tests. Acute kidney failure is treated by fi nding and treating the underlying cause.
Chronic kidney failure can’t be cured as long-term damage is irreversible and treatment focuses
on controlling symptoms and slowing progression.
Kidney Stones –
Urine can sometimes have so much waste in it that it crystallises and forms into small stones in the kidneys. Usually, there are chemicals in our urine that stops these crystals from forming, however in some people these chemicals don’t work well enough. Kidney stones can cause extreme pain which starts in the back and spreads around to the abdomen. Doctors will take a urine sample to check for blood, infection and acidity. A CT scan can usually establish a definitive diagnosis as it picks up between 97-98% of all kidney stones. The most common treatment is called extracorporeal shockwave lithotripsy. This is the process of breaking down the stone using shockwaves so they can pass out of the body more easily.
The bladder is the organ that collects and stores urine. Some common conditions are:
Urinary Incontinence –
Usually the bladder will hold urine until you decide to empty it. However, with this condition, control is lost and passing urine becomes involuntary. There are at least 3 million adults in the UK that can’t control their bladders as they would like to. Diagnosis is based on the history and whether there is a pattern to the symptoms and a doctor may ask for a diary of toilet trips. Treatment will depend on the cause of the problem. Urinary tract infections (UTI’s) are treated with antibiotics. For other conditions, practicing pelvic exercises to strengthen muscles might be suggested, or other types of medication.
Interstitial Cystitis –
This condition is caused when the lining of the bladder becomes inflamed. It affects both men and women with 75% being over the age of 30. Interstitial cystitis can also be referred to as painful bladder syndrome or chronic pelvic pain syndrome. The condition can be hard to diagnose. Symptoms include urinating often, painful urination and pain in the abdominal area. There is no cure for this condition and treatment therefore focusses more on symptom management. Treatments include re-training of the bladder, stretching the bladder by fi lling it with water or surgical procedures.
Urinary Tract Infection –
This condition is also referred to as a UTI and is the second most common type of bodily infection. They are usually caused by bacteria from the rectal passage entering the urinary tract. This is usually through the urethra. Symptoms include urinating more often, pain or burning during urination, pressure above the pubic bone in women and a sensation of fullness in the rectum for men. A doctor will test a urine sample to give a diagnosis. UTI’s are treated using antibiotics.
Male Reproductive Organs
The male reproductive system is made up of two glands called testes, the scrotum that they sit in and the penis. There are a wide range of conditions that can affect the male reproductive organs.
Some of these are outlined below:
Testicular Cancer –
This is one of the most survivable cancers if detected early through self-examination. It’s most common in young men, with over 50% who get it being below the age of 35. The most common symptom to look out for is a lump or swelling in one of the testicles. A GP will conduct an examination and if cancer is suspected the patient will be referred to a specialist for further testing before a diagnosis. The three main treatments commonly used are chemotherapy, radiotherapy, and surgery.
Erectile Disfunction –
This is also commonly referred to as ED. It is the constant or recurring inability to get or maintain an erection that’s sufficient for sexual activity. Usually this affects men over 40 and around 1 in 10 men overall, making it a very common condition. Some triggers can be stress, depression, or physical causes. Treatment is normally medication, however there are other medical procedures that can be done.
Male Infertility –
The World Health Organisation state that around 1 in 6 people are affected by infertility worldwide. Being infertile is defined as an inability to produce children after at least 1 year of unprotected intercourse. Diagnosis includes taking a medical history, physical examination, and sample analysis. Treatment options are looked at once the underlying cause has been found.
A vasectomy is a surgical procedure that is a form of contraception. It involves cutting and tying the tubes which deliver the sperm from the testicles to the prostate to produce semen. This means that during male ejaculation there is no sperm present in the semen. Having a vasectomy is usually a personal choice and so does not require a diagnosis. This procedure is reversible, but the effectiveness depends on the length of time it’s been since the initial operation.
The prostate is a gland which is found beneath the bladder in males. It starts off smaller in boys and grows larger during puberty when testosterone levels increase. Its main function is during sexual intercourse to produce the fluid which transports sperm. Common prostate conditions are Prostate cancer, Benign Prostatic Hyperplasia (BPH) and Prostatitis.
Prostate Cancer – This is the most common type of cancer in men. It accounts for around 26% of new cancers in males in the UK (Urology Foundation). Age is the biggest risk factor for this type of cancer. It’s possible to have no symptoms at all with prostate cancer but some common symptoms are:
- Blood in the urine
- Bone pain
- Sudden weight loss
- Needing to urinate more frequently or urgently
- Difficulty passing urine
This type of cancer can be diagnosed following development of symptoms or from regular tests and check-ups. If someone is suspected of having prostate cancer, there are 3 specific tests that are carried out. These are a Prostate-Specific Antigen (PSA) Measurement, Digital Rectal Examination (DRE) and a Trans-Rectal Ultrasound (TRUS) with a biopsy.
Treatment depends on the type of cancer and how aggressive it is.
Benign Prostatic Hyperplasia (BPH) –
This is a progressive disease which usually aff ects men over 40. It is a growth of the prostate gland that is non-cancerous. It can cause problems with urinating as it reduces the ability of the urethra to expand. Some signs include weak urine stream, taking longer than usual to urinate and needing to urinate more frequently. A doctor will diagnose the condition by fi rst taking a history and conducting an examination. They may then order further tests which can include blood tests and urine studies. Treatment will depend on the severity of symptoms and can include medication or surgery.
Prostatitis is when the prostate gland becomes infl amed. It is one of the most common urological conditions with approximately 25% of UK urology consultations being for this condition. The condition can occur at any age but is more common between the ages of 30 to 50. There are 2 main types of prostatitis:
- Acute Prostatitis – Symptoms occur suddenly. It can cause severe pain in and around the male genitals, lower abdomen, and the lower back. It can also cause pain when urinating and sufferers feel generally unwell. Commonly this is treated with painkillers and antibiotics.
- Chronic Prostatitis – Symptoms are generally present for 3+ months and are the same as acute prostatitis, however they don’t start as suddenly or as aggressively. Symptoms may also come and go over time. Treatment focuses on managing the symptoms using medication.
If you are experiencing any of the symptoms mentioned, it’s important to contact your GP.