The Definitive Guide to Urology: Urinary Tract Diseases and Men's Reproductive Health

What exactly does a urologist do? Learn more about urology, urinary tract diseases, and male reproductive health here.

Male fertility is not talked about as frequently as female fertility, and some males feel uncomfortable discussing this topic. But it’s a common concern—30% of infertility cases are related to male factors.

One way to learn more about your fertility is to get a semen analysis done and to speak with a healthcare provider. Can you see a urologist for your fertility questions? Read on to find out.

What Is Urology?

Urology is the field of medicine that focuses on the urinary tract and reproductive system. Some  specialties urologists practice include:

  • Male infertility, which focuses on the problems that prevent a man from getting his partner pregnant
  • Women’s urology, which focuses on medical conditions affecting women's urinary tract
  • Neurourology, which focuses on urinary tract diseases caused by the nervous system
  • Pediatric urology, which focuses on urinary tract problems in children
  • Urologic oncology, which focuses on the cancers within the urinary system such as the bladder, kidneys, prostate, and testicles

What Do Urologists Do?

Urologists diagnose and treat conditions that affect the urinary tract. They also treat conditions that affect the male reproductive system. Some urologists also perform surgery on these systems.

Why Do Men See Urologists?

Men go to the urologist for several reasons, including:

  • Urinary tract infections (UTIs)
  • Kidney stones
  • Bladder inflammation (cystitis)
  • Erectile dysfunction
  • Enlarged prostate gland
  • Kidney, prostate, or testicular cancer
  • Kidney blockage

What Are Some Urinary Tract Conditions in Women?

A woman might see a urologist because of:

  • Bladder prolapse, in which the bladder falls from its normal position into the vagina
  • Cancer of the bladder or kidneys
  • Cystitis
  • Kidney stones
  • Overactive bladder
  • UTIs
  • Urinary incontinence

Reasons a child might see a urologist include:

  • Bedwetting
  • Blockages in the urinary tract

What Are the Most Common Urinary Tract Diseases?

Urinary tract infections (UTIs) and kidney stones are commonly encountered urinary tract diseases. UTIs are one of the most common types of bacterial infections. If they’re treated promptly, they usually resolve without complications, but they may worsen quickly if they’re not.

Lower Urinary Tract Infections

Lower UTIs occur when bacteria invade the bladder or urethra. The bacteria often come from the stool  (since the rectum is close to the urethra) or the skin near the urethra. The most common bacteria in all UTIs is called E. coli (Escherichia coli). If it isn’t treated, it may spread to the entire urinary tract, including the kidneys.

Lower UTIs are more common in women, although men get them as well. This occurs because women's urethras are shorter than men's, so the bacteria can travel more quickly and easily.

Lower UTI symptoms occur in the urethra and bladder and include:

  • Frequent urination
  • Urgent need to urinate but only passing small amounts of urine
  • Pain or burning on urination
  • Cloudy or bloody urine

Diagnosis and Treatment

A healthcare provider can diagnose a UTI using a urine test (urinalylsis) and a laboratory test to see if bacteria are present (urine culture).

After a UTI is diagnosed, the provider will recommend the appropriate antibiotics. Some over-the-counter medicines are available to help relieve the discomfort, but it’s a good idea to consult a healthcare provider to test for infection before using them, since they may simply mask the symptoms and allow an infection to get worse.

Risk factors

Women are more likely to contract a lower UTI because they have shorter urethras. However, other factors increase your risk of urinary tract infections, including:

  • Pregnancy
  • Being sexually active
  • Recent placement of a urine catheter
  • History of prior UTI or family history of UTI
  • Using spermicides

Kidney Infection (pyelonephritis)

Kidney infections (pyelonephritis) are often caused by severe or untreated lower UTIs. The bacteria multiply in the bladder and travel toward the kidney. This condition needs to be treated immediately as it can have serious complications.

Symptoms

The symptoms of a kidney infection include:

  • Fever and chills
  • Back pain or flank pain (the part of your side between the hip and ribs)
  • Nausea and vomiting
  • Burning on urination
  • Frequent urination
  • Blood in the urine

Diagnosis and Treatment

Kidney infections are treated with antibiotics, either oral or intravenous depending on how sick the person appears.

Kidney Stones

Kidney stones, or nephrolithiasis, are another common condition that affects the urinary tract. Kidney stones occur when high levels of minerals like calcium form hard, stone-like deposits or crystals and travel through the urinary tract. About 600,000 people in the U.S. each year experience kidney stones.

Symptoms of kidney stones include:

  • Severe pain in the flank, lower abdomen, or back
  • Pain radiating to the groin
  • Pain while urinating
  • Blood in the urine
  • Cloudy urine
  • Frequent urination
  • Nausea or vomiting

Diagnosis and Treatment

The best test for kidney stones is a CT scan, which lets the healthcare provider visualize exactly where stones are located. Other tests are done to see how well the kidneys are functioning, like blood tests and a urinalysis.

Kidney stones may pass out on their own through the urethra. This is often very painful and usually causes bleeding. If a stone gets stuck or doesn’t pass through on its own, further treatment, such as surgery may be required.

What Are Some Common Urology Procedures?

Urologists can perform special tests to evaluate the urinary tract, including:

  • Cystogram: Dye is inserted into the bladder and X-rays are used to visualize it.
  • Cystoscopy: A thin scope with a camera is inserted into the urethra to see the inside of the urethra and bladder. see the inside of the  to check out your urethra and bladder
  • Urodynamic testing, which measures the pressure and volume of the bladder

Some of the surgeries they may perform include:

  • Biopsy of the bladder, kidneys, or prostate
  • Kidney transplant, replacing a diseased kidney with a healthy one
  • Prostatectomy, removal of part or all of the prostate gland to treat cancer
  • Sling procedure, inserting mesh strips to support the urethra and treat urinary incontinence
  • Vasectomy, which involves cutting and tying of the vas deferens, which are the tubes that sperm travels through to create semen

When Should You See a Urologist?

While your primary care physician can treat UTIs, you may be referred to a urologist if symptoms worsen.

You may also see a urologist if you have symptoms of conditions that require specialized treatment, such as:

  • Blood in your urine not due to a UTI
  • Frequent UTIs
  • Difficulty urinating
  • Incontinence
  • Weak urine flow
  • Lump in the testicles
  • Erectile dysfunction

Why Is Seeing a Urologist Important?

Having a urologist may help maintain good urinary and reproductive health when you have a condition that affects the urinary tract. Getting treatment early may keep conditions from worsening or spreading.

Is a Man Seeing a Urologist the Same As a Woman Seeing a Gynecologist?

Yes and no. A gynecologist focuses specifically on women's reproductive health. A urologist does treat issues relating to men's reproductive health, but they also take care of the urinary tract in men and women.

So, in a way, urologists are the closest equivalent men have to a gynecologist.

If you are looking for a doctor to focus on men's reproductive health and fertility, it’s a good idea to look for a urologist who specializes in male infertility.

The reason urologists focus on both the urinary tracts and the male reproductive tract is because they’re so closely related. If you are experiencing problems with your urinary tract, it may also have an effect on your reproductive tract.

Can Men See Urologists for Fertility Questions?

If you are experiencing infertility in your partnership, it is always a good idea for both partners to be checked by their doctors to see what may be causing infertility. For an easy way for a men to start learning about fertility, he can order a Ro Sperm Kit and get a fertility report, all without going to a clinic.

Why Aren't We Talking More About Male Infertility?

Many people experience infertility, including 9% of men in the United States. Unfortunately, some people are uncomfortable discussing fertility with a healthcare provider.

What Determines Male Fertility?

Male fertility is based upon many factors, including:

  • Sperm production: Producing enough sperm (usually over 39 million per milliliter of ejaculate). Sperm production relies on hormones like testosterone, LH, and FSH.
  • Sperm function: Sperm must have normal motility (forward movement) and morphology (shape) to swim to fertilize an egg.
  • Semen production: Glands called the seminal vesicles must produce enough semen to nourish sperm and carry them towards an egg.
  • Anatomy: The reproductive tract should be clear of any blockages (like scar tissue or inflammation from infections).

What Contributes to Male Infertility?

Many factors that can contribute to male fertility, including lifestyle factors and overall health and well being. Some examples of this include the following.

Obesity and Lack of Exercise

Physical activity provides many positive benefits for your body. In males, it also increases testosterone, which contributes to sperm production, improves sperm count, motility, and morphology, and and increases overall sperm quality.

Sitting down and watching TV for long periods of time actually leads to lower sperm quality. Studies have found that men who watch 20 hours of TV per week have lower sperm counts than those who don’t watch TV.

Excessive Alcohol Consumption

Excessive alcohol production may decrease sperm count and sperm motility. It may also decrease semen production and semen semen volume.

Luckily, alcohol and sperm health have a reversible relationship, meaning if you cut back on drinking, your sperm health may improve. It takes about three months after quitting for your sperm production to be restored to normality.

Excessive Smoking

Tobacco is loaded with chemicals that damage not only your lungs but also your sperm. Studies have found that smoking is linked to decreased sperm count, poor sperm motility, abnormal sperm morphology, DNA damage, and low semen volume.

After quitting smoking, it takes about three months for your sperm to regenerate, since sperm production and maturation takes about 60-90 days.

Recreational substances and Medication

Taking recreational substances, over the counter drugs, and some prescription medications can also impact male fertility. Some drugs that may lead to changes in semen quality include:

  • Testosterone supplements
  • Cocaine
  • Opiates
  • Antidepressants
  • Blood pressure medications
  • Chemotherapy

If any of these drugs or medications are necessary for your physical or mental health, you may consider freezing your sperm. Sperm freezing allows a safe alternative for people who take medications or drugs that may cause problems in the sperm or semen.

What Is Sperm Freezing?

Sperm freezing is the storage of sperm at extremely cold temperatures to keep the sperm safe for future use. It is frozen using liquid nitrogen and protective chemicals and then kept in special freezers. The sperm can remain healthy and viable for years.

Sperm freezing has been around since 1866 but gained popularity starting after the 1970s. Today, sperm freezing is a highly accepted technique in preserving male fertility. Many couples who struggle with infertility benefit from sperm freezing.