Urology is the field of medicine that focuses on the urinary tracts of males and females, and on the reproductive system of males. In men, the urinary system overlaps with the reproductive system, and in women the urinary tract opens into the vulva. In both sexes, the urinary and reproductive tracts are close together, and disorders of one often affect the other. The organs covered by urology include the kidneys, ureters, urinary bladder, urethra, and the male reproductive organs (testes, epididymis, vas deferens, seminal vesicles, prostate and penis).

The discipline combines management of medical (i.e., non-surgical) problems such as urinary infections, and surgical problems such as the correction of congenital abnormalities and the surgical management of cancers. Such abnormalities within the genital region are called genitourinary disorders.

Urologists are also involved in the assessment and treatment of incontinence. Urodynamics is the study of the pressure within the urinary system and urologists often use diagnostic techniques such as flow cystometry or ambulatory urodynamic profiles to determine the best method of treatment for the patient. This could include medical prescription (e.g. oxybutynin or multiple alpha-blockers) or surgical intervention (e.g. urethral suspension/slings).

More on [ Urology ]

All Urology Jobs

South Central, KS :: Kansas :: Rural Health Education & Services
Urologist Option to be hospital employed or in a solo practice. There are currently no other urologists on staff. The hospital is a 69-bed acute care facility with a 51-bed short-term and long-term
Great Location :: Michigan :: Minerva Recruiting
Requirements BC/BE practicing urologist, or graduating resident or fellow. Reason for Recruitment There is a strong community need for a local urologist. Practice Details Multispecialty
North Central :: Kansas :: Rural Health Education & Services
KRC.0708.0701.13 Urologist New position for a two-campus, 99 bed, regional acute care hospital. The modern facility offers full laparoscopic system, family birthing rooms, a well-equipped intensive

Urology / Nephrology News From Medical News Today

In Prostate Cancer Patients Proton Therapy Is Well-Tolerated
Tue, 03 Nov 2009 05:00:00 -0800
Proton beam therapy can be safely delivered to men with prostate cancer and has minimal urinary and rectal side effects, according to a study presented November 2, 2009, at the American Society for Radiation Oncology's 51st Annual Meeting in Chicago.
Prostate Cancer Recurrences Reduced By Adding Proton Therapy "Boost" To X-Ray Radiation Therapy
Tue, 03 Nov 2009 05:00:00 -0800
Men who receive a "boost" of proton therapy after receiving a standard course of X-ray radiation therapy have fewer recurrences of their prostate cancer compared to men who did not receive the extra dose of proton radiation, according to a first-of-its-kind study presented November 2, 2009, at the American Society for Radiation Oncology's 51st Annual Meeting in Chicago.
Amylin Pharmaceuticals And Eli Lilly And Company Statement On FDA's BYETTA(R) (Exenatide) Injection Update
Tue, 03 Nov 2009 01:00:00 -0800
Amylin Pharmaceuticals, Inc., (Nasdaq: AMLN) and Eli Lilly and Company (NYSE: LLY) issued the following statement in response to the U.S. Food and Drug Administration (FDA) update on BYETTA® (exenatide) injection. "The FDA update issued today aligns with the BYETTA label approved last week. The current label reflects our understanding of post-marketing reports of renal events and provides physicians with updated guidance about appropriate use in patients with renal conditions.

BMC Urology - Latest Articles

Donor site morbidity in oral mucosa graft urethroplasty: implications of tobacco consumption
Rahul Janak SinhaVishwajeet SinghS SankhwarDivakar Dalela Mon, 21 Sep 2009 00:00:00 -0000
Background: The purpose of this prospective study was to evaluate the donor site morbidity in patients who have undergone oral mucosa graft urethroplasty for stricture of the urethra. The impact of smoking and oral consumption of tobacco and/or paan masala on the donor site was also assessed. This study is probably the first of its kind where the affect of smoking, paan masala and tobacco chewing on the donor site morbidity has been documented. Methods: Forty-eight patients suffering from stricture of the urethra underwent oral mucosa graft urethroplasty between July 2005 and December 2007. The patients were divided into two groups (users or non-users) based on tobacco consumption and oral hygiene. The donor site was evaluated at frequent intervals for pain, swelling, numbness, bleeding, salivation and tightness of mouth. Results: Donor site morbidity was more in users with poor oral hygiene. Pain scores were higher amongst the users and the morbidity persisted longer in the users compared to non-users with good oral hygiene. Conclusion: Patients who consume tobacco and have poor oral hygiene should be warned regarding poorer outcomes after oral mucosa graft urethroplasty.
A systematic review of the diagnostic accuracy of prostate specific antigen
Philip HarveyAmman BasuitaDeborah EndersbyBen CurtisAphrodite IacovidouMary Walker Thu, 10 Sep 2009 00:00:00 -0000
Background: Prostate cancer is the fourth commonest cancer in the UK, and the incidence is rising. The reference standard for diagnosing this condition is prostate biopsy, an invasive procedure.This study systematically reviews recent literature on tPSA accuracy. The time period was restricted to ensure that the estimates referred to contemporary tPSA tests and prostate cancer reference standards. The focus of this review was restricted to European populations as tPSA levels are known to vary by population group. Methods: Medline was searched (from 01/1998 to 01/2008) and Embase (from 01/1998 to 01/2008), which returned 3087 citations. These were assessed by 6 reviewers, who shortlisted 54 of possible relevance. 2 reviewers assessed each using the following inclusion criteria: data collection between 1998-2008; tPSA measurements for all participants; histological confirmation of the diagnosis; samples from a European population and sufficient data to calculate 2 × 2 tables. The final set of 10 included studies represented 5373 participants. Quality of the included studies was assessed in duplicate using criteria suggested by the Cochrane Collaboration. Review Manager 5.0 software was used to analyse the data, including plotting a series of summary receiver operator curve spaces (SROC). Results: tPSA sensitivities ranged from 0.78 to 1.00 and specificities from 0.06 to 0.66. Positive likelihood ratios ranged from 0.83 to 2.90 and negative likelihood ratios ranged from 0.00 to 3.75 Conclusion: tPSA has a role to play as one of several indicators for prostate biopsy along with abnormal digital rectal examination and urinary symptoms. However, tPSA test has a high false positive and significant false negative rate. It is important that clinicians understand these limitations.
Commentary: the role of cytologic analysis of voided urine in the work-up of asymptomatic microhematuria
Deep TrivediEdward Messing Thu, 10 Sep 2009 00:00:00 -0000
Microscopic hematuria is a common finding in patients presenting to both primary care doctors as well as urologists. Sources of microscopic hematuria include infection, stones, inflammatory disorders as well as cancer of the genitourinary tract, particularly urothelial cancer. A primary focus in the urologic workup of hematuria is to rule out cancer. This is done using radiographic studies as well as procedures such as cystoscopy and bladder biopsy. As the authors state in their article titled "The utility of serial urinary cytology in the initial evaluation of the patient with microscopic hematuria", cytologic analysis of voided urine, though attractive due to its noninvasive nature, has been found to have the neither the sensitivity, cost-effectiveness, nor the ease of administration necessary to replace more invasive diagnostics in the evaluation of microscopic hematuria.
Utility of serial urinary cytology in the initial evaluation of the patient with microscopic hematuria
Kogenta NakamuraAli KasraeianKenneth IczkowskiMyron ChangJohn PendletonSatoshi AnaiCharles Rosser Thu, 10 Sep 2009 00:00:00 -0000
Background: We determine the utility of serial urinary cytologies in patients presenting with microscopic hematuria who were evaluated with upper and lower urinary tract studies to rule out a malignancy. Methods: Two hundred and thirty-seven patients with the diagnosis of microscopic hematuria were evaluated at an inner-city tertiary care hospital. Of these 239 patients, 182 patients had 405 cytologies obtained as part of their evaluation for hematuria. In addition, all patients had their lower urinary tract and upper tract thoroughly evaluated. Results: Two hundred and seventy four cytology samples were read as normal, 104 (26%) as atypia, 7 (2%) as suspicious/malignant, and 20 (5%) as unsatisfactory. Seventeen patients (9.3%) had biopsy confirmed bladder cancer. Of these 17 patients, 2 had normal cytology, 11 had atypia, and 5 had suspicious/malignant. No patient had a positive cytology and a negative biopsy. Overall the number of hematuric patients harboring bladder cancer was small (7%). Cytology #1 detected 4 cases of cancer, cytology #2 detected an additional case and cytology #3 did not detect any additional cancers. Conclusion: Because of this low prevalence of bladder cancer in patients presenting with microscopic hematuria and the low sensitivity of detecting bladder cancers, the utility of urinary cytology in the initial evaluation of patients with hematuria may be minimal. The exact role of urinary cytology in the evaluation of hematuria is unknown.
Diabetes related risk factors did not explain the increased risk for urinary incontinence among women with diabetes. The Norwegian HUNT/EPINCONT study
Marit EbbesenYngvild HannestadKristian MidthjellSteinar Hunskaar Thu, 10 Sep 2009 00:00:00 -0000
Background: Previous studies have shown an association between diabetes mellitus (DM) and urinary incontinence (UI) in women, especially severe UI. The purpose of this study was to investigate whether diabetes related variables could explain this association. Methods: The study is part of the EPINCONT study, which is based on the large Nord-Trøndelag Health Study 2 (HUNT 2), performed in the county of Nord-Trøndelag, Norway, during the years 1995 - 1997. Questions on diabetes and UI were answered by a total of 21 057 women aged 20 years and older. Of these 685 were identified as having diabetes, and thus comprise the population of our study. A variety of clinical and biochemical variables were recorded from the participants. Results: Blood-glucose, HbA1c, albumine:creatinine ratio (ACR), duration of diabetes, diabetes treatment, type of diabetes, cholesterol and triglycerides did not significantly differ in women with and without UI in crude analyses. However, the diabetic women with UI had more hospitalizations during the last 12 months, more homecare, and a higher prevalence of angina and use of oestrogene treatment (both local and oral/patch). After adjusting for age, BMI, parity and smoking, there were statistically significant associations between any UI and angina (OR 1.89; 95% CI: 1.22 - 2.93), homecare (OR 1.72; 95% CI: 1.02 - 2.89), and hospitalization during the last 12 months (OR 1.67; 95% CI: 1.18 - 2.38). In adjusted analyses severe UI was also significantly associated with the same variables, and also with diabetes drug treatment (OR 2.10; 95% CI: 1.07 - 4.10) and stroke (OR 2.47; 95% CI: 1.09 - 5.59). Conclusion: No single diabetes related risk factor seems to explain the increased risk for UI among women with diabetes. However, we found associations between UI and some clinical correlates of diabetes.
HIV-associated bladder cancer: a case series evaluating difficulties in diagnosis and management
Elizabeth GaughanBruce DezubeMark BowerDavid AboulafiaGerry BohacTimothy CooleyLiron Pantanowitz Mon, 31 Aug 2009 00:00:00 -0000
Background: Chronic human immunodeficiency virus (HIV) infection is associated with an increased incidence of Non-Acquired Immunodeficiency Syndrome (non-AIDS) defining cancers. To date, only a limited number of cases of bladder cancer have been linked with HIV infection. We sought to describe the clinical characteristics of HIV-associated bladder cancer. Methods: A retrospective study was performed involving HIV-positive patients with bladder cancer, combining cases from multiple institutions with published case reports. Data regarding patient demographics, HIV status, clinical presentation, pathology, cancer treatment, and outcome were analyzed using descriptive statistics. Results: Eleven patients were identified with a median age of 55 years (range, 33 - 67). The median CD4+ count at cancer diagnosis was 280 cells/mm3 (range, 106 - 572 cells/mm3). Six patients (55%) had a known risk factor for bladder cancer, and nine (82%) presented with hematuria. Ten patients had transitional cell carcinoma, and most had superficial disease at presentation. Treatment included mainly transurethral resection of bladder tumor followed by a combination of local and systemic therapies. One patient received intravesical bacillus Calmette-Guèrin (BCG) without complication. Several patients (55%) were alive following therapy, although many (64%) suffered from local relapse and metastatic disease. Conclusion: Bladder cancer is part of the growing list of cancers that may be encountered in patients living longer with chronic HIV-infection. Our patients presented at a younger age and with only mild immunosuppression, however, they experienced an expected course for their bladder cancer. Hematuria in an HIV-infected patient warrants a complete evaluation.

Subscribe to Urology RSS feed