Introduction to Urology

Urology is a sub-specialty of surgery. Urologists look after both male and female patients (including children) having diseases of the urinary system. They also deal with problems of the male reproductive system (genital tract). Besides, urologists also perform kidney transplant and dialysis-related surgical treatment for patients with kidney failure.

Although there are some differences between the urinary systems of male and female, they basically include kidneys, ureters, urinary bladder and urethra in both sexes. Besides, due to close proximity of the adrenal glands with the kidneys, urologists also treat certain adrenal diseases. The male reproductive system includes testis, spermatic cord (vas deferens), prostate and penis.

Common urological problems include:

1.  Tumours of kidneys, ureters, bladder, prostate and testis, etc.
2.  Urinary calculi in kidneys, ureters and bladder
3.  Infection, e.g., pyelonephritis, cystitis, urethritis, prostatitis, epididymo-orchitis
4.  Trauma, e.g., kidney injury, penile fracture.
5.  Kidney transplant and dialysis-related procedures
6.  Female urology (Urinary incontinence, pelvic floor disorders)
7.  Paediatric urology, congenital urinary tract anormalies
8.  Voiding dysfunction (neurological or non-neurological), including benign prostate enlargement
9.  Male sexual dysfunction
10.  Male infertility

Pain is a common symptom of urological diseases. Common sites of pain are the loin area, lower abdomen, groin region, perineum, scrotum and penis. Burning pain when passing urine, abnormal urethral discharge are also common symptoms of lower urinary tract infection. To find out the different origins and causes of pain, medical consultation and appropriate investigations will be necessary.

In middle-aged and elderly men, prostate disease and voiding dysfunction are giving rise to more and more concern. The usual presenting symptoms are weak stream, urinary frequency, nocturia (getting up at night to pass urine), urgency and/or incontinence.

Blood in urine is an alarming urinary symptom especially if no pain is present. It is regarded as a sign of urological malignancy until proven otherwise. Early malignancies of the urinary tract are usually treatable and curable. Prompt medical consultation is therefore necessary.

With the change in social culture and attitude, male infertility and sexual disorders are no longer embarrassing problems. The presence of effective treatments also encourages more people to seek medical advice on these problems. Urologists play major role in management of erectile dysfunction, ejaculatory disorders, sex drive disorders and male factors infertility.