What is Urology?

Urology is the surgical specialty that essentially focuses on the disorders or diseases associated with the urinary tracts of males and females, and the male reproductive system. Medical professionals who specialise in this field are called Urologists and are trained to effectively diagnose, treat, and manage patients suffering from related disorders. The various organs covered by urology include – kidneys, ureters, urinary bladder, urethra, and male reproductive organs namely – the, epididymis, vas deferens, seminal vesicles, prostate and penis.

Urology involves the management of problems such as urinary tract stones, infections and benign prostatic enlargement, as well as complicated surgical problems such as the surgical management of different types of cancers and correction of congenital defects. Moreover, it is closely related to other medical fields including Oncology, Nephrology, Gynaecology, Gastroenterology, and Endocrinology. It is a discipline that combines the study of different organs and physiological systems, comprising different sub-fields.

When to see a urologist?

You may consult a urologist if you face issues such as:

  • Painful urination, straining or difficulty in passing urine, poor flow, frequency or urgency and incomplete voiding
  • Abdominal pain radiating to the groin with or without nausea or fever
  • Blood in the urine or Hematuria, which could be an early sign of a bladder or kidney cancer
  • Urinary tract infection, kidney stones and bladder infections
  • An increase in PSA levels or a change in PSA, the most sensitive indicator of prostate cancer
  • Any defect or abnormality of the kidney revealed by an X-ray
  • A testicular mass or continuous pain in scrotum
  • Male infertility problems such as low sperm count and sperm abnormalities
  • Erectile dysfunction or ejaculatory problems

What causes kidney stones?

Factors that could increase the potential risk of developing kidney stones include:

  • Dehydration
  • People who live in regions that have predominantly warm climates and those prone to excessive sweating
  • Consuming food rich in high protein, sodium and sugar
  • Obesity
  • Gastric bypass surgery, inflammatory bowel disease or chronic diarrhoea can bring about changes in the digestive process, which could in turn affect the assimilation of calcium and water
  • Other medical conditions such as Renal tubular acidosis, Cystinuria, and Hyperparathyroidism
  • High uric acid levels
  • Recurrent Urinary tract infections
  • Family history of stones
  • Men are more vulnerable to developing kidney stones when compared to women
  • Certain medications

What’s the best way to treat kidney stones?

The treatment of kidney stones depends on its size, location and composition. Keeping your body hydrated and taking certain medicines can help a small stone pass easily. However, for large problematic stones, there are certain other treatment options such as:

Extracorporeal Shock Wave Lithotripsy or ESWL is a process that uses shock (sound) waves to break or disintegrate a large kidney stone into tiny fragments so that it can easily pass out of the body through the urine. It has a success rate of 70% and isn’t used as commonly now as opposed to the past due to the need for repeat procedures for complete stone clearance. It is typically preferred in paediatric age-groups and for small soft stones.

Ureteroscopic Stone Removal (URS) uses a small telescope with a laser to disintegrate stones stuck in the ureters. With a success rate of over 95%, it is the preferred modality of management of ureteric stones obstructing the flow of urine.

Percutaneous Nephrolithotomy (PCNL, PNL) is an endoscopic surgical procedure that is used to remove large stones (>2cm) from the kidneys, with a success rate of >95%. Nowadays, we use smaller sized instruments to gain access to kidney stones using Miniperc and Microperc techniques.

Retrograde IntraRenal Surgery (RIRS) uses a flexible endoscope to enter the kidney through the urethra to crush stones or ablate tumours using a laser. Its success rate is >95% and is a lesser invasive technique to remove multiple renal stones, especially if lesser than 1.5cm.

There’s blood in my urine. What could be causing this?

Blood in urine, also known as Hematuria, is in fact a symptom and not a particular condition. Cases of hematuria should be precisely evaluated by the doctor to determine or rule out an underlying cause. Blood in urine can usually come from the kidneys, ureters, bladder or urethra

Some of the possible causes of blood in urine include:

  • Infections or stones in the bladder or kidney
  • Benign prostatic hyperplasia or enlarged prostate
  • Prostate cancer
  • Tumour in the bladder, kidney, or ureter
  • Injury to the kidney due to an accident or sports
  • Vigorous exercise
  • Consuming blood thinners like Aspirin, Clopidogrel and the like
  • Certain kidney diseases such as glomerulonephritis or inflammation that occur in the kidneys’ filtering system

It’s painful to urinate; what could be the problem?

Dysuria refers to pain, discomfort, or burning sensation when urinating. This symptom is more common in women than in men. However, it is commoner in older men than the young ones.

Some of the common causes of painful urination are:

  • Urinary tract infections (UTI) caused due to several factors such as diabetes, advanced age, enlarged prostate, kidney stones, pregnancy and having a urinary catheter in place.
  • Vaginal infection
  • Sexually transmitted infections such as Genital herpes, Chlamydia and Gonorrhea

How can I urinate less frequently at night?

Some of the things you can do to reduce urinary frequency are:

  • Bladder retraining, or in other words, training your bladder to hold urine for a longer time and urinate less frequently over a period of about 12 weeks
  • Kegel exercises to help strengthen the pelvic muscles around the bladder and urethra so as to increase bladder control and to minimize urinary urgency and frequency
  • Not consuming foods that upset your bladder or act as diuretics such as caffeine, alcohol, carbonated drinks, chocolate, artificial sweeteners, or spicy food
  • Consuming abundant high-fibre food, as constipation may worsen symptoms associated with an overactive bladder syndrome
  • Drinking adequate water to prevent constipation and over-concentration of urine
  • Avoiding too much water, just before bedtime, as it can cause night-time urination
  • Keeping  blood sugar levels under control if diabetes has been diagnosed as the cause

What are the most common procedures Urologists perform?

The most common procedures performed by urologists in an office include:

  • Cystoscopy or visual scope inspection of the urethra, bladder and prostate in men
  • Removal of stents
  • Dilatation of the Urethra
  • Urodynamic studies

Common procedures performed in an operation room setting include:

  • Robotic or Laparoscopic removal of the kidney, prostate, bladder or testis owing to cancer
  • Transurethral surgeries for benign prostate hypertrophy and bladder tumours using lasers
  • Endoscopic removal of the kidney, ureteral or bladder stones using lasers
  • Kidney transplant
  • Robotic and Laparoscopic reconstructive surgeries like Pyeloplasty or Reimplant
  • Urethral stricture surgeries
  • Vasectomy, Penile implants or Incontinence surgeries