A urologist is a medical specialist focused on the male genitourinary system, including the urinary tract (kidneys, bladder, ureters, and urethra) and the male reproductive organs (penis, testes, prostate, and seminal vesicles). Visiting a urologist is a proactive step in managing health issues like urinary difficulties, sexual dysfunction, or concerns about the prostate. The initial appointment is a structured process designed to gather detailed information and perform specific examinations to determine the underlying cause of any symptoms.
Preparing for the Appointment
A little preparation can make the appointment more productive and efficient. Patients should gather all relevant medical documentation, including prior lab results, imaging reports, and a history of past surgeries. It is helpful to prepare a list of current medications, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
Checking insurance requirements is also a practical step, as some plans require a referral from a primary care physician before seeing a specialist. Patients should specifically ask the urology office whether they need to arrive with a full bladder. This is often requested because a urine sample is typically needed for immediate testing, and the doctor may perform a flow test or an ultrasound to check bladder emptying.
Discussing Your Medical History and Symptoms
The verbal consultation is a deep dive into the patient’s history, focusing heavily on the genitourinary system. The medical staff will ask broad questions about general health conditions, such as diabetes, hypertension, and previous illnesses, as these can affect urological function. They will also inquire about family history of conditions like prostate or kidney cancer.
The conversation will become specific when discussing symptoms, covering voiding habits, sexual health, and pain. Urologists often ask about the frequency of urination, the strength of the urine stream, and any urgency or leakage. For sexual health, questions will cover erectile function, libido, and pain during intercourse.
To quantify the severity of urinary symptoms, the urologist may ask the patient to complete a standardized questionnaire. One common tool is the International Prostate Symptom Score (IPSS), which uses a series of questions to assign a numerical grade to the impact of prostate-related symptoms. Being open and honest about sensitive topics, such as erectile dysfunction or incontinence, is important because these are common issues the urologist is trained to address.
The Urological Physical Examination
Following the discussion, the urologist will conduct a physical examination focused on the abdomen and the genitourinary area. The examination usually begins with an abdominal check, where the physician gently palpates the lower abdomen and flanks. This part of the exam helps check for tenderness, masses, or distention that might indicate issues with the kidneys or a full bladder.
Next, the physician will perform an external genital examination to inspect the penis and scrotum. This inspection checks the penis for abnormalities, like lesions or unusual curvature, and examines the opening of the urethra. The testicles will be carefully palpated to check their size, texture, and consistency, and to feel for lumps, masses, or signs of a varicocele.
The examination will often conclude with a Digital Rectal Exam (DRE), a quick procedure to evaluate the prostate gland. The physician inserts a lubricated, gloved finger into the rectum, allowing them to feel the prostate, which sits just in front of the rectum. The purpose of the DRE is to assess the prostate’s size, symmetry, and texture, checking for hard areas or nodules that may be a sign of disease.
Common Diagnostic Tests Performed
Objective testing often begins with a Urinalysis, a simple, non-invasive test performed on the provided urine sample. This analysis uses a dipstick and microscopic examination to check for blood cells, white blood cells, protein, or bacteria, which can indicate infection or other conditions. A urinalysis offers immediate insights into kidney function and the presence of urinary tract infections.
Blood tests are a standard part of the diagnostic process, with the Prostate-Specific Antigen (PSA) test being particularly common for men. The PSA test measures the level of this protein in the blood, which may be elevated due to prostate enlargement, inflammation, or prostate cancer. The urologist will interpret the PSA result alongside the DRE findings and the patient’s age and overall risk factors.
For patients experiencing difficulties with urination, a Uroflowmetry test may be performed in the office. This non-invasive test measures the speed and volume of the urine flow by having the patient urinate into a specialized funnel connected to an electronic sensor. The resulting flow curve and measurement of the maximum flow rate help the urologist assess potential obstruction in the urinary tract.