A urology exam is a medical assessment designed to evaluate the health of the urinary tract and, in males, the reproductive organs. This field of medicine focuses on the kidneys, ureters, bladder, urethra, and male structures like the prostate, testes, and penis. The purpose of the exam is to investigate symptoms related to urination, pain, sexual function, fertility, and to screen for conditions such as kidney stones, infections, and certain cancers. A comprehensive urology visit follows a structured approach, moving sequentially from a detailed discussion of the patient’s history to a hands-on assessment and common laboratory and imaging tests.
Preparation and Initial Consultation
The initial consultation involves a detailed conversation about the patient’s medical history and current symptoms. Patients are often asked to complete a questionnaire upon arrival to document the frequency and severity of issues, such as lower urinary tract symptoms or sexual health concerns. Patients should prepare a list of all medications, including over-the-counter drugs, vitamins, and herbal supplements, as many substances can affect urinary or reproductive function.
Arriving with a full bladder is necessary because most initial visits require a urine sample for immediate testing. The consultation begins with the urologist taking a focused history, asking specific questions about the onset, duration, and nature of any pain, changes in urinary habits, or episodes of incontinence. Discussion also covers lifestyle factors, including fluid intake, diet, smoking, and alcohol use, all of which can influence urological health.
This history-taking session allows the specialist to form a preliminary diagnosis and determine the most appropriate subsequent steps for the physical examination and testing. For instance, men may be asked to rate their symptoms using standardized tools, like the International Prostate Symptom Score (IPSS), to quantify the impact of a potentially enlarged prostate on their quality of life. The information gathered during this initial discussion guides the entire evaluation process.
The Standard Physical Assessment
The physical assessment is tailored to the patient’s gender and presenting complaint, but it generally begins with an examination of the abdomen. The urologist may gently palpate or tap (percuss) the area over the kidneys in the back (costovertebral angle) and the lower abdomen. This checks for tenderness, masses, or a distended bladder, which could indicate urinary retention.
For male patients, a genital examination is performed, particularly when investigating issues like pain, fertility, or masses. This involves inspecting the penis for abnormalities and checking the testes for size, masses, or tenderness, looking for conditions like a varicocele. The assessment of the prostate gland is performed through a Digital Rectal Exam (DRE), where the doctor inserts a gloved, lubricated finger into the rectum.
The DRE allows the urologist to assess the prostate’s size, shape, and consistency, checking for hard nodules or unusual firmness that might suggest prostate cancer or benign enlargement. For female patients, the physical exam may include an assessment of the external genitalia and a pelvic examination. This checks for issues like pelvic organ prolapse or tenderness in the pelvic structures, especially if symptoms suggest urinary incontinence or chronic pelvic pain.
Common Diagnostic Procedures
Diagnostic procedures incorporate tests to gather microscopic and biochemical data about the urinary system. Urinalysis is the most common diagnostic test, performed on the sample provided at the start of the appointment. This test checks the urine for signs of infection, such as white blood cells or bacteria, and can also detect blood (hematuria), protein, or sugar, which may point to kidney disease or diabetes.
Blood tests are used to evaluate overall kidney function by measuring levels of substances like creatinine and blood urea nitrogen. For men, a Prostate-Specific Antigen (PSA) test is frequently ordered, which measures the amount of this protein in the bloodstream. While elevated PSA can indicate prostate cancer, it can also be raised by less serious conditions like an enlarged or inflamed prostate.
Imaging is used to visualize the internal structures of the urinary tract. The most common imaging test is the ultrasound, which uses sound waves to create real-time pictures of organs like the kidneys, bladder, and prostate. Ultrasound is a painless way to detect kidney stones, blockages, masses, or to measure post-void residual volume (PVR), which is the amount of urine remaining in the bladder after emptying.