For men only:
When to see a Urologist
Jim, a 48-year-old businessman, went to his family physician because
he saw blood in his urine after a vigorous work-out. At the time of his
visit his primary care doctor saw no blood in his urine on the dipstick
and so told him "Don't worry, it's probably from the exercise." His
doctor was not concerned and said that some men just have blood in their
urine, probably from their prostate and it shouldn't be a problem
because there's no sign of infection.
Two years later, Jim was talking to a new doctor when he mentioned
that he had intermittent blood in his urine. Concerned, the doctor
insisted that he see a urologist, a specialist in disorders of the male
and female urinary tract as well as the male reproductive system.
The
urologist discovered that Jim had a fairly large and aggressive bladder
cancer.
The lesson is that some health problems require care that is beyond
the scope and training of primary care physicians - sometimes it takes a
specialist to recognise a problem. But how do you know when you need to
take the step of seeing a urologist?
Here are just a few of the most common symptoms or conditions that
should prompt you to make an appointment:
If you have 'testicular pain or mass', you should have a urologist
check you ought to be sure it is not torsion (severe pain from twisting
that must be surgically fixed immediately) or even a tumor. Sure, it
might be just inflammation or an infection, but torsion or a cancer is
not something you want to miss as they both require immediate action.
Sadly, many men with testicular cancer go undiagnosed for months
before they are referred to a urologist.
'Blood in the urine', called haematuria, is another reason to see a
urologist - yes, even if the blood is only seen once and never seen
again. Haematuria can be blood that you see (gross haematuria) or even
blood only seen in lab tests (microscopic haematuria). You should never
assume that blood is nothing to worry about. Even though it may be
nothing serious, it might be the only early warning sign of an
underlying bladder or kidney cancer, where early detection can make the
difference between an easy curative treatment or much more aggressive
surgery if the cancer has time to grow unchecked.
See a urologist if you have an 'elevated PSA' or 'abnormal prostate
exam' (neither of these is a definitive indication that you have
prostate cancer - only that you might have it).
A 'PSA that is climbing' is even more worrisome. Though there is much
debate by government officials, there is no debate among urologists that
early detection and treatment of an aggressive prostate cancer can save
your life.
The old idea of "let's just watch this and see what happens" can have
serious consequences.
If a man has 'prostate cancer', then urologists are the only
specialty trained to oversee and recommend a variety of possible
treatments, to include observation, radiation, chemotherapy, as well as
provide hormone therapy or curative surgery.
If someone is unable to urinate, called 'urinary retention', then he
must have a urologic evaluation to find out if this is a long-standing
problem that needs correction or if this will get better with a week or
two with a drainage catheter to let the bladder heal and medications to
relax the prostate.
'Kidney stones' are another reason to see a urologist. Though many
doctors can treat the pain of the stone as it passes, only urologists
are trained in the advanced techniques to non-surgically pulverise or
remove stones, whether in the kidney, the ureter or the urinary bladder.
'Kidney masses' or 'tumours' should always be evaluated by a
urologist. In the old days, it was common for a doctor to find a mass on
a patient's kidney and have a radiologist simply biopsy the lesion.
This can miss the cancer and even cause the cancer cells to spread.
Today, urologists can often identify what the mass is by a variety of
non-invasive tests and then if needed, remove the lesion or kidney.
Advances in laparoscopic and robotic surgery have revolutionized kidney
cancer care.
'Male infertility' requires a comprehensive exam and testing, again
by a urologist. Oftentimes there are other underlying problems and so
the infertility is correctable when the problem is treated.
Other times, more advanced techniques are needed to correct the
problem such as a varicocele, which is a collection of veins in the
scrotum.
For the most challenging issues, microsurgical reconstruction of the
vas or sperm retrieval may be required.
-WebMd
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