Andrologist is a doctor who specializes in the diagnosis and treatment of diseases of the male reproductive system; carries out diagnostics and outpatient treatment of prostatitis, urethritis, erectile dysfunction and decreased libido, urolithiasis, kidney diseases and bladder, sexually transmitted diseases and sexually transmitted infections.

What is the competence of an Andrologist?

Accordingly, an andrologist is the “most” male doctor, whose professional tasks are:

Male infertility;
- hypogonadism (a broad group of conditions of various origins caused by insufficient activity of the male gonads, which is expressed in hormonal abnormalities and directly affects fertility rates) regardless of the desire to have offspring;
- erectile dysfunction;
- pathological changes ejaculation (acceleration, pain, difficulty achieving, absence);
- male contraception;
- inflammatory processes of male genital organs;
- recurrent decline in male sexual functions (male menopause).

What diseases does Andrologist deal with?

Erectile dysfunction (impotence), ejaculation disorders ( premature ejaculation), congenital or acquired curvature of the penis, pathological changes in the organs of the scrotum.

What organs does the Andrologist deal with?

Kidneys, ureter, bladder, urethra, prostate, urethra, testicles, penis, epididymis.

When should you contact an Andrologist?

Real reasons for consulting an andrologist may be:

Childless marriage. Infertility in the family has become one of the most important medical and social problems last decades in Ukraine and Europe.

In our country, 20% of marriages are infertile. And in 40% of cases this happens due to the man’s fault. We can talk about male infertility in the absence of the desired conception with regular sexual intercourse with healthy woman childbearing age within 1 year (if contraceptives are not used);
- conditions characterized by a decrease (loss) of sexual desire with a parallel weakening of the strength and frequency of erections that occur, underdevelopment of the genital organs, insufficient development of secondary sexual characteristics, decreased tone of the external genitalia, i.e. indicating a possible deficiency or imbalance of sex hormones and requiring medication correction;
- problems with potency.

Almost every man in his life has at least once encountered difficulties in obtaining or maintaining an erection sufficient for satisfactory sexual intercourse. Many representatives of the stronger sex have not been able to solve this problem. intimate problem independently, taking a passive wait-and-see position, relying on “maybe”, self-medication and advice from friends. The latest advances in andrology provide real prospects for restoring an erection and maintaining sexual activity.

Erectile dysfunction is a condition that can be successfully corrected and eliminated. Awareness of the problem and making a decision about qualified medical care is the first and necessary step towards this goal;

The need to obtain information about the basics of family planning and safe sex, mental hygiene of sexual life and activities that increase the likelihood of conception, features of intimate contacts during pregnancy and after the birth of a child;
- symptoms indicating inflammatory (often infectious) damage to the genital organs, such as the presence of unpleasant sensations, discomfort, itching, pain in the urethra, any discharge from it, an unpleasant odor from the penis, pain, heaviness, burning in the perineum, lower abdomen, groin area, in the testicles;
- frequent and imperative urge to urinate, a feeling of incomplete emptying of the bladder, thinning of the urine stream, difficult and intermittent urination, the presence of floating purulent threads in the urine;
- accelerated ejaculation, weariness, painful orgiastic sensations.

If the listed symptoms are detected, as well as when you practice uninitiated sex with casual partners, a medical examination is necessary.

When and what tests should be done

- Spermogram;
- General prostate-specific antigen;
- Free prostate-specific antigen;
- Carcinoembryonic antigen;
- Creatinine in urine;
- Urea in urine;
- Calcium;
- Potassium/sodium/chlorides;
- Inorganic phosphorus;
- General blood test;
- Creatinine;
- Urea;
- Hepatitis B;
- Herpes virus;
- Candidiasis;
- Syphilis.

TO laboratory diagnostics include blood and urine tests. A general blood test shows the state of hemoglobin in the patient’s blood. If it is low, it may indicate kidney disease.

A biochemical blood test reveals the content in the blood various substances such as uric acid and creatinine. If their amount in the blood is higher than normal, this indicates kidney disease. This analysis can also help diagnose other diseases that may be associated with the genitourinary system.

Other tests are performed to determine the degree of renal failure. biochemical tests, for example, for the presence of enzymes.

In urology, the normal amount of urine excreted by a person is 1-1.5 liters. If the amount of urine is more or less, this indicates problems in the genitourinary system.

When analyzing urine, they pay attention to the amount and color of urine, and also determine what substances are contained in the urine, for example, it could be large amounts of protein or blood, which is a sign of disease or infection.

What are the main types of diagnostics that an Andrologist usually performs?

During instrumental examination, a special catheter is inserted into the bladder. The main indication for such a study is an increase in prostate gland, which creates urine retention in the bladder. In urology, they also do puncture biopsy of the kidneys, bougienage of the urethra, cystomanometry to measure pressure in the bladder and other studies.

In most clinical cases, to clarify the diagnosis, the urologist resorts to additional laboratory and instrumental studies. A general blood test of the patient allows us to identify the development of an inflammatory process in the patient’s body; a biochemical study shows the concentration of urinary pigments in the blood, demonstrating functional state kidney A urine test is very informative. It draws attention to the relative density, which changes as a result of disturbances in the concentrating ability of the kidneys. The color of urine depends on the content of the urobilin pigment in it; normally it is straw-yellow without foreign inclusions. Color changes may indicate dietary habits, intake of certain medicines. Detection of glucose and protein impurities in the urine also helps in the diagnosis of urological diseases.

The study of urinary sediment provides information about the filtering ability of the kidneys, the presence of an inflammatory process throughout the system, and identifies the causative agent of the infectious process.

Among the instrumental methods for examining patients, bladder catheterization is widely used, which makes it possible to normalize the outflow of urine when it is retained and to examine the sterility of urine.

Bougienage of the urethra is used to determine the degree of narrowing urethra and its mechanical expansion.

Application needle biopsy kidneys and prostate gland allows specialists to carry out detailed study cellular composition of tissues for the diagnosis of cancer.

Cystomanometry is prescribed by a urologist to measure the pressure in the cavity of the bladder, which indicates its patency and full function.

The use of an endoscope to diagnose various urological diseases allows you to examine the condition of organs from the inside without resorting to surgery. For these purposes, urethroscopy, cystoscopy, and pyeloscopy are used.

X-ray methods for examining patients are the oldest among diagnostic methods. Studying a survey x-ray allows a specialist to evaluate the features anatomical structure organs of the patient’s genitourinary tract, see the presence of stones in the cavities, changes in the size and shape of organs as a result of the development of a tumor or a chronic pathological process.

X-ray examination using contrast agents allows the most complete assessment of the functional ability of organs.

In today's world, the vast majority of young people have their first sexual experience in adolescence.

At the same time, not everyone thinks about the safety of sex, but is guided only by positive emotions resulting from it. Moreover, some men continue their outside contacts even while married. Therefore, all men are required to be screened for sexually transmitted infections.

Carriage of these infections can lead to a decrease in the concentration and motility of sperm, and, as a result, to infertility.

Secondly, one cannot turn a blind eye to the existence of various methods of sexual satisfaction, including oral and anal sex.

Microorganisms that penetrate during such unprotected contacts into the reproductive tract, bring chaos to the existing biocenosis. All this is manifested by both genital dysbacteriosis and the development of a nonspecific inflammatory process in the reproductive tract.

Considering this fact, both partners who practice such contacts should be examined for the flora living in the reproductive system.

In men, for these purposes, bacteriological seeding of sperm is performed on special nutrient media, which makes it possible to determine microorganisms and their sensitivity to antimicrobial agents, find out their number.

Thirdly, sperm testing is necessary. Sperm, unlike the egg, mature within 72-75 days, every hour they are in the testicles healthy man up to 100 million pieces are formed. However, the sperm formed in the testicle is not yet able to fertilize the egg on its own, since the movement apparatus is defective and the enzymes for neutralizing the protective shell of the egg remain immature. The male reproductive cell acquires all these properties in the epididymis.

As studies have shown, the most complete ejaculate in terms of fertilization occurs after 3-5 days of sexual abstinence, therefore men are recommended for the specified period of abstinence.

After preliminary hygienic measures, sperm is collected only through masturbation. It is very important to collect all the ejaculate without spilling a drop. Often, the first portion of sperm flies past the sperm receptacle, while it contains the largest portion of motile sperm.

As a result of examining incompletely collected ejaculate, the impression may be created that the sperm is inferior.

A spermogram answers questions about the number of sperm, their motility, morphology (structure), viability, the presence of other cellular elements in the ejaculate (spermatogenesis cells, leukocytes, erythrocytes) and allows the doctor to draw conclusions about the estimated fertilizing ability of the sperm.

Fourthly, some couples may have the so-called immune factor of infertility. This means that the body of a man or woman produces specific proteins against sperm, which prevent their interaction with the egg. These proteins are one of the reasons for the so-called “incompatibility of spouses.”

In this regard, it is advisable to examine a man’s blood and semen for the presence of antisperm antibodies.

In cases of detection of any infection or deviations in the parameters of the ejaculate, it is advisable to contact a specialist. Most common reasons deviations of spermogram indicators from the norm are stressful situations, overwork, visiting steam rooms and saunas, occupational hazards, drug use, smoking, alcohol abuse.

Negative effect on functioning reproductive system also causes stagnation in the reproductive system due to rare sexual intercourse and a sedentary lifestyle.

Thus, it is possible to normalize ejaculate parameters even without participation medications - proper organization way of life.

When organizing meals, the diet must include fish, seafood products, cottage cheese, nuts, honey, garlic, herbs, vegetable oils, fresh vegetables and fruits. You should limit the consumption of overly hot and spicy foods, smoked foods, animal fats, strong alcoholic drinks and beer. Adequate sleep, normalization of weight, adequate nutrition, dosed physical activity (swimming, running, football, volleyball, etc.), correction of sexual life - all this will independently improve the tone of the body in general and the reproductive system in particular.

Unfortunately, the combination of unfavorable environmental and psychosocial factors affecting modern man, has an increasing impact negative action on male reproductive function.

Thus, WHO observations over the past half century indicate a decrease in average sperm parameters.

03.12.2018

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Not so long ago, urologists were involved in the treatment of so-called male diseases. Now andrology is identified as a separate medical branch. Its tasks include studying the anatomy, physiology and pathology of the male genital organs only. Unlike urologists, andrologists do not treat urinary tract diseases.

When to contact an andrologist

A male doctor should be contacted if any disturbances occur on the part of the male genital organs.

The main ones include:

• pain or discomfort in the perineum and genital area. Often the symptom occurs once, but this is not a reason to postpone the visit;
• the appearance of unpleasant sensations when straining, physical activity, sexual intercourse;
• pain radiating to the anus, lower back, thigh;
• deformation or enlargement of the scrotum and penis, even if there is no pain;
• redness or cyanosis of the skin of the genitals and perineum;
• rashes on the skin of the pubis, penis, scrotum, perineum;
• compactions noticed on palpation;
• varicose veins of the spermatic cord;
• pathological discharge of various types;
• traumatic injuries to the external genitalia, pubis or tailbone;
• complaints related to urination - frequent trips to the toilet, itching and burning during urination;
• erectile dysfunction, syndrome premature ejaculation, decreased sexual desire;
• absence of seminal fluid or an increase in its quantity, the appearance of an unpleasant odor, change in color and consistency, the appearance of blood and pus;
• inability to get pregnant within a year;
• if necessary, choose contraceptives.

You should visit an andrologist to preventive examination in the presence of chronic diseases, as well as all men over 40 years of age. In addition, a doctor of this specialty advises potential sperm donors and all patients who are preparing for in vitro fertilization. It is advisable to consult an andrologist when planning a natural pregnancy.

What diseases does an andrologist treat?

The responsibilities of an andrologist include diagnosis, therapy, and prevention of diseases of the external and internal genital organs of men, namely:

• scrotum;
• penis;
• testicles and epididymis;
• prostate;
• seminal vesicles.

The doctor identifies deviations in the structure and functionality of organs, diagnoses pathologies, and, if possible, eliminates them. Also provides recommendations to prevent illness and prevent recurrent episodes. The goal of an andrologist, like any other doctor, is to completely cure the disease. If for some reason this cannot be done, then the doctor tries to achieve the most stable remission.

The main diseases that an andrologist diagnoses and treats include:

• infertility - the inability to conceive a child within a year with active sexual activity;
• absence or undescended testicles into the scrotum (anorchidism, cryptorchidism);
• erectile dysfunction;
• andropause - the age period during which testosterone production decreases;
• sexually transmitted diseases;
• congenital anomalies of the male reproductive system;
• traumatic injuries;
• endogenous deficiency in the production of male sex hormones;
• disruption of the processes of reproduction and maturation of sperm;
• gynecomastia - enlargement of the mammary glands caused by hormonal imbalance;
• baldness caused by an imbalance of male sex hormones.

Therapy with an andrologist is also indicated for depressive disorders associated with erectile dysfunction. Sometimes a therapist, surgeon or specialist doctor refers you for a consultation with an andrologist. The reason for such tactics may be symptoms indicating pathology of the male genital organs.

Every human reproduction clinic should be staffed by a full-time andrologist. Only a specialist can make the correct diagnosis and prescribe necessary treatment, as well as qualitatively prepare the patient for in vitro fertilization.

Diagnostic methods used in andrology

The first and most important diagnostic techniques used by an andrologist are anamnesis collection and an objective examination.

When collecting anamnesis, the doctor asks the patient in detail about the complaints that have arisen. If possible, find out the time and reason for their appearance, dynamics.

It is important for the doctor to assess the signs of puberty and correctly compare the size of the organs to the age. In addition, the andrologist will definitely palpate the man’s genitals in a lying and standing position - this will eliminate neoplastic processes and a number of other diseases.

After examining and palpating the genital organs, the doctor measures blood pressure, assesses the thickness of the fat layer in the waist area, examines the mammary glands, and performs reflex tests.

This is followed by palpation of the prostate gland. It is passed through the anus. During palpation, the size of the organ, its mobility, elasticity, and consistency are assessed. If deviations are detected, additional research is prescribed.

Of the laboratory and instrumental tests in andrology, the following are used:

• Ultrasound;
• X-ray examination;
• endoscopic examination;
• uroflowmetry;
• intracavernous tests;
• biopsy;
• spermogram;
• checking the concentration of hormones in blood plasma;
• biochemical screening, general blood and urine analysis;
• PCR;
• genetic diagnostics;
• analysis for tumor markers;
• rheofallography;
• CT, MRI.

Ultrasound examination is performed with both an abdominal and transrectal probe. Transrectal ultrasound is considered more informative and does not require special training. Due to its high information content, relative cheapness and ease of implementation, ultrasound examination used as a screening method. There are no contraindications to the procedure. Average duration manipulations - 10–15 minutes.

With the help of ultrasound, the doctor can assess:

• structure of internal organs and tissues;
• presence of pathological inclusions;
• signs of the inflammatory process;
• circulatory disorders;
• structural anomalies.

With the help of ultrasound, the doctor can see most diseases of the male reproductive system.

Endoscopic examination performed only by an andrologist who has undergone special training. The main instrument used during the procedure is an endoscope. This optical instrument equipped with a photo or video camera. Using it, the doctor can examine the mucous membrane of the urethra, identify pathological changes, and carry out diagnostic manipulations.

Uroflowmetry - diagnostic technique, which is used to record the rate of urination. It is used for diseases of the prostate, bladder, and sexually transmitted infections.

Intracavernous tests indicated for problems with erection. During these procedures, the doctor injects vasodilators into the cavernous bodies. The presence of an erection indicates psychogenic reasons impotence.

Biopsy necessary if a malignant neoplasm is suspected. A small amount of tissue is collected under ultrasound guidance. Pathomorphological examination allows for differential diagnosis of malignant tumors, as well as determining their type, origin, and degree of differentiation.

Spermogram- a laboratory test that allows you to evaluate the motility and structure of male germ cells.

Blood test for hormones shows the level biologically active substances in blood plasma. Based on it, the doctor can make the correct diagnosis and prescribe its treatment. In addition, the analysis will show what caused a particular disease.

Biochemical screen d, general blood and urine tests allow you to assess the general condition of the patient’s body and evaluate the functioning of internal organs and systems.

PCR- most exact method diagnosis of infectious diseases. Its essence is to copy a DNA molecule and create a large number of copies. This makes it possible to recognize the pathogenic pathogen.

Molecular genetic diagnostics consists in determining the number of chromosomes in a set, analyzing seminal fluid for DNA fragmentation of male germ cells.

Determination of the level of oncological markers- prescribed for suspected malignant disease.

Computed and magnetic resonance imaging used for visualization of internal organs and tissues. These are highly informative techniques with which you can see even the most minor changes.

Treatment methods in andrology

After diagnosing the disease and establishing its cause, the andrologist draws up a treatment plan. Complexity and individual approach- the basic principles on which the doctor relies. At the same time, the doctor tries to use highly effective medications, physiotherapeutic procedures, and modern medical equipment. This allows you to achieve good results in the shortest possible time.

In his practice, the andrologist uses both conservative and surgical treatment methods.

The main ones include:

• Drug treatment (antibacterial agents, anti-inflammatory, analgesic, antifungal, immunomodulatory, symptomatic). In each case, the volume of conservative therapy is determined individually.
• Hormone therapy.
• Diet therapy.
• Physiotherapeutic treatment.
• Psychotherapy.
• Sex therapy.

Surgical treatment is indicated in the following cases:

• if the patient is diagnosed with a pathology, the therapeutic treatment of which will obviously be ineffective;
• with congenital and acquired defects of the structure of the genital organs;
• to eliminate malignant and benign tumor processes;
• for the purpose of reconstruction of male genital organs (urethroplasty, penis, testicles).

To improve potency, local treatment is used - medications are injected into the cavernous bodies of the penis. By affecting blood vessels, medications increase potency.

Each of the treatment methods used in andrology has its own advantages and disadvantages. It is very important to trust an andrologist with high level qualifications so that he can draw up a competent therapeutic plan and achieve maximum therapeutic effect.

All that is required from the patient is to consult a doctor when the first suspicious symptoms appear, and also visit an andrologist with for preventive purposes. Timeliness is one of key factors positive prognosis for the life and health of the patient. Timely treatment will completely eliminate the pathology and avoid serious complications.

If healing techniques have completely exhausted themselves, but did not give the desired effect, auxiliary ones come to the rescue reproductive technologies.

These include:

• IVF - in vitro fertilization;
• ICSI - injection of sperm into the cytoplasm of the egg;
• IMSI - injection of a morphologically correct sperm into the cytoplasm of the egg;
• artificial insemination - the introduction of prepared sperm directly into the uterus.

Assisted reproductive technologies allow a man to become a father even with such serious illnesses, such as azoospermia (complete absence of germ cells in the seminal fluid), complex genetic disorders, absence of one of the testicles or penis.

Where can I consult an andrologist?

You can get a consultation with an andrologist in both public and private clinics. The first thing you will encounter in municipal clinics is long queues and appointments at inconvenient times, but you need to visit the doctor several times. The second point is paid diagnostics. Even if the doctor sees you for free, you will have to pay separately for additional examination methods, as well as for medications.

Consulting with a paid clinic is much easier, and often cheaper, since the first appointment at the human reproduction center is free. Our clinic constantly monitors the level of qualifications of specialists, has its own laboratory and innovative diagnostic equipment. This allows you to undergo additional examination literally in one day. Reception is by appointment only. You can choose a time convenient for you and visit a doctor. To get to our doctor, just fill out the electronic feedback form or call the phone number listed on the website.

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Make an appointment with a urologist

Who is a urologist?

Urologist is a doctor who diagnoses, treats and prevents diseases genitourinary system, as well as other related organs.

The areas of activity of a urologist include:

• Diseases urinary system in men and women. This group of pathologies includes dysfunction of the kidneys, ureters ( which carries urine from the kidneys to the bladder), bladder and urethra ( urethra).
• Disorders of the reproductive system in men. IN this group includes diseases of the testicles and their appendages, prostate, and penis.
• Diseases of the adrenal glands. The adrenal glands are special glands that secrete various hormones. These hormones regulate the activity of many systems in the body ( including the reproductive system).

It is worth noting that urology is a surgical specialty. A urologist works primarily in a special urology department of a hospital. At the same time, many clinics have a urologist’s office, where the doctor consults patients on various issues, conducts a clinical examination and, if necessary, prescribes additional tests or instrumental studies. If a pathology requiring surgical treatment is detected, the doctor may recommend hospitalization to the patient.

Interesting facts

• The first “urologists” appeared in the 5th century BC. Then they were called “stone cutters” because they knew how to remove stones from the bladder surgically. It is worth noting that in those days the concepts of medicine were very scarce, so operations were carried out without anesthesia and in unsanitary conditions. More than half of the patients died.
• The first specialized urology department was opened in Paris in 1830.
• International Urologist Day is celebrated on October 2.

Today, urology as a specialty has become very developed, and therefore smaller varieties have appeared in it related to the treatment of certain pathological conditions.

Pediatric urologist

The need to identify pediatric urology as a separate specialty is due to the fact that the anatomy and physiology of the pediatric genitourinary system differs from those of an adult. Pediatric urologist deals with the diagnosis and treatment of congenital malformations of the bladder, urinary tract or external genitalia ( in boys). This doctor can also perform various urological surgeries on children.

Urologist-sexologist ( sex therapist)

This is a doctor who studies sexual sexual) human behavior, as well as the diagnosis and treatment of various pathologies in this area. Sexology is inextricably linked with urology, which is due to the anatomical and functional connection between sexual desire and the organs of the reproductive system ( in men). At the same time, it is worth noting that in order to become a sexologist, a urologist must undergo additional training.

Urologist-oncologist

Doctors in this specialty study, diagnose and treat tumor diseases of the genitourinary system. The need to separate oncourology into a separate specialty is due to the fact that the removal of benign and ( especially) malignant tumors requires the surgeon to have certain theoretical knowledge and practical skills that ordinary urologists do not possess.

A urologist-oncologist treats:

• tumors ( cancer) kidneys;
• prostate cancer;
• testicular tumors;
• tumors of the penis and so on.

What is the difference between a urologist and a reproductive specialist?

A reproductive specialist is a doctor who deals with issues of infertility in men and infertility in women. Reproductology is a rather narrow specialty that can be mastered by both urologists and doctors of other professions ( for example, gynecologists). Unlike a reproductive specialist, a urologist focuses his attention not only on the issue of infertility, but also on other problems of the patient’s genitourinary system.

What does a urologist-andrologist treat?

A urologist-andrologist specializes in studying issues related to the male reproductive system and also treats diseases or malformations of the male genital organs.

The areas of activity of an andrologist include:

• Male infertility problems- they can be caused anatomical features genital organs or a violation of the hormonal activity of the testicles ( male gonads).
• Male contraception issues– methods to prevent pregnancy in a sexual partner.
• Issues of reducing sexual activity in men– including in old and senile age.

What does a urologist surgeon do?

As stated earlier, urology is primarily surgical specialty. A urologist-surgeon works in a special urological department of a hospital, where he treats patients with various diseases requiring surgical ( operational) interventions.

The responsibilities of a urologist surgeon include:

• patient examination;
• appointment of additional laboratory and instrumental studies;
• identification of indications for surgery;
• preparing the patient for surgery;
• performing surgical treatment;
• postoperative management of the patient ( prevention of possible complications, identification of side effects, prescription of drug treatment after surgery, and so on).

What is the difference between a urologist and a gynecologist?

As mentioned earlier, a urologist deals with the treatment of the reproductive system in men. A gynecologist deals with the diagnosis, treatment and prevention of diseases of the female reproductive system. If during the examination the gynecologist reveals that a woman has any problems with the urinary system ( diseases of the kidneys, bladder, etc.), he should refer the patient for a consultation with a urologist.

What is the difference between a urologist and a nephrologist?

A nephrologist is a doctor who studies the functions, as well as diagnoses, treats and prevents kidney diseases. On the one hand, nephrology is closely related to urology. At the same time, nephrology considers kidney damage as a consequence of diseases of other organs and systems, and also evaluates the impact of the affected organ on the entire body as a whole.

Impaired kidney function can be a consequence of diseases of the cardiovascular, nervous, endocrine, urinary and many other systems of the body. A nephrologist examines all of the above systems, assesses their effect on kidney function, identifies existing disorders and prescribes appropriate treatment. The urologist concentrates his attention only on those issues that are associated with impaired urinary function of the kidneys.

What is the difference between a urologist and a venereologist?

Venereology is a field of medicine that studies sexually transmitted infectious diseases.

The urologist's competence includes treatment of:

• prostate adenomas;
• genitourinary system infections;
• testicular diseases;

• bladder diseases;
• kidney diseases;
• erectile dysfunction;
• male infertility.

Prostatitis

Prostate ( prostate) is an organ of the male reproductive system that is located below the bladder and surrounds upper section urinary canal ( which passes through the gland). Under normal conditions, the prostate produces a special substance necessary for normal functioning sperm ( male reproductive cells). Its other function is to block the outlet of the bladder during erection ( by increasing the volume and squeezing the urinary canal), which is necessary to protect sperm from accidental exposure to acidic urine.

With the development of prostatitis ( prostate inflammation) it can increase in size, as a result of which it will also compress the urethra, disrupting the process of urine excretion. Prostatitis is treated by a urologist who prescribes anti-inflammatory and antibacterial drugs ( in the event that the cause of the disease is an infection). Surgical treatment for uncomplicated prostatitis is not required.

Prostate adenoma

Prostate adenoma is a benign tumor characterized by the proliferation of cells in this organ. At the same time, gradual compression of the urethra also occurs, which over time leads to disruption of the urination process.

This disease develops mainly after 45 years of age, which is associated with disruption of hormonal activity in the male body. At the initial stages of the disease, the urologist may prescribe drug treatment (antiandrogen drugs are used to reduce the effect of male sex hormones on prostate growth). In advanced cases, when the overgrown prostate tissue almost completely blocks the urinary canal, surgical removal of the organ is resorted to.

Infections

A urologist treats bacterial infections of the external genitalia or urinary tract. When such diseases are detected, drug treatment is prescribed ( various antibacterial, anti-inflammatory and other drugs are used), and if they are ineffective, surgical treatment can be performed, if possible.

A urologist can treat:

• Infectious cystitis– inflammation of the bladder caused by pathogenic microorganisms.
• Balanita– inflammation of the glans penis.
• Balanoposthitis– inflammation of the scalp, as well as foreskin in the area of ​​the penis.
• Urethritis– inflammation of the urethra ( the urethra, which releases urine from the bladder).
• Urethritis– inflammation of the ureters.

It is worth noting that, if necessary, the urologist can call for a consultation with an infectious disease specialist - a doctor specializing in the treatment of infectious diseases.

Testicular diseases

The testicles are organs of the male reproductive system in which male reproductive cells are formed ( spermatozoa) and male sex hormone ( testosterone). Development of various pathological processes in the testicles may reduce sexual desire men or even lead to male infertility. That is why, if pain or other strange sensations appear in the scrotum area, a man should consult a urologist as soon as possible. The doctor will be able to conduct a full diagnosis, identify possible violations and start treatment in a timely manner ( medical or surgical).

A urologist diagnoses and treats:

• Orchita. Inflammation of the testicle that develops with bacterial or viral infections ( for example, with gonorrhea, mumps). Treatment is predominantly medicinal ( antibacterial and anti-inflammatory drugs are used). Surgical treatment is extremely rarely required ( in neglected, intractable drug therapy cases).
• Epididymitis. Inflammation of the epididymis caused by infections. Treatment is also medicinal.
• Hydrocele. With this pathology, there is an accumulation of fluid between the membranes of the testicle, which leads to an increase in its size. Treatment depends on the cause of the disease and may be medication ( antibiotics and anti-inflammatory drugs are used) or surgical ( The testicular membranes are dissected and the pathological fluid is removed).
• Spermatocele. Characterized by the formation of a cyst ( fluid-filled cavity) in the epididymis. Treatment is predominantly surgical ( cyst removal).
• Varicocele. With this pathology there is pathological expansion veins of the spermatic cord, in which the vessels supplying the testicle, nerves and the vas deferens pass. Treatment is surgical ( the affected veins are ligated and removed).
• Testicular torsion. With this pathology, the testicle twists around its axis, as a result of which the nerves and vessels passing into the spermatic cord. The consequence of this is the development of ischemia ( blood supply disorders) of the testicle itself, which without treatment will inevitably lead to its necrosis ( mortification) for 5 – 6 hours. Treatment of the disease can be conservative ( an attempt is made to untwist the testicle from the outside). If ineffective this method, as well as in case of late admission of the patient ( 3 – 4 hours after the onset of the disease) surgical treatment is indicated - opening the scrotum, untwisting the testicle and fixing it.
• Testicular injuries. At traumatic injury testicles ( accompanied by a violation of its integrity) surgery is usually performed ( testicle removal).

Bladder diseases

The bladder is a kind of reservoir in which urine accumulates, constantly flowing from the kidneys through the ureters. Bladder diseases can significantly disrupt the functioning of the human genitourinary system.

A urologist treats:

• Cystitis. Inflammation of the lining of the bladder, most often caused by infection. Treatment is medicinal ( antibiotics are used).
• Congenital developmental anomalies. There may be a disturbance in the shape, size or structure of the bladder. If these disorders do not in any way affect the child’s quality of life, no treatment is required. At the same time, if the urination process is disrupted, it may be necessary to surgical correction defect.
• Bladder diverticulum. A diverticulum is a pathological protrusion of the bladder wall. This “protrusion” can retain urine, which contributes to the formation of stones and the development of infection. Treatment is surgical ( removal of the diverticulum and suturing of the bladder wall).
• Bladder neck stenosis. At the neck of the bladder is the opening of the urethra, through which urine is released. Presence of stenosis ( pathological narrowing) in this area can disrupt the process of urination and cause the development of infectious and other complications. In the initial stages of the disease, conservative treatment is possible, while in advanced cases surgery is indicated.
• Tumors. When a tumor is detected in the wall of the bladder, treatment tactics are determined by a urologist-oncologist ( chemotherapy, radiotherapy or surgery may be used).

Urolithiasis

With this pathology, the formation of hard, dense stones in various parts of the urine is noted. excretory system (in the kidneys, ureters, bladder). At the initial stage of development, stones do not in any way affect the processes of urine formation and urination, and therefore people do not even suspect their presence for a long time. As the disease progresses, the stones increase in size and can block various parts of the urinary tract, which is usually accompanied by the development of renal colic ( severe pain syndrome).

When treating urolithiasis, a urologist may use non-surgical ( crushing stones using ultrasound) or surgical methods (removal of stones during surgery). Also of particular importance are diet therapy and other methods of treatment and prevention of stone formation, which the urologist will tell the patient in detail about.

Urinary incontinence ( enuresis)

This disease is characterized by involuntary urination, which occurs mainly at night. More often ( in more than 95% of cases) enuresis occurs in children, which is associated with the imperfection of their central nervous system. Neuroses, nervous strain and other stress factors can contribute to the development of pathology.

Since this disease is more related to the child’s nervous system, it is treated by neurologists and neuropathologists. If urinary incontinence is caused by anatomical defects of the urinary system ( what can be observed with congenital anomalies of the bladder), the disease is treated by a urologist.

Kidney diseases

The kidney is the main organ of the excretory system in which urine is formed. The list of kidney diseases is quite large, and the treatment of most of them requires the participation of a nephrologist, urologist and other specialists simultaneously.

A urologist may be involved in the treatment of:

• inflammatory kidney diseases ( glomerulonephritis, pyelonephritis);
• infectious kidney diseases;
• kidney damage in diabetes mellitus;
• kidney damage when taking certain medications;
• for kidney tumors;
• when kidney stones are detected, and so on.

Phimosis

This disease is characterized by a pathological narrowing of the foreskin covering the head of the penis. The foreskin is so narrowed that the head cannot be completely exposed. This can create certain difficulties in a person’s sexual life, and also causes the development of infectious and non-infectious complications ( in particular difficulty urinating).

Phimosis can be caused by injury or inflammatory lesion foreskin for various infectious diseases. Phimosis can also be congenital, but it is worth remembering that in only half of children at the age of 1 year, the foreskin easily moves, exposing the head of the penis.

Treatment of the disease can be conservative or surgical. In the first case, special methods of stretching the foreskin can be used, which a urologist will tell you in more detail after assessing the condition of this area of ​​skin. As practice shows, conservative methods can be very effective and avoid surgery in more than 50% of cases. At the same time, with severe phimosis, in which the process of urination is disrupted and there is a danger of rupture of the foreskin, surgical treatment is indicated.

Decreased potency and erectile dysfunction ( impotence)

Potency is a man's ability to perform sexual intercourse. Violation of this function can develop under various pathological conditions both from the genitourinary system and from other organs.

It is immediately worth noting that for a complete and adequate treatment of potency disorders, first of all, it is necessary to accurately identify the cause of the disease and eliminate it. To resolve this issue, a urologist ( which men most often turn to with similar problems) may attract specialists from other areas of medicine.

The reason for the decrease in potency may be:

• Decreased concentration of male sex hormone ( testosterone) in the blood. This pathology should be treated by an endocrinologist.
• Use of certain toxic substances ( marijuana, alcohol). If alcohol or drug addiction is detected, consultation with a narcologist is recommended.
• Stress. It has been scientifically proven that chronic overexertion, lack of sleep and exposure to stressful situations significantly weakens a man's sex drive, leading to the development of erectile dysfunction. In this case, consultation and treatment with a psychotherapist, neurologist or neurologist is recommended.
• Obesity. Sedentary lifestyle, prolonged sitting and overweight bodies also contribute to the development of impotence.
• Infectious diseases genitourinary system. For untreated prostatitis ( inflammation of the prostate), urethritis ( ) or cystitis ( inflammation of the bladder) testicular complications may develop, which can lead to disruption of testosterone production.

Frequent urination

Frequent urination may be a sign of cystitis ( this disease has been described previously) or neurogenic bladder. This pathology characterized by a violation of the nervous regulation of the activity of the bladder, which can manifest itself as a frequent and painful urge to urinate, during which non-urinary fluid is released large number urine. Treatment of the disease is conservative ( medicinal) and is carried out jointly by a neurologist and a urologist.

Premature ejaculation ( ejaculation)

The causes of this pathology may be psychological disorders or disorders of the central nervous system ( including diseases of the spine and spinal cord). In this case, issues of diagnosis and treatment should be dealt with by psychotherapists, psychiatrists, neurologists and neuropathologists. At the same time, the disease can develop due to organic damage to the organs of the genitourinary system ( for untreated prostatitis, urethritis, etc.). These pathologies are treated by a urologist according to the previously described principles.

Does a urologist perform circumcision of the foreskin ( circumcision)?

A practicing urologist-surgeon can perform circumcision of the foreskin for medical reasons ( in the presence of severe phimosis, with frequent infections ). Circumcision has also been found to help treat premature ejaculation. The fact is that after the procedure, the skin in the area of ​​the head of the penis thickens somewhat, and its sensitivity decreases, which has a “therapeutic” effect.

The operation itself is relatively safe and is usually performed under local anesthesia, however, at the request of the patient, it can also be performed under general anesthesia ( when a person falls asleep and doesn't remember anything).

Does a urologist treat hemorrhoids?

Hemorrhoids are characterized by damage to the hemorrhoidal veins in the rectum and anus. This pathology is treated by a proctologist, and the urologist has nothing to do with it.

Does a urologist treat infertility?

Issues of female infertility are mainly dealt with by gynecologists. At the same time, urologists ( andrology) can take an active part in the treatment of male infertility, which may be associated with both a disorder ( decrease) sexual desire, and with organic damage to various organs of the reproductive system.

The causes of male infertility can be:

• decreased potency;
• erectile dysfunction;
• ejaculation disorder ( ejaculation);
• abnormal development of the genital organs;
• genetic abnormalities ( disorders of germ cell development);
• inflammatory diseases of the genital organs;
• immunological lesions of the testicles ( may occur after injury);
• disturbances in the formation of germ cells ( spermatozoa).

Many of the listed pathologies cannot be cured by a urologist alone, so quite often the doctor, after a preliminary examination, refers the patient for consultation to other specialists.

Should a urologist examine pregnant women?

In the absence of any diseases from the genitourinary system, pregnant women do not need to visit a urologist. At the same time, it is worth remembering that during pregnancy a number of changes occur in a woman’s body, in particular, there is a restructuring of hormonal levels and compression of internal organs ( growing fruit). All this predisposes to stagnation of urine in the bladder and to the development of various diseases.

During pregnancy, the risk of developing:

• Pyelonephritis – inflammatory disease kidney disease caused by pathogenic microorganisms.
• Glomerulonephritis– an infectious-inflammatory disease in which the urinary function of the kidneys is impaired.
• Urolithiasis.

If any of these pathologies are detected or worsened during pregnancy, you should immediately consult a urologist. Only he will be able to make an accurate diagnosis and, if necessary, prescribe the optimal treatment that will help cope with the disease, at the same time, without harming the mother or developing fetus.

For what symptoms should you contact a urologist?

Indications for consultation with a urologist may include dysfunction of the genitourinary system, as well as any unusual sensations in bodies related to this system.

Indications for consultation with a urologist are:

• frequent urination;
• rare urination ( 1 – 2 times a day);
• urinary incontinence;
• pus in the urine;
• decreased sex drive ( in men);
• inability to perform sexual intercourse ( for men).

What can a patient expect at an appointment with a urologist?

A visit to a urologist, like any other specialist, is accompanied by a number of standard procedures ( survey, inspection, survey, etc.), on the basis of which the doctor makes a preliminary diagnosis, and, if necessary, prescribes additional examinations.

Preparing before going to the urologist

There are several simple recommendations that should be performed before visiting a urologist. This will make the consultation as productive as possible and help the doctor make a more accurate diagnosis.

Before going to the urologist, it is recommended:

• Refrain from sexual intercourse. The fact is that after the examination, the doctor may need certain tests ( for example, urine analysis or semen analysis). If the patient had sexual intercourse the day before, this can significantly complicate or make it impossible to collect test data, which will increase the duration of the diagnostic process.
• Empty your bladder. This should be done not right before visiting the doctor, but 1 – 2 hours before. In this case, at the time of consultation, a certain amount of urine will be collected in the bladder, which may be required for some examinations or tests.
• Empty your bowels. This procedure is necessary if the reason for visiting a doctor is problems with the prostate ( the doctor may perform a rectal examination of the organ).
• Observe personal hygiene rules. In the morning, before visiting the doctor, you need to take a shower and put on clean underwear.
• Get ready mentally. During the consultation, the doctor may ask questions that some people may be embarrassed or embarrassed to answer. It is important to remember that the diagnosis and adequacy of treatment depend on the reliability and accuracy of the information received, so all the doctor’s questions should be answered honestly and completely.

Before visiting a doctor, you should not use any antibacterial or antiseptic solutions to wash the external genitalia, as this may distort the data laboratory tests and complicate the diagnosis process.

What questions can a urologist ask during a consultation?

During the consultation, the doctor may ask the patient about the circumstances of the disease, its manifestations, and so on.

At the first consultation, the urologist may ask:

• How long ago did the disease begin?
• How does the disease manifest?
• Do you have problems with urination?
• What causes/increases symptoms?
• Does the patient suffer from any known diseases of the genitourinary system?
• Did your parents or close relatives have similar diseases ( with siblings)?
• Does the patient have chronic diseases other organs and systems ( heart, liver and so on)?
• Does the patient have a regular sexual partner?
• What methods of contraception ( protection) does the patient use?
• Has the patient suffered from sexually transmitted diseases?
• Does the patient have children?
• Is the patient taking narcotic drugs?
• Does the patient abuse alcohol?
• Does the patient smoke?

It is worth noting that the list of questions may differ significantly depending on which organ is affected and how severely it is affected.

How are men examined by a urologist?

After interviewing the patient, the doctor must examine the external genitalia.

During the examination, the doctor assesses:

• Penis shape– its excessive curvature can be a cause of infertility, and also indicate high probability the presence of other developmental anomalies.
• Penis sizes– its underdevelopment is possible with a reduced concentration of the male sex hormone in the blood.
• State skin in the genital area– in order to identify foci of inflammation, ulcers, cracks or other deformations.
• Condition of the glans penis (for this purpose the doctor exposes her) – to identify phimosis or inflammatory processes in this area.
• Condition of the testicles– the doctor palpates ( probes) testicles and epididymis, assessing their shape, size and consistency.
• Condition of the scrotum– in order to identify varicocele or an infectious-inflammatory process.
• Bladder condition I - for this, the doctor may ask the patient to lie down, and then begin to apply light pressure on the bladder area ( just above the pubis).
• Kidney condition– the urologist can lightly tap the patient’s lumbar region with the edge of his palm ( on which the kidneys are projected), assessing his reaction ( the occurrence of pain may indicate the presence of an inflammatory process).

Also a mandatory stage of the examination is a digital rectal examination of the prostate. The essence of the method is as follows. The patient lies on his side and tries to press his knees to his chest. The doctor puts on a sterile glove, lubricates it with special oil and inserts his index finger into the patient's anus. At a depth of several centimeters, it identifies the prostate, which is located between bladder and intestines ( the doctor probes it through the wall of the rectum). Next, the doctor evaluates the size, consistency and shape of the prostate. If during the examination the patient feels sharp stabbing pains, he must inform the doctor about this ( this symptom may indicate the presence of prostatitis).

It is worth noting that all of the above studies are carried out only when indicated.

How are women examined by a urologist?

Women are examined in a special gynecological chair, also after a detailed interview. The doctor examines the external genitalia and urethra ( if necessary). Also a doctor in mandatory palpates ( probes) area of ​​the bladder and kidneys, assessing the patient's response. The occurrence of pain in the pelvic area or in the lumbar region may indicate the presence of inflammatory processes and usually requires additional instrumental studies.

Does a urologist do prostate massage?

A urologist can perform digital prostate massage for various forms of prostatitis ( prostate inflammation), when conventional treatments ( antibiotic therapy, anti-inflammatory drugs) are not effective enough. Therapeutic effect This procedure is to improve microcirculation in the prostate, which improves the access of antibacterial drugs to it. Also, during the massage, the release of secretions from the gland is stimulated, which helps restore the patency of its ducts and also has a beneficial effect on the course of the disease.

Preparing for a prostate massage involves having a bowel movement ( sometimes this may require a cleansing enema, which should be performed in the morning before going to the doctor). The procedure itself is as follows. The patient lies down on the couch and presses his knees to his chest ( curls up into a ball). The doctor puts on a sterile glove, treats the index finger with Vaseline and inserts it into the patient's anus. At a depth of about 5 cm, he feels the prostate, after which he begins to massage it, lightly pressing on the gland tissue. If at any stage of the procedure the patient experiences pain, he should immediately inform the doctor.

The duration of the massage is about 1 - 2 minutes, after which the patient can go home. The course of treatment consists of 10 - 15 procedures, performed with a break of 1 - 2 days.

Prostate massage is contraindicated:

• In the acute phase of prostatitis– in this case, the procedure will be extremely painful.
• If prostate cancer is suspected– possible damage to the tumor and the appearance of metastases ( distant tumor foci).
• If you have stones in the prostate– it may be damaged during the procedure.
• For prostate adenoma.
• For prostate tuberculosis.
• In the presence of an infectious-inflammatory process in the anal area– the procedure will be very painful, and infection may spread.

Is it possible to call a urologist at home?

If for one reason or another the patient cannot ( or doesn't want to) visit a urologist, a doctor can be called to your home. It is immediately worth noting that this service is most often provided by private clinics and medical centers, and therefore is paid.

When visiting a patient at home, a urologist can:

• Collect anamnesis. By asking the patient in detail about his problems, the doctor can suggest the presence of a particular disease.
• Conduct an objective examination. At home, the doctor can examine the external genitalia, palpate the patient’s bladder and abdomen, examine the lumbar region, and so on. In the case of a male examination, a digital examination of the prostate is also performed ( if necessary). All this allows us to make a preliminary diagnosis.
• Perform an ultrasound examination ( Ultrasound). The doctor can take with him a small portable device that will allow him to perform the study right at the patient’s bedside.

If after the examination the doctor is not sure of the diagnosis, he may recommend that the patient visit the hospital, take tests and undergo additional examinations. In milder cases, the doctor can make recommendations regarding the treatment of the patient's existing disease.

How often should you visit a urologist for prevention?

Young people who do not experience any problems with the genitourinary system do not need preventive consultations with a urologist. At the same time, as men age, the risk of developing a disease such as prostate adenoma increases. This is a benign tumor, which, however, can interfere with the process of urination, and when exposed to unfavorable factors, it can degenerate into cancer. This is why all men over 45 years of age are recommended to visit a urologist annually for a digital examination of the prostate. This simple procedure will allow timely detection of pathological changes in the gland and prompt treatment, which can save the patient’s life.

What tests and studies can a urologist prescribe?

After interviewing the patient and conducting a clinical examination, the doctor may prescribe additional laboratory or instrumental tests that will allow a more accurate assessment of the functions of the organs of the genitourinary system and make the correct diagnosis.

The urologist may prescribe:

• general urinalysis;
• general blood test;
• sperm analysis ( spermogram);

• tests to detect genitourinary tract infections;
• ultrasound examination ( Ultrasound).

Urinalysis

This is a simple and cheap test that allows you to evaluate the excretory function of the kidneys, identify urinary tract infections, and so on.

The patient collects material for the study himself, collecting a certain amount of morning urine into a special sterile jar. The day before the examination, it is recommended to perform a hygienic toilet of the genitals, as otherwise you may get distorted results. During morning urination, the first portion of urine ( which is released during the first 1 - 2 seconds) should be released into the toilet, after which you need to substitute the jar and fill it with about 50 ml. Then her ( jar) must be immediately closed and taken to the laboratory for examination.

During a urine test, the following is assessed:

• Urine color. Normal urine is straw-yellow in color. A red tint may indicate blood in the urine, while a brown tint may indicate liver or blood problems.
• Transparency of urine. Normal urine is clear. The appearance of cloudiness is possible if there are any foreign inclusions in it ( blood cells, protein, bacteria, pus, salts).
• Density of urine. Normally, this indicator ranges from 1010 to 1022 g/liter. An increase or decrease in urine density can be observed if the concentration function of the kidneys is impaired.
• Acidity of urine. This indicator can vary widely, depending on the type of diet, lifestyle and functional state of the kidneys.
• Presence of protein in urine. Normally, the protein concentration in urine should not exceed 0.033 g/liter. An increase in this indicator can be observed in diseases of the kidneys, heart, immune system and so on.
• Presence of glucose ( Sahara) in urine. Normally, there is no sugar in the urine. Its appearance usually indicates that blood glucose levels are significantly elevated.
• Presence of pathological inclusions. At various diseases and metabolic disorders, substances may appear in the urine that are not normally detected in it ( ketone bodies, bilirubin, hemoglobin and so on). If these elements are identified, additional research is required.
• The presence of blood cells in the urine. Under normal conditions, a small number of white blood cells may be found in the urine ( immune system cells) and red blood cells ( blood cells). However, a significant increase in the concentration of these cells indicates the presence of a pathological process in the organs of the genitourinary system.
• Presence of bacteria in urine. They can appear with infectious and inflammatory diseases of the kidneys, bladder, urethra, prostate or external genitalia.

Blood test

General blood test ( UAC) is a routine research method that is prescribed to patients during hospitalization, in preparation for surgery, or in some other situations. IN urological practice An indication for prescribing OAC may also be a suspicion of a genitourinary tract infection.

The presence of infection may be indicated by:

• Increased total white blood cell count (more than 9 x 10 9 /liter). Leukocytes are cells of the immune system that fight infection. In case of infection of any organ human body their amount in the blood increases.
• Increased erythrocyte sedimentation rate ( ESR). Given laboratory value also allows you to identify signs of infection in the body. With the development of an infectious-inflammatory process in any organ, the so-called proteins of the acute phase of inflammation are released into the blood. They interact with red blood cells ( red blood cells), increasing the rate of their settling to the bottom of the test tube during the study ( more than 10 mm per hour in men and more than 15 mm per hour in women).

Other indicators general analysis blood ( blood cell concentration, hemoglobin level and so on) are important only in preparation for surgical interventions or if the patient has other diseases.

Sperm analysis ( spermogram)

This study is prescribed if a man has problems conceiving children ( for example, in the case of an infertile marriage in order to identify possible reasons male infertility). The essence of the study is that sperm obtained from a man is examined under a microscope, assessing its quantitative and qualitative characteristics.

Preparation for the study involves abstaining from sexual intercourse for 4 to 5 days. During this period of time, it is also recommended to exclude alcohol, drugs, smoking, and visiting a bathhouse or sauna.

The analysis is taken on the day of the study by the patient himself ( through masturbation). The resulting material must be placed in a special sterile tube in full ( loss of some sperm may distort the results of the study).

Basic spermogram parameters

Indicator	Normal values
Sperm quantity	Not less than 2 ml
Consistency
Color	White or grayish
Smell	Specific
Acidity(pH)
Viscosity(measured by the length of a thread trailing a drop of semen released from a special syringe)
Liquefaction time(this refers to the liquefaction of the ejaculate under the influence of prostate enzymes, as a result of which its viscosity becomes less than 2 cm)	10 – 40 minutes
Sperm count(in 1 ml)	20 – 120 million
Total number of sperm in the test material	40 – 500 million
Actively motile sperm	Not less than 25%
Poorly motile sperm	Not less than 50%
Immotile sperm	No more than 50%
Spermagglutination(sperm adhesion)	Absent
Leukocytes	3 – 5 in field of view

Cystoscopy

The essence of this study is as follows. Through the urethra ( urethra) a special flexible tube is inserted into the bladder ( cystoscope), equipped optical system. This allows you to visually examine the walls of the urethra, bladder and terminal ureters ( where they enter the bladder). This is necessary to identify the source of bleeding, suppuration, tumor, rupture or other damage to the listed organs.

The examination itself is carried out under local or general anesthesia, so the patient experiences virtually no pain. After the examination and cessation of anesthesia ( pain relief) there may be moderate pain along the urethra, which may intensify during urination.

Cystoscopy is contraindicated:

• With urethritis ( inflammation of the urethra) – the risk of additional damage to the walls of the urethra increases.
• For prostatitis ( inflammation of the prostate) – difficulties may arise during insertion of the device.
• In case of obstruction of the urethra- for example, with adenoma or prostate cancer, which can compress the urethra, preventing the advancement of the cystoscope.
;
• candidiasis;
• gonococcal infection and so on.

If the patient is suspected of having bacterial infection, the resulting material is sown on special nutrient media. On these media, bacteria grow and multiply within several days, forming large colonies. By examining these colonies, the doctor can determine the exact type of infectious agent, as well as determine which antibiotics it is suitable for ( pathogen) maximally sensitive ( this will help prescribe the most effective treatment).

If the purpose of the study is to identify a viral infection, culture on nutrient media will be ineffective ( viruses don't grow on them). In this case it can be used special method polymerase chain reaction ( PCR), with the help of which microparticles of viral tissue can be detected in the material being studied, thereby confirming the diagnosis.

Ultrasound ( ultrasound examination) kidneys, testicles, prostate, bladder

Ultrasound is a cheap research method that allows you to study the structure of internal organs. The essence of the method is as follows. A special sensor attached to the human body sends ultrasonic waves of a certain length deep into the body. These waves are reflected from tissues and internal organs, then arriving at a special receiver located near the sensor. Based on data on reflected waves, the computer forms an image of organs located in the path of ultrasound.

In urological practice, ultrasound examination may be needed in cases where clinical methods do not allow an accurate diagnosis to be made.

The urologist may prescribe:

• Ultrasound of the kidneys. Allows you to evaluate the structure of the organ, as well as its shape and location, which can change in various pathologies. Ultrasound can also detect stones in the kidneys or ureters, which helps confirm the diagnosis of urolithiasis.
• Ultrasound of the bladder. Allows you to identify stones or tumors in the bladder. Also, conducting a study after urination allows you to identify residual urine retained in the bladder due to various pathologies ( for example, with adenoma or prostate cancer, with bladder diverticulum, and so on).
• Ultrasound of the prostate. Allows you to evaluate the structure of the gland and timely identify pathological changes characteristic of adenoma or cancer.
• Ultrasound of the testicle. Helps confirm the diagnosis of inflammation of the testicle or epididymis, varicocele, hydrocele, testicular cyst, and so on.

It is worth noting that ultrasound is an absolutely safe and painless examination, therefore, if necessary, it can be performed several times.

Jokes about urologists

A sign on the urologist’s door: “You can’t just walk in and brag.”
A man enters the urologist's office.
- Hello doctor, I...
The doctor fills out the documentation and, without raising his head, says:
- Take off your clothes!
- Doctor, but I...
- Take off your pants, I said!
The patient has undressed, stands, shifts from foot to foot. The doctor finished writing, raises his head and says:
- I'm listening to you.
- I’m a plumber, I came to fix the faucet...


A man runs into the urologist’s office and says:
- Doctor, castrate me quickly!
- What are you, dear, why do you need this...
- Doctor, do it quickly, I’ll pay any money!
The doctor has nowhere to go, since the patient demands - he castrated him, stands, washes his hands and asks:
- But still, dear, why did you need this?
- You see, doctor, I’m marrying a Jewish woman, and that’s the custom among them.
- So, maybe you wanted to get circumcised?
- Well, yes, what did I say?

******************************************************************************************

A very shy guy comes to the urologist and, blushing, says:
- You see, doctor, one of my friends seems to have become infected venereal disease and asked me to find out what he should do now...
The doctor answers:
- I understood everything. Take off your pants and show your friend.

******************************************************************************************

At the clinic:
- Hello, I need a consultation with a urologist and an ophthalmologist.
- Wow, why suddenly go to such different specialists?
- I can’t understand - either I’m colorblind, or my urine is green...

******************************************************************************************

An old man of 95 years old comes to the urologist and says:
- Doctor, after sex I have some kind of noise in my head, do you know what it is?
- This is applause, grandpa!

Before use, you should consult a specialist.

Andrologist is a specialty of a doctor who treats pathological processes and diseases of the male reproductive system. Andrology was formed as a branch of urology, studies a number of problems of men's health and is at the intersection of such disciplines as endocrinology, sexology, dermatology, venereology, plastic and vascular surgery. According to WHO definition, the main task of this discipline is reproductive health men. An andrologist specializes in the diagnosis, treatment, prevention of diseases of the male genital area and social adaptation patients.

Most often, this specialist is consulted with problems of sexual disorders, impotence, erectile dysfunction, prostate problems, and restoration of potency. The professional sphere of an andrologist also includes the problems of pediatric andrology, which studies issues of delayed sexual development in boys and adolescents. The doctor also deals with such a serious problem as male infertility. Thus, a doctor in this specialty must have extensive knowledge in a range of medical disciplines.

One of the most common reasons for seeking advice from an andrologist is erectile dysfunction. The definition of erectile dysfunction means the inability to achieve and maintain an erection sufficient for sexual intercourse. It occurs in men of any age, but men in age are most often affected. age group 40 - 60 years. Its appearance may be based on organic reasons and psychological. The main risk factors for development are diseases such as diabetes mellitus, vascular atherosclerosis, hypertension, renal and liver failure, thyroid diseases, neurological disorders, hormonal imbalance, as well as alcohol abuse, smoking, drug use and other factors.

There are several methods for treating erectile dysfunction:

• intracavernosal administration of drugs. The method is to administer injections special drugs into the corpus cavernosum, acting on the vessels of the penis. As a rule, after this there is a significant improvement in erection.
• drug therapy. A number of medications are used that increase the intensity of blood flow in the vessels of the penis and help improve erection.
• psychotherapy and sex therapy. It is used for psychogenic erectile dysfunction. Treatment is carried out jointly with a psychotherapist.
• vacuum erectile therapy. Vacuum erectors are used various models to get an erection. This technique is painless and safe, but inconvenient to use and provides relatively low quality of erection.
• surgical methods of treatment. Vascular surgeries on the penis and penile prosthetics are performed. Vein operations are performed successfully and most effectively to limit venous outflow. The most radical method of treatment is penile prosthesis. These treatment methods are used in cases where conservative therapy is ineffective.

– a doctor specializing in the treatment and diagnosis of diseases of the male reproductive system. He provides diagnostics and outpatient treatment of urethritis, prostatitis, decreased libido and erectile dysfunction, bladder and kidney diseases, sexually transmitted infections and sexually transmitted diseases.

What is the competence of an andrologist?

An andrologist is the most “masculine” doctor, whose work poses the following professional tasks:

• hypogonadism (a wide group of conditions of different origins caused by insufficient activity of the male gonads, as evidenced by hormonal abnormalities and fertility indicators), regardless of the desire to have children;
• pathological changes in ejaculation (pain, absence, acceleration, difficulty achieving);
• inflammation of the male genital organs;
• erectile dysfunction;
• male contraception;
• recurrent decline in male sexual functions (male menopause).

What diseases does an andrologist treat?

• acquired or congenital curvature of the penis;
• premature ejaculation (impaired ejaculation);
• pathological changes in the organs of the scrotum.

What organs does an andrologist deal with?

• Ureter;
• urethra;
• urethra;
• penis;
• kidneys;
• bladder;
• prostate;
• urethra;
• epididymis.

When is it necessary to contact an andrologist?

The real reasons for seeking a consultation with an andrologist are:

• childless marriage. In recent decades, in Europe and Ukraine, infertility in the family has become one of the most important social and medical problems. 20 percent of marriages in our country are infertile. And in 40 percent of cases it is the man’s fault. Male infertility is indicated by the absence of conception within a year during regular sexual activity with a healthy partner of childbearing age (when contraceptives are not taken);
• problems with potency. Almost every man at least once in his life experiences difficulty maintaining or achieving an erection that is sufficient for satisfactory sexual intercourse. Many men were unable to solve an intimate problem on their own, taking a passive wait-and-see attitude, relying on the advice of friends and self-medication. Thanks to latest achievements in andrology, men are given real prospects to restore an erection and maintain sexual activity. is a condition that can be eliminated and corrected. First of all, to achieve this goal, it is important for a man to recognize the problems and make a decision about professional medical care;
• a condition characterized by a loss (decrease) of sexual desire with a simultaneous weakening of the frequency and strength of erections that occur, lack of development of secondary sexual characteristics, underdevelopment of the genital organs, decreased tone of the external genitalia, that is, which indicate a possible imbalance or deficiency of sex hormones and require drug correction ;
• signs that indicate inflammatory damage to the genital organs: discomfort, discharge from the urethra, pain, burning and heaviness in the perineum, groin area, lower abdomen, testicles, discomfort, unpleasant odor from the penis;
• imperative and frequent urge on urination, thinning of the urine stream, a feeling of incomplete emptying of the bladder, the presence of floating purulent threads in the urine, intermittent and difficult urination;
• the need to obtain information about the basics of safe sex and family planning, the characteristics of intimate contacts during pregnancy and after childbirth, mental hygiene of sexual life and activities that increase the likelihood of conception;
• accelerated ejaculation, safety of orgiastic sensations, weariness.

If the listed signs appear and when you practice uninitiated sex with casual partners, a medical examination is required.

What tests should be done and when?

• Common prostate-specific antigen;
• Carcinoembryonic antigen;
• Urea in urine;
• Sodium/potassium/chlorides;
• General blood test;
• Urea;
• Syphilis;
• Spermogram;
• Free prostate-specific antigen;
• Creatinine in urine;
• Calcium;
• Inorganic phosphorus;
• Creatinine;
• Hepatitis B;
• Candidiasis.

Laboratory diagnostics include urine and blood tests. A general blood test allows you to determine the state of hemoglobin in the blood. Its decrease may indicate kidney disease.

A biochemical blood test determines the content of various substances in the blood (creatinine, uric acid). Their increased quantity in the blood indicates kidney disease. Using this analysis, you can also diagnose other diseases associated with the genitourinary system.

To determine the degree of kidney failure, other biochemical tests are performed, for example, for the presence of enzymes.

The normal amount of urine excreted by a person is considered to be 1-1.5 liters. With less or more content urine this indicates problems in the genitourinary system.

When analyzing urine, attention is paid to the color and amount of urine, substances contained in the urine are determined, for example, a large amount of blood or protein, which indicates an infection or disease.

What are the main types of diagnostics performed by an andrologist?

When performing instrumental research A special catheter is inserted into the bladder. The main indicator for such a study is the increased size of the prostate gland, which causes urine to be retained in the bladder. Also in urology, puncture biopsy of the kidneys, cystomanometry to measure pressure in the bladder, dilation of the urethra and other studies are performed.

In many clinical cases For accurate diagnosis the urologist uses additional instrumental and laboratory tests. Due to a general blood test, it is possible to identify the development of inflammatory processes in the patient’s body, and thanks to a biochemical study, the concentration of urinary pigments in the blood is determined, showing the functional state of the kidneys. A urine test is very informative. It reveals the relative density, which changes due to a violation of the concentrating ability of the kidneys. The color of urine is affected by the content of the urobilin pigment in it; normally, urine has a straw-yellow color without any inclusions. A change in color indicates dietary habits and the use of certain medications. Detection of protein and glucose impurities in urine also helps in the process of diagnosing urological diseases.

As a result of urinary sediment, information is obtained about the presence of inflammatory processes throughout the system, the filtering ability of the kidneys, and the causative agent of infectious processes is determined.

Among the instrumental research methods, bladder catheterization is widely used, which makes it possible to normalize the outflow of urine when it is retained and to conduct a study of the sterility of urine.

Bougienage of the urethra is used to determine the degree of narrowing of the urethra and its mechanical expansion.

Through a puncture biopsy of the prostate kidneys, specialists examine in detail cellular composition tissues for diagnosing cancer.

Urologists prescribe cystomanometry to measure the pressure in the bladder cavity, which indicates its full function and patency.

Thanks to the use of an endoscope in the process of diagnosing various urological diseases, it is possible to study the condition of organs from the inside without resorting to surgical interventions. For this purpose, pyeloscopy, cystoscopy, and urethroscopy are used.

The oldest diagnostic methods are X-ray methods. A survey X-ray allows the doctor to evaluate the features of the anatomical structure of the urinary tract organs, see the presence of stones in the cavities, changes in the shape and size of organs during the development of tumors or chronic pathological processes.

Through X-ray examination using contrast agents, the functional capacity of organs is fully assessed.

VIDEO

IN modern times many young people have their first sexual experience in their youth.

At the same time, not everyone thinks about the safety of sex, but is guided only by the positive emotions that they receive as a result of it. In addition, some men, even while married, continue to have outside contacts. Therefore, all men should be screened for sexually transmitted infections.

Carriage of this infection can lead to a decrease in sperm motility and concentration, and therefore to infertility.

Also, one should not turn a blind eye to the existence different ways sexual satisfaction, including anal and oral sex.

Microorganisms that penetrate the reproductive tract during such unprotected contacts bring chaos to the existing biocenosis. All this is manifested by both the development of nonspecific inflammatory processes in the reproductive tract and genital dysbiosis.

Taking into account this fact, both partners who practice such contacts are required to be examined for the flora of the reproductive system.

For such purposes, a bacteriological culture of sperm is taken from men on special nutrient media, which makes it possible to determine microorganisms, their number and sensitivity to antimicrobial agents.

A sperm test is also required. Unlike an egg, sperm mature in 72-75 days; in the testicles of a healthy man, up to 100 million are produced every hour. But the sperm that has formed in the testicle cannot yet fertilize the egg on its own, because the movement apparatus is defective and the enzymes that neutralize the protective shell of the egg remain immature. The male reproductive cell acquires these properties in the epididymis.

According to research, a more complete ejaculate for fertilization occurs after 3-5 days of sexual abstinence, therefore men should follow the specified period of abstinence.

After preliminary hygienic measures, sperm is collected only by masturbation. It is important to collect all the ejaculate without dropping a drop. Often the first portion of sperm passes by the sperm receptacle, while it contains most of the motile sperm.

When examining incompletely collected ejaculate, an impression is created of defective sperm.

A spermogram determines the number of sperm, their mobility, structure (morphology), viability, the presence of other cellular elements in the ejaculate (leukocytes, spermatogenesis cells, erythrocytes) and allows doctors to draw conclusions about the fertilizing ability of sperm.

Some couples experience immune factor infertility. This means that the body of a woman or man produces specific proteins against sperm, preventing their interaction with the egg. This protein is one of the reasons for “spousal incompatibility.”

Therefore, it is advisable to examine a man’s sperm and blood for the presence of antisperm antibodies.

If abnormalities or infection are detected in the parameters of the ejaculate, it is advisable to contact a specialist. The most common reasons for abnormal spermogram indicators are occupational hazards, stressful situations, visiting saunas and steam rooms, smoking, overwork, drug use, and alcohol abuse.

Stagnation in the reproductive system due to rare sexual intercourse also adversely affects the functioning of the reproductive system. sedentary lifestyle life.

Thus, it is possible to normalize ejaculate parameters even without the use of medications - by properly organizing your lifestyle.

When organizing meals, the diet must necessarily include seafood, nuts, garlic, vegetable oils, fish, cottage cheese, honey, herbs, fresh fruits and vegetables. It is necessary to limit the consumption of spicy and very hot foods, animal fats, smoked meats, beer and spirits. Normalizing weight, dosing physical activity (running, volleyball, swimming, football, etc.), adequate sleep, adequate nutrition, correction of sex life - all this allows you to independently improve the overall tone of the body, including the reproductive system.

Unfortunately, the combination of unfavorable psychosocial and environmental factors, which act on modern man, have a greater negative impact on reproductive functions men.

Thus, over the past half century, WHO observations indicate a decrease in average sperm parameters.

Sperm concentration decreases every year by 2 percent, motility by 1.5 percent. This trend will inevitably lead to an increase in the number of men with reduced fertility. Reduce likelihood similar problems will help healthy image life, which is very popular in the world.