What is a Urologist?
A urologist is a physician who has completed medical school, a urology residency training program, and is certified by the American Board of Urology to diagnose and treat disorders of the urinary tract in both males and females, as well as conditions of the male reproductive system. 1
Scope of Practice
Urologists manage a broad spectrum of conditions affecting multiple organ systems:
- Urinary tract disorders in both sexes, including the kidneys, ureters, bladder, and urethra 1, 2
- Male reproductive system conditions, including the prostate, testicles, penis, and fertility issues 3, 4
- Benign conditions such as benign prostatic hyperplasia (BPH), overactive bladder, urinary incontinence, erectile dysfunction, and urinary tract infections 3, 2, 4
- Malignant diseases including bladder cancer, kidney cancer, prostate cancer, testicular cancer, and upper tract urothelial carcinoma 1, 2
- Congenital abnormalities and disorders of sex differentiation, particularly in pediatric urology 1
Training and Certification
- Urologists complete a urology residency following medical school and must be certified by the American Board of Urology 1
- Pediatric urologists complete an additional 2-year pediatric urology fellowship after general urology training and can earn a subspecialty certificate in pediatric urology from the American Board of Urology 1
- Training encompasses both medical management and surgical intervention, including endoscopic, open, and minimally invasive procedures 1, 5
Clinical Responsibilities
Urologists function in multiple capacities:
- Primary care provider for urologic conditions, managing conditions like BPH, erectile dysfunction, and overactive bladder independently 3, 6
- Surgical specialist performing procedures ranging from endoscopic interventions to major reconstructive surgery 1
- Consultant to primary care physicians and other specialists for complex urologic problems 5, 6
- Multidisciplinary team member in conditions requiring coordinated care, such as disorders of sex differentiation (working with endocrinologists, psychologists, and geneticists) and urologic malignancies (collaborating with medical oncologists and radiation oncologists) 1
Common Clinical Scenarios
Urologists routinely evaluate and treat:
- Male lower urinary tract symptoms including urgency, frequency, dysuria, and nocturia, often related to BPH or overactive bladder 1, 7, 8, 9
- Urethral stricture disease, determining stricture location and length to guide endoscopic versus surgical management 1
- Urinary tract infections in males, which are always considered complicated and require thorough evaluation 7, 8, 6
- Hematuria, requiring immediate urologic referral before treatment initiation 7, 8
- Urologic emergencies such as testicular torsion, major urologic trauma, and acute urinary retention 1, 5
When to Refer to a Urologist
Primary care physicians should refer patients to urology when encountering:
- Gross or microscopic hematuria 7, 8
- Abnormal prostate-specific antigen or suspicious digital rectal examination 7, 8, 9
- Recurrent urinary tract infections 7, 8
- Palpable bladder suggesting urinary retention 7, 8
- Neurological disease affecting bladder function 7, 8, 9
- Severe obstruction with urinary flow rate <10 mL/second 8, 9
- Solid malignancies of the kidney, bladder, or testicle 1
- Disorders of sex development in newborns 1