> Definition of Urology? > What is a Urologist? > Urinary System Overview
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Urology is the medical specialty dedicated to the treatment of disorders and diseases related to the male and female Genito-Urinary organs including the kidney, ureters, bladder, prostate and genitalia. Problems in these areas are common and new medical technology continues to offer an expanding array of effective treatments.
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A Urologist is a physician who has completed a certified residency training program. A board certified Urologist has successfully completed oral and written exams conducted by the American Board of Urology. Urologists must repeat certification exams every 10 years. Urologists have specialized knowledge and skill with regard to problems of the male and female urinary tract and the male reproductive organs. Although urology is classified as surgical subspecialty, the urologist requires knowledge of internal medicine, pediatrics, gynecology, and other specialties. The doctors and staff at The Urology Team P.A. are experienced medical professionals in the specialty of urology. Our board certified urologist and staff focus is primarily on the treatment and diagnosis of adult male and female urinary system disorders.
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Most people have two kidneys and they are found up under the ribcage toward the back. They are intimately associated with the adrenal glands. The kidneys themselves serve as filtering units for the blood. At any given time, about one quarter of a person's total blood volume is circulating through the kidneys, which is an inordinately high volume considering the kidneys take up a relatively small portion of the overall body mass. When everything is functioning properly, the kidneys filter the blood, saving the valuable portions of the blood and excreting unneeded substance in liquid form down the ureters. The ureters are the drainpipes from the kidneys into the bladder. If for some reason the kidneys cannot perform their function as filtering units because of congenital problems, obstructions, stones, infection, or tumors, urologists are consulted to treat these particular conditions. Transplantation of a kidney from a donor to a patient with kidney failure is done with a urologist as a central part of the surgical team. The Urologist can often harvest a donor kidney laparoscopically, minimizing the surgery necessary for the donor.
Urological treatment may consist of either medical treatment or surgical treatment. What sets urologists apart from other specialists that deal with the kidneys, such as nephrologists, is that urologists are trained as surgeons.
When urologists are asked to evaluate patients, they often will examine a urine specimen to see if it contains blood or signs of infection. Often some type of radiographic examination is also ordered, such as ultrasound or a CT scan. When these types of investigation are not adequate for diagnosis, the urologist may choose to look directly into the urinary tract using a scope and special types of x-rays.
If a patient is found to have a condition requiring surgery, such as a tumor of the kidney, the urologist would be the one to perform the surgery necessary to remove part or all of the kidney, or in some rare instances, the ureter also. When nephrectomy (kidney removal) is needed for benign or cancerous kidney tumors, this can often be accomplished laporoscapically. The Urology Team has performed the majority of Laparoscopic procedures in the Austin area.
If kidney stones are discovered, treatment may be surgical, but rarely requires an incision these days. There are multiple methods of breaking up and/or removing stones, such as shock wave treatments or laser treatments.
If the kidney develops severe infection such as formation of an abscess, the urologist would also perform drainage of the abscess.
Pediatric patients are most often seen by urologists for congenital problems such as obstruction of the kidney or malformations of the lower urinary tract. The accepted community standard now is for these abnormalities to be treated by urologists who specialize in the area of pediatric urology.
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The bladder is located down in the pelvis just in front of the rectum and serves as a reservoir for storage of urine. When things are working properly, the kidneys will empty their contents through the ureter into the bladder where the urine is stored for several hours before emptying. The bladder plays a key role in the urinary tract in that it keeps urine flowing in the proper direction, not allowing it to flow backwards into the kidneys, and ensures that the urinary tract is emptied of waste contents periodically. If for some reason the bladder does not function properly, or if it develops infection, stones, or tumors, the urologist is asked to treat these conditions.
Bladder infection or cystitis is very common in women because the urethra, a conduit for urine to leave the body, is short and allows relatively easy access of bacteria up into the bladder from the outside. Normally these bacteria are washed out of the bladder during voiding, but occasionally, they remain causing infection and symptoms. In males, cystitis is less common since the urethra is longer and the bladder is further away from the outside of the male body.
Interstitial cystitis (IC) is a chronic bladder disorder also known as painful bladder syndrome or frequency-urgency-dysuria syndrome. IC occurs more often in females, usually from ages 20-65. In the beginning, symptoms closely resemble recurrent or chronic bladder infection, but often bacteria typically found in urinary tract infections are not cultured. In this disorder, the bladder wall can become inflamed and irritated. It seems most probable that the cause of IC may be an autoimmune reaction in which the body's defense system targets normal bladder tissue. The inflammation can lead to scarring and stiffening of the bladder, decreased bladder capacity, pinpoint bleeding and in rare cases, ulcers in the bladder lining. For more information on this subject click here.
Bladder stones are not nearly as common as they used to be because of improvements in nutrition and early recognition and treatment of bladder neck and uretral obstruction.
Bladder cancers arise on the inside of the bladder wall. The fragile cancerous tissue often bleeds a bit causing a redness of the urine. Unfortunately the bleeding often stops by itself and the urine may be clear for several weeks or months as the tumor continues to grow. The cancer often stays confined to the inside of the bladder wall and can be removed surgically. These cancers were at one time found much more often in men than women, but they are becoming more common in women because more women are smoking. Unlike kidney tumors, cigarette smoking or chemical exposure often causes bladder tumors.
A dysfunctional bladder that cannot store urine properly can result in incontinence or leakage of urine at inappropriate times. Causes can include neurologic diseases, diabetes and changes that occur after childbirth. The treatment of incontinence will depend on the cause.
When asked to examine a patient with bladder problems, the urologist will often use the same studies that he uses to evaluate the kidneys, for example, a urinalysis and x-rays. It is not uncommon for a urologist to recommend direct inspection of the bladder with a scope to rule-out tumors or stones or other potential causes of problems.
Treatment of various diseases of the bladder can be medical (i.e. treatment of an infection with antibiotics) or surgical. For example, bladder stones can be broken up with either laser treatment or shock wave treatment. Due to size or location, they may need to be removed by making an incision. Superficial bladder tumors may be removed using a scope, but tumors that grow deeply into the muscle of the bladder may necessitate removal of the entire bladder and require creation of an alternative route for drainage of urine. One very common operation performed by urologists is re-suspension of the bladder in women who are experiencing incontinence that medicine cannot help.
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