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Urology, or genitourinary surgery, is a medical and surgical discipline that focuses on diseases of the male and female urinary tract system and the male genitalia. The organs that are focused on in urology include the urethra, bladder, ureters, adrenal glands and the kidneys, and the male reproductive organs include the penis, prostate, seminal vesicles, vas deferens, epididymis and testes. The reproductive and urinary systems are closely linked, therefore a disease of one often affects the other. For this reason, the broad term used in urology is genitourinary disorders.
The residency programme for urology is 4-5 years depending on which country you live in. In order to qualify for a urology post, a doctor has to complete their undergraduate studies as well as a 1-2 year internship training period. If the candidate for the post is successful with their application, they will then begin in the residency programme and be trained and mentored by a urology consultant specialist.
Numerous sub-specialties in urology exist and they are completed by training in fellowship programmes that can take 1-3 years to complete. They include the following:
This discipline includes the performance of minimally-invasive urologic procedures, and is done by making use of instruments and small cameras that are inserted into the urinary tract. The cornerstone procedure of endourology is transurethral surgery where most of the urinary tract can be reached via the urethra. The addition of robotic surgery and laparoscopy has further subdivided this branch of urology.
Laparoscopy is a quickly evolving discipline of urology and has replaced some open surgical procedures. Many prostatectomies recently are being done by robotic-assisted surgeries, although there is some controversy surrounding this regarding cost-effectiveness versus added benefit to the patient.
Conditions that cause abnormal urination, as well as those that involve the neurological system of the urological anatomy are managed here. Disorders and diseases spinal cord injuries, strokes and multiple sclerosis can negatively impact the lower urinary tract. This may then result in conditions such as urinary retention and urinary incontinence.
This sub-specialty concentrates on managing conditions such as cancers of the penis, testicles, ureters, kidneys, bladder, adrenal glands and prostate.
Here, the focus is on the restoration of both function and structure to damaged areas of the genitourinary tract. Issues such as traumatic injuries from gunshots, etc., obstruction in the urethra due to disease and injuries sustained during childbirth are examples of conditions that are managed in the discipline.
Andrology mainly concerns male infertility and focuses on the male reproductive system. Disorders such as erectile dysfunction and ejaculatory issues are managed here.
Conditions such as congenital abnormalities of the genitourinary tract, cryptorchidism (undescended testes), underdeveloped genitalia, vesicoureteral reflux and enuresis occur in children and are managed in this sub-specialty.
This sub-specialty of urology deals with conditions in females that include urinary incontinence, pelvic organ prolapse and an overactive bladder. This discipline overlaps with that of urogynecology, which is a sub-specialty of gynecology.