When should you see a urologist? 7 signs not to ignore

A urologist specialises in the urinary tract of men and women, and in the male reproductive system. Yet many patients wait months before seeing one, out of embarrassment or hoping the problem will "go away on its own".

Most urological problems are easier to treat when they are managed early. Here are the 7 signs that should prompt an appointment, and those that call for urgent care.

What is a urologist?

A urologist is a doctor and surgeon specialising in the urinary tract (kidneys, ureters, bladder, urethra) and the male reproductive organs (prostate, testicles, penis). Urologists treat common and usually benign conditions such as infections, stones or an enlarged prostate, as well as more serious diseases such as urological cancers.

Not to be confused with a nephrologist, who treats problems with how the kidneys work (kidney failure, for example), without surgery.

7 signs you should see a urologist

1. You urinate often, especially at night

Getting up two or more times every night, feeling sudden urges or going to the toilet every hour is not "just part of getting older". In men over 50, the most common cause is benign prostatic hyperplasia (BPH). In both men and women, an overactive bladder, an infection or diabetes can also be responsible.

Learn more: prostate conditions, and our article benign prostatic hyperplasia.

2. Your urine stream is weak or interrupted

A weak stream, needing to strain, dribbling afterwards or feeling that the bladder is not empty are signs of an obstruction — most often the prostate, sometimes a narrowing of the urethra. Left untreated, it can lead to infections, bladder stones or urinary retention.

3. You have seen blood in your urine

Blood in the urine (haematuria) must always be investigated, even if it happened only once and without pain. The cause is often benign (infection, stone), but it can also reveal a tumour of the bladder or kidney, especially in smokers and after 50.

The work-up starts with a urine test and an ultrasound, followed if needed by a CT scan and a camera examination of the bladder (cystoscopy). To learn more, read our article blood in the urine: causes and tests.

4. You have intense pain in your back or side

Sudden, very intense pain on one side of the back, spreading to the lower abdomen or groin and often with nausea, suggests renal colic. It is usually caused by a stone blocking the flow of urine.

Learn more: kidney stones, diagnosis and treatment, and our article kidney stones and renal colic: symptoms, treatment and prevention.

5. Urinary infections keep coming back

Simple cystitis in women is usually treated by a general practitioner. A urologist's opinion is advised for repeat infections (several a year), infections in men — often linked to the prostate —, infections with fever, or infections associated with blood in the urine or a stone.

Learn more: urinary infections and disorders, and our article recurrent urinary infections in women.

6. You have erection problems

Difficulty getting or keeping an erection for more than three months is common, and more so with age. Don't hesitate to talk about it: these problems respond well to treatment. They can also be the first sign of artery disease, diabetes or a hormone deficiency, which is why a check-up is useful.

Learn more: erectile dysfunction and sexual health, and our article erection problems: causes and treatment.

7. You are struggling to conceive

A male factor is found in about half of couples who have difficulty conceiving. After 12 months of regular unprotected intercourse — or 6 months if the woman is over 35 — the work-up should include the man. The first test, a semen analysis, is simple and non-invasive.

Learn more: male infertility, and our article semen analysis: how to read the results.

Summary table: when should you see a doctor?

Other situations where a urologist can help

• A high PSA or questions about prostate cancer screening: read High PSA, what next?
• A lump or swelling in a testicle, even if painless.
• Urinary leakage, on exertion or with urgency, in women and men.
• An unexpected finding on an ultrasound or CT scan: kidney cyst, stone, enlarged prostate.
• A bend or pain in the penis during erection.
• A tight foreskin or questions about circumcision: read phimosis and circumcision.

What happens at a first consultation?

The visit starts with a discussion of your symptoms, medical history and medication. It is followed by a clinical examination suited to your situation; for the prostate, this includes a digital rectal exam, which is quick and only mildly uncomfortable.

Depending on the case, the urologist may order simple tests: urine test (dipstick, urine culture), blood test (PSA, kidney function), ultrasound or urine flow measurement (uroflowmetry). The diagnosis and treatment options are then explained, and you choose together.

Do you need a referral letter to see a urologist?

No, you can book an appointment directly. If your doctor referred you or you already have test results, bring them along: they make the consultation easier.

Seeing a urologist in Agadir

Dr. Abdellatif Mitach, urologist and andrologist, sees patients at his practice on Avenue Hassan II in Agadir. You can book an appointment online or explore all of his areas of expertise.

Sources

• French Association of Urology (AFU), patient information: urofrance.org
• European Association of Urology (EAU), Patient Information: patients.uroweb.org
• French National Authority for Health (HAS): has-sante.fr