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John Randolph Medical Center

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Retreat Doctors' Hospital

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Urology

Defining Urological Care

Urology is a branch of medicine that focuses on the urinary and reproductive tracts in men and women. Urologists are highly trained physicians who specialize in diagnosing and treating urological disorders and diseases. They focus on the medical management of patients with urological conditions, perform surgeries, and treat sexual problems in men.

Urological Conditions

The complexity of the urinary and reproductive tracts can give rise to a host of problems, including:

  • Cancer. Urological cancers include the bladder, kidneys, and adrenal glands, as well as other parts of the urinary tract. In men, cancer may occur in the prostate, testicles, or other parts of the reproductive system.
  • Erectile Dysfunction (ED). Often a symptom of an underlying condition, erectile dysfunction occurs when the penis cannot achieve sufficient rigidity for sexual intercourse.
  • Incontinence. A malfunction in the urinary system that results in a loss of bladder control, incontinence is often caused by weakening of the pelvic floor muscles during pregnancy.
  • Kidney disease. Damage to the kidneys can lead to swelling of the hands and ankles, high blood pressure, and other symptoms. When the kidneys no longer work, kidney failure occurs, which can be fatal.
  • Kidney stones. Small, hard deposits of mineral and acid salts form in the kidneys, affecting urination and causing extreme pain.
  • Male infertility. An inability to conceive can be the result of damage to the reproductive system, or from a variety of sperm-related disorders.
  • Painful Bladder Syndrome. Also called interstitial cysticitis, this chronic inflammation of the bladder can cause discomfort ranging from mild to severe.
  • Prostatitis. Infection or inflammation of the prostate can result in painful urination or ejaculation.
  • Renal transplant. Following kidney failure, transplant of a kidney is necessary to preserve life.
  • Urinary Tract Infection (UTI). Primarily affecting women, urinary tract infections occur when bacteria migrate from the digestive tract to the urethra, causing abnormal and painful urination.

When to See a Urologist

Any of the following symptoms suggests a problem in the urinary tract and should be evaluated by a urologist:

  • Blood in the urine
  • Difficulty urinating
  • Frequent or urgent need to urinate
  • Pain in the lower back, pelvis, or sides
  • Pain or burning during urination
  • Urine leakage
  • Weak urine flow, dribbling

Men who experience any of the following urological symptoms should seek medical care:

  • Decreased sexual desire
  • Lump in the testicle
  • Trouble getting or keeping an erection

Diagnosis of Urological Conditions

Some mild urinary problems, such as urinary tract infections, can be diagnosed and treated by a primary care provider. A referral to a urologist is necessary for more serious problems.

A variety of tests are used to identity and diagnose urological conditions:

  • Biopsy
  • Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans
  • Cystogram (X-ray of the bladder)
  • Cystoscopy (looking inside the urinary tract with a small scope)
  • Ultrasound
  • Urine tests
  • Urodynamic tests (to measure the pressure and volume inside the bladder)

Treatment of Urological Problems

After diagnosis, treatment of urological problems depends on the condition. Both medical management (including medication) and surgery are options.

Medication used to treat urological conditions include:

  • Antibiotics for infections
  • Chemotherapy and hormone therapy for cancers
  • Drugs that smooth the muscle of the bladder for urinary incontinence
  • Phosphodiesterase 5 (PDE5) inhibitors for erectile dysfunction

Surgical options to treat urological conditions include:

  • Laparoscopic, or minimally invasive surgery
  • Laser therapy
  • Open surgery
  • Robotic surgery

Urological surgery may be used to:

  • Break up or remove kidney stones
  • Relieve stress incontinence
  • Remove a tumor
  • Remove part of a kidney
  • Transplant a kidney

Locations

Chippenham Hospital

Henrico Doctors' Hospital

Johnston-Willis Hospital

Retreat Doctors' Hospital