A urologist is a physician specializing in the diagnosis and treatment of conditions affecting the urinary tract in both men and women, as well as the male reproductive system. This specialization covers the health of the kidneys, bladder, ureters, and urethra, alongside the testes, prostate, and penis. Because many urologic issues share similar symptoms, a specialist consultation helps accurately pinpoint the underlying cause, which can range from minor infections to more serious systemic diseases.
Changes in Urinary Function
A common reason men consult a urologist involves a gradual decline in the mechanics of urination, often referred to as lower urinary tract symptoms. These changes are frequently attributed to benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland that occurs as men age. The enlarged prostate can compress the urethra, leading to difficulties with urine flow.
Men may notice a weak or slow urinary stream, hesitancy (delay in starting the stream), or persistent dribbling. These flow issues can progress to a feeling of incomplete bladder emptying, which causes the need to urinate again shortly after leaving the bathroom.
Changes in the frequency and timing of urination also warrant an evaluation. Nocturia, the need to wake up one or more times during the night to urinate, is a common symptom of bladder irritation or prostate issues. Similarly, excessive daytime frequency (urinating more than eight times in 24 hours without increased fluid intake) can indicate an overactive bladder or an underlying issue. Mild discomfort or a burning sensation during urination, known as dysuria, should also be examined to rule out infections or inflammation.
Sexual and Reproductive Health Concerns
Urologists are also specialists in male sexual function and reproductive health, treating conditions that impact fertility and intimacy. Erectile dysfunction (ED), the persistent inability to achieve or maintain an erection sufficient for sexual intercourse, is a common condition managed by urologists. Because ED can be an early indicator of other systemic problems like cardiovascular disease or diabetes, a urological evaluation provides an opportunity to assess overall health.
Concerns regarding low testosterone, or hypogonadism, are also managed by urologists, particularly when symptoms include reduced libido, fatigue, or changes in body composition. They can perform blood tests to measure hormone levels and recommend appropriate hormone replacement therapy or other treatments. For couples experiencing difficulty conceiving, a urologist specializing in male fertility can perform a thorough evaluation, including semen analysis and physical examination for structural issues like a varicocele.
A varicocele, an enlargement of the veins within the scrotum, can sometimes impair sperm production and quality. Urologists are trained to offer surgical correction for this and other structural blockages affecting sperm delivery. Men considering permanent contraception will consult a urologist for a vasectomy, and a specialized urologist can also perform a vasectomy reversal for those wishing to restore fertility.
When Pain Requires Immediate Attention
Acute symptoms require immediate attention, often necessitating a visit directly to a urologist or emergency room. The presence of blood in the urine, known as hematuria, is a serious sign that must be investigated promptly. Hematuria may be visible (pink, red, or cola-colored) or microscopic, detected only through laboratory testing.
Even if the hematuria is painless and occurs only once, it can indicate conditions ranging from kidney stones and severe infections to bladder or kidney cancer. Another acute emergency is the sudden, severe onset of testicular pain, which can signal testicular torsion. Testicular torsion occurs when the spermatic cord twists, cutting off the blood supply, and requires surgical intervention within hours to prevent the loss of the organ.
Sudden, excruciating pain in the flank or lower back that radiates into the abdomen or groin is a hallmark symptom of a kidney stone obstructing urine flow. This pain is frequently accompanied by nausea and vomiting and can pose a risk of kidney damage or severe infection. The complete and sudden inability to pass urine, known as acute urinary retention, causes intense lower abdominal pain and demands immediate catheterization to drain the bladder and relieve pressure.
Age-Related Screening and Preventative Consultations
Urologists also play a preventative role by guiding men through age-related health screenings, even in the absence of symptoms. The primary focus is prostate cancer screening, which involves discussing the risks and benefits of the prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE). For men at average risk, this screening conversation should begin around age 50.
Men considered to be at a higher risk, including African American men and those with a first-degree relative (father or brother) diagnosed before age 65, should begin this discussion earlier, around age 45. Screening may start as early as age 40 for those with multiple first-degree relatives who had the disease at an early age. The frequency of follow-up screening is determined by the initial PSA level; a low PSA might permit testing every two years, while a higher level may require annual checks.
Beyond cancer screening, preventative consultations involve monitoring for the development of BPH, which commonly begins to affect men in their 50s. Regular check-ups allow for the early detection and management of these conditions before they significantly impact a man’s quality of life. The urologist can assess overall urological health and address any subtle changes over time.