The Daily Schedule Of A Urologist

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.

Training

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.

Sub-specialties

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:

​Endourology

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

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.

Neurourology

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.

Urologic oncology

This sub-specialty concentrates on managing conditions such as cancers of the penis, testicles, ureters, kidneys, bladder, adrenal glands and prostate.

Reconstructive urology

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.

READ Abnormal Urine Color: What It Tells (And Doesn't Tell) About Your Health

Andrology

Andrology mainly concerns male infertility and focuses on the male reproductive system. Disorders such as erectile dysfunction and ejaculatory issues are managed here. 

Paediatric urology

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.

Female urology

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.

The Daily Schedule Of A Urologist

Patients operated on by urologists are seen 1-2 times a day in the general wards as well as the ICU. The patients are seen every day and are under the care of the urologist until they are ready to be discharged. Urologists are also consulted by other specialists such as nephrologists and gynaecologists, who are closely linked to each other's specialties.

A urologist may provide on-call services to the hospital they work at around 2-3 times a week, depending on the availability of staff. They will be consulted by primary healthcare personnel and casualty doctors, working in the emergency room, to manage patients who have urological disorders.

Monday

The week starts with the urologist dealing with administrative issues such as confirming their surgical lists, patient consultations and meetings with surgical representatives and hospital staff such as management.

The specialist will consult with patients and manage medical issues, such as urinary tract infections and benign prostatic hyperplasia (BPH), either conservatively or by admitting patients to the ward to be managed further. If patients need surgical intervention of their pathology, they will have a surgery date booked for them. 

Tuesday

Tuesday usually comprises of performing surgery for the entire day. The urologist may also provide emergency consultations between elective cases. 

Surgeries that can be performed on this day include time consuming ones such as prostatectomies (removal of the prostate, usually due to severe enlargement or if there's a tumour present), cystectomies (removal of the bladder, usually due to cancer), nephrectomies (removal of the kidney due to cancer or trauma) and open procedures that are needed to remove kidney stones.

Wednesday

Wednesdays can be used to perform procedures that can be done at day-surgery clinics, where patients can be discharged the same day but need general anasthesia to perform the procedure, or perform procedures in the procedure room of the specialist's office. Nervous system disorders are managed with therapies that include catheterization of the bladder (urethral or suprapubic), injecting anticholinergic drugs or Botulinum toxin (Botox) into the bladder wall, as well as advanced but a less commonly used treatment such as sacral neuromodulation.

The urologist will also consult with patients to manage acute issues, as well as follow up post-surgical patients.

READ Botox Approved by FDA to Treat Loss of Bladder Control

Thursdays

The urologist will perform procedures such as lithotripsies (using sonar waves to break up kidney stones), cystoscopies (using cameras to visualise the bladder) and then perform other procedures such as taking biopsies of the bladder wall or removing kidney stones which are situated lower down in the ureter and circumcisions.

The afternoon will be used to train under- and post-graduate doctors, if the doctor is involved with the academic programme, for further research or to fill in chronic prescriptions and motivation letters to medical insurance companies.

Friday

The urologist will consult with patients in the morning and continue to manage acute illnesses and schedule patients for surgery for the following week. They will then deal with any pending administrative issues and end their work week.

If the urologist is on-call for the weekend, they will then take care of their patients and those of other urologists who have discussed their patients with them.