Urology is the branch of medicine that treats diseases and disorders that affect the genito-urinary system, and doctors who specialize in this field are known as urologists. Urologists address problems of the urinary system in men and women and the male reproductive organs such as the penis, prostate, epididymis, seminal vesicles, and testes. As men start to age, it is natural for them to experience some symptoms related to the genitourinary system. Apart from ageing, various causes like genetics (birth defects), injury, infections or cancer may lead to deterioration or functional disorder in some parts of the urinary system. Sometimes, common urology problems in men like urinary incontinence, infertility, or benign lesions may lead to discomfort, pain, embarrassment or even deterioration in overall quality of life if left untreated. It is prudent to consult specialists as soon as one notices symptoms to avoid further complications. At Medanta, we have subspeciality trained urologists who are adept at diagnosing and treating issues related to the male urinary tract and reproductive system.

 

 

MALE UROLOGICAL CONDITIONS: 

• Congenital conditions: These include anomalies due to birth defects and inherited conditions that affect the urinary tract (kidneys, ureters, and bladder) or the genital tract (reproductive organs). Some of these anomalies can be diagnosed during development in the womb, infancy, or childhood, while others can go undetected until symptoms develop in adolescence or adulthood. 

 

• Some of these conditions are as follow: 

 

• Renal agenesis: absence of one or both kidneys by birth : 

 

• Renal hypoplasia: when the kidney does not develom completely

 

• Renal ectopia: the kidney is abnormally located

 

• Renal dysplasia: abnormal structures inside the kidney

 

• Posterior Urethral Valve (PUV): abnormality in the urethal passage hampering the free flow of urine leading to backflow and damage to the urinary tract and kidneys.

 

• Vesicouretric reflux (VUR): when urine flows back into the ureters or kidneys leading to their damage.

 

• These problems can be treated effectively if detected early in life. They are manged by a Pediatric Urologist or any urologist trained in managing such conditions.

 

• Infertility: This situation arises due to an inability to conceive a child after more than a year of unprotected intercourse. Infertility affects 15% of couples, with men accounting for half of all cases. A good urologist can diagnose the reason for infertility and suggest a treatment plan based on that. Hormone levels, mood, low sperm count, and stress can contribute to infertility problems in men, and the treatment is decided based on the cause. Many causes are reversible if detected and manged early.

 

• Urinary Incontinence: This condition arises when the muscles of the pelvic wall weaken and cause involuntary urination. It is generally more common in aged men and is seen as a symptom of other urological disorders. A person may lose control of their bladder, leading to leaking or frequent urination while doing activities like jogging, laughing, coughing, and other everyday activities.

 

• Erectile Dysfunction: This dysfunction occurs when a man is unable to get or maintain an erection for sexual intercourse. Erectile dysfunction may cause embarrassment and depression in men as it is a very important aspect of a person’s life. Urologists have several treatment options for erectile dysfunction, like medication, hormone replacement, and surgery (penile prosthesis).

 

• Prostatitis: This is a non cancerous inflammation or infection found in the prostate gland that displays symptoms similar to UTI. Prostatitis can lead to pain in urination, lower back pain, pelvic and abdominal pain. Doctors generally prescribe antibiotics to reduce the swelling and bring the prostate back to its normal size.

 

• Prostate Cancer: The prostate gland is located below the bladder and produces a fluid that protects and transports the sperm. Cancer that affects the prostate gland is known as prostate cancer and is one of the leading causes of death in men. When the cells in the prostate gland become cancerous, they start to grow abnormally and multiply at a rapid pace. It is advisable for men to get their PSA levels checked annually, and treatment options are decided based on these levels.

 

• Benign Prostatic Hyperplasia(BPH): This is a medical term for an enlarged prostate or swelling that is non cancerous in nature. Benign prostatic hyperplasia generally affects men over the age of 50, and men who have a family history of erectile dysfunction or other health issues are more vulnerable. BPH leads to an increase in prostate size that in turn puts pressure on the bladder outlet, leading to frequent urination. Even after urination, one feels that the bladder has not emptied out fully and a weaker urine stream is noticeable. This situation further leads to the development of urinary tract infections and can be treated by medication and monitoring. In severe cases, the urologist might suggest surgery for BPH (TURP/ HOLEP).

 

• Testosterone Deficiency: Testosterone is a male hormone that is produced by the testicles and governs normal sexual functions and development, like a deeper voice and facial hair during puberty in men. This deficiency occurs when a man’s body produces insufficient testosterone, leading to a loss in sex drive, poor erections and depression.

 

SYMPTOMS OF UROLOGY PROBLEMS

There are several symptoms that act as indicators of urological problems, and it is advisable to contact a good urologist when one experiences these common problems. A proper diagnosis then enables the doctor to provide the appropriate treatment plan and reduce the pain and discomfort. The following symptoms are generally associated with urology problems in men: 

 

• Difficulty in urination
• Pain or burning sensation during urination
• Blood or other discharge found in urine
• Fever and chills
• Pain in flanks or lower back
• Pain in genitals 

 

 

However, it must be noted that many of the urological conditions do not produce any symptoms or these manifest much later when the disease has already progressed. Many such conditions are detected during routine visits and health check-ups.

 

UROLOGY TESTS AND PROCEDURES

 

Urologists treat problems involving the male urinary tract and reproductive organs after running tests and procedures that allow for a correct diagnosis. Urology diseases are associated with many different conditions, and there are specific tests and procedures aimed at diagnosing particular conditions. The doctors run these tests after understanding the patient’s symptoms and conducting a physical examination. Some of the common tests and procedures that are used for diagnosis are:

 

• Abdominal/renal ultrasound: This ultrasound is a non-invasive imaging procedure and is used to examine organs in the abdomen, like the kidneys and bladder. The abdomen is scanned using a hand-held device that allows the doctor to see a high-resolution image of the inside part of the body.

 

• Benign Prostatic Hypertrophy (BPH) Symptom Score: This is a questionnaire that is filled out by the patient and allows the doctor to judge the mildness or severity of a patient’s symptoms depending on the score. This test does not help to gauge the size of the prostate.

• Uroflowmetry: It’s a machine that checks the flow rate in suspected bladder outlet obstruction.

 

• Computerized Tomography (CT) Scan: These scans are done using imaging technology that creates high-resolution images of the inner parts of the body. Doctors generally opt for a CT scan to check for kidney stones, or masses of the kidneys, ureter, bladder.

 

• Magnetic Resonance Imaging (MRI): A contrast MRI is done to diagnose and determine the local extent of prostate cancer.

• Cystoscopy: A cystoscope is a small, flexible fiber optic telescope that is used to examine the inner lining of the urethra and bladder. Cystoscopy is generally performed when the patient complains of recurring urinary tract infection, painful or bloody urination, or when growth has been detected on other imaging tests.

• Cytology: This is the examination of a urine sample to identify abnormal cells, cancer cells, or other organisms within the urine.

• Intravenous Pyelogram (IVP) or Urogram (IVU): This process is used to examine the upper urinary tract, kidneys, and ureters. The process involves injecting a dye into a nearby vein and taking images that record the spread of the dye.

• Prostate Biopsy: This procedure involves taking a sample of tissue from the prostate. This is usually done when abnormalities are found in rectal examinations and cause brief discomfort.

 

• Urodynamics: These tests are conducted to evaluate lower urinary tract function.