Urology is the medical and surgical specialty that focuses on the urinary tracts of males and females, and on the reproductive system of males. Medical professionals specializing in the field of urology are called urologists and are trained to diagnose, treat, and manage patients with urological disorders. The organs covered by urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs (testes, epididymis, vas deferens, seminal vesicles, prostate and penis). Urology is one of the most competitive specialties to enter for physicians.
The urinary and reproductive tracts are closely linked, and disorders of one often affect the other, so a major part of the conditions managed in urology fall in the area of genitourinary disorders. Urology combines management of medical problems such as urinary tract infections and benign prostatic hyperplasia, as well as surgical problems such as the surgical management of cancers, the correction of congenital abnormalities, and correcting stress incontinence. Urology is closely related to, and in some cases overlaps with, the medical fields of oncology, nephrology, gynecology, andrology, pediatric surgery, gastroenterology, and endocrinology.
Urinary tract infections affecting every age group in both sexes comprise a significant fraction of urological practice. While urinary tract infection may be the obvious and definitive clinical symptom at presentation, it may also reflect other disorders of the urinary tract such as obstructive uropathy. Much recent interest has been focused on the characterization of pathogenic bacteria that are particularly prone to cause persistent urinary tract infections, specifically pyelonephritis. Bacteriuria is such a common clinical problem that there is inevitably a large cross-disciplinary approach to this problem. Urologists often interact with internists, pediatricians, and gynecologists in the management of patients with bacteriuria.
The importance of urologic problems seen primarily in women (stress urinary incontinence, interstitial cystitis, urethral diverticuli, etc.) is being increasingly recognized. The diagnosis and therapy of urinary incontinence constitute a significant portion of most urology practices. New therapies, both surgical and non-surgical, are being constantly developed. The number of female patients treated by urologists is substantial, and urologists need to understand gender differences in the medical and surgical approaches to these patients.
Male sexual dysfunction and infertility have become virtual subspecialties. The management of impotence has been revolutionized first and foremost by the introduction of prosthetic devices in urology. The area of prosthetics in urology has gradually expanded to encompass not only the various forms of penile prostheses, but also the use of the artificial urinary sphincter. The management of infertility in the male has generally focused on the surgical correction of various acquired and congenital obstructions within the genital system, and increasingly sophisticated efforts to diagnose and treat the problem of coexisting male subfertility and varicocele. Continued improvements in the medical management of male infertility require a high level of expertise in the area of reproductive physiology and endocrinology.
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