Urologist-andrologist: who they are and what conditions they treat
A urologist-andrologist is a specialist doctor who diagnoses, treats and prevents conditions affecting the male genitourinary and reproductive systems. They combine in-depth knowledge of urology (diseases of the kidneys, bladder and urethra) and andrology (conditions affecting male infertility, sexual function and hormonal balance).
This specialist’s remit includes the treatment of the following diseases and conditions:
- Male infertility. All its forms — secretory, obstructive and immunological — as well as conditions associated with impaired sperm quality (for example, due to varicocele).
- Inflammatory conditions. Prostatitis, urethritis (inflammation of the urethra), orchitis (inflammation of the testicle), epididymitis, cystitis and other urinary tract infections.
- Sexual disorders. Erectile dysfunction, reduced libido (sexual desire), premature or delayed ejaculation.
- Prostate disorders. Benign prostatic hyperplasia (prostate adenoma), chronic prostatitis.
- Age-related changes. Male menopause (andropause), accompanied by a drop in testosterone levels and a deterioration in well-being.
When a man should book an appointment with an andrologist
Many men are unsure exactly which symptoms warrant a visit to an andrologist and often put off seeing a doctor. However, there are a number of clear signs indicating the need for a consultation. Ignoring these warning signs can lead to the development of chronic conditions requiring more complex and prolonged treatment.
A consultation with a urologist-andrologist is necessary if the following symptoms appear: Age is a specific indication for a visit to an andrologist. Men over the age of 45 are advised to undergo a preventive check-up with a urologist-andrologist at least once a year, even if they have no symptoms. This allows for the timely detection of an adenoma or prostate cancer in the early stages, when treatment is most effective.
- Problems with urination. Excessively frequent, painful or difficult urination; a weak urine stream; a feeling of incomplete bladder emptying; frequent night-time urges.
- Pain. Discomfort or pain in the lower abdomen, in the scrotum, testicles or perineum, as well as during sexual intercourse.
- Abnormal discharge. Any unusual discharge from the urethra, particularly if it has an unpleasant odour or a change in colour.
- Sexual dysfunction. Reduced libido (sexual desire), weak or absent erections, premature ejaculation.
- Difficulty conceiving. Failure of the partner to become pregnant after a year of regular sexual intercourse without using contraception.
- External changes. Lumps, changes in the shape or size of the testicles, or the appearance of rashes or redness on the genitals.
How the consultation proceeds: examination and diagnosis
An initial consultation with a urologist-andrologist is a comprehensive examination that begins with a detailed discussion. The doctor will ask about your symptoms, when they first appeared, your lifestyle, any past injuries, infections, and any chronic or hereditary conditions. It is important to answer questions about your sex life honestly, as this information directly influences the diagnosis and choice of treatment.
After taking your medical history, the specialist will proceed to a physical examination. The procedure is standard, painless and takes very little time.
As a rule, the examination includes: Following the examination, laboratory and imaging tests are prescribed to establish an accurate diagnosis. The doctor decides which specific tests are necessary. The standard set of tests usually includes a semen analysis (particularly in cases of infertility), an ultrasound scan of the scrotum and an ultrasound scan of the prostate. Blood tests for sex hormones, prostate-specific antigen (PSA) and tests for sexually transmitted infections (STIs) may also be required.
- Visual assessment. The doctor examines the external genitalia, paying attention to the condition of the skin and checking for rashes, deformities or signs of inflammation. Hair growth is also assessed, which helps to gauge the state of the hormonal balance.
- Palpation. The doctor gently feels the scrotum, testicles and their appendages to detect lumps, growths, tenderness or signs of varicocele (enlargement of the veins in the spermatic cord).
- Rectal examination. If necessary, particularly in men over 40 or in cases of urinary complaints, a digital rectal examination of the prostate is carried out via the rectum. This allows the doctor to assess its size, consistency and whether there is any tenderness.
