Urology is a medical specialty responsible for the study of Organs structural organs that make up the urinary tract of men and women, in addition to caring for the male reproductive system. The area is also dedicated to the development and execution of procedures and techniques that allow the diagnosis and treatment of diseases that affect these two systems.
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The urologist, therefore, takes care of several illnesses and alterations that affect people of both sexes and of different ages — whether accompanying inpatients, performing specific surgeries or attending in the office. With regard specifically to human health care, urology has an essential role in the execution of preventive exams for the early detection of diseases.
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The importance of urology in men's health
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The popular belief that the urologist is a professional who only takes care of male health, although mistaken, is justified by the anatomical characteristics of the male organs: in men, the urinary system is integrated with the reproductive system.
Because of this, the role of urology also includes the care of male reproductive organs.
Although the urologist can work in all segments that involve the area, there is a subspecialty of urology that is specifically dedicated to taking care of the male reproductive system: andrology. Andrology deals with human health in an interdisciplinary way, from adolescence to senescence. See more about the andrologist doctor.
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Whether due to lack of information or prejudice, there are still few men who regularly consult with these professionals. According to a survey by the Brazilian Society of Urology (SBU), at least half of Brazilian men have never consulted a urologist.
QUANDO PROCURAR UM UROLOGISTA?
A ida ao urologista é recomendada tanto para homens quanto para mulheres quando há algum desconforto que envolva o sistema urinário e/ou para acompanhamento de alguma condição já existente. No caso dos homens com mais de 40 anos, a visita ao urologista deve ser realizada anualmente para realização do exame de toque para prevenção do câncer de próstata.
Os sinais e sintomas abaixo podem indicar que você precisa se consultar com um urologista:
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Dor na região lombar;
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Dor testicular;
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Incontinência urinária;
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Presença de sangue na urina;
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Dificuldade ou dor para urinar;
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Noctúria (vontade de fazer xixi diversas vezes durante a noite);
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Histórico de cálculo renal;
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Qualquer outra condição que envolva o sistema urinário.
A IMPORTÂNCIA DO UROLOGISTA NA SAÚDE
O envelhecimento humano, por mais saudável que seja, passa por uma série de eventos que podem afetar a qualidade de vida, principalmente os referentes à saúde do homem: cálculos urinários, infecções urinárias de repetição, disfunções sexuais e da próstata, incontinências urinárias e alguns tipos de tumores relacionados ao trato urinário. Todas essas condições são diagnosticadas, tratadas e acompanhadas pelo urologista.
No entanto, os homens hesitam em procurá-lo por medo, desconhecimento e até preconceito. Ainda são poucos os homens que se consultam regularmente com estes profissionais.
VASECTOMY
Vasectomy is a surgery where the vas deferens (channels that carry sperm from the epididymis to the urethra for ejaculation) are cut. It is a simple procedure, minimally invasive and very effective as a contraceptive method. Studies conducted by Dr. Jorge Hallak describe that men who underwent vasectomy had increased sexual function, especially in sexual desire and satisfaction, and no case had erectile dysfunction.
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Despite this, statistics show that many men shy away from vasectomy because they believe it leads to impotence and loss of masculinity.
Another fear concerns the surgical recovery of the vasectomy. As directed by the Urology Care Foundation, it is necessary to rest on the day of the procedure, and to minimize the discomfort, ice packs in the region. The use of analgesics is usually advised, but this will depend on each case.
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If a man wants a pregnancy after a vasectomy, reversal surgery is quite effective. In this surgery, the vas deferens are reconnected, allowing sperm to be ejaculated into the semen again, allowing pregnancy by natural methods.
SEXUALLY TRANSMITTED INFECTIONS (ISTS)
Sexually Transmitted Infections (STIs) are diseases caused by viruses, bacteria and other microorganisms transmitted through sexual contact, without the use of male or female condoms. In addition to acting directly in the diagnosis and treatment of STIs, the urologist provides advice on the best methods of preventing these infections and having a healthy sex life.
URINARY TRACT INFECTIONS (UTI)
Urinary tract infections (UTIs) occur when microorganisms invade any part of the urinary system—this could be the urethra (urethritis), bladder (cystitis), or kidneys (pyelonephritis). This is a problem that can affect both men and women, although it is estimated that females are affected 10 to 20 times more often than males.
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UTIs usually have characteristic symptoms that cause a lot of discomfort, including:
Burning when urinating (dysuria);
Urgency to urinate even after emptying the bladder;
Bloody urine (hematuria);
Pain in the pelvic or lumbar region;
General malaise;
High fever (when it develops into pyelonephritis).
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At the first signs of these symptoms, the patient must go to the doctor to receive the correct diagnosis and start the appropriate treatment, because when a UTI is not treated correctly, it can progress to pyelonephritis and seriously compromise the functioning of the kidneys.
PROSTATE CANCER
The prostate is a gland responsible for manufacturing the prostatic fluid released at the time of ejaculation along with the seminal fluid. Data from the National Cancer Institute (INCA) show that more than 68 thousand new cases of prostate cancer are identified per year, mainly affecting men over 50 years of age. This number corresponds to an estimated risk of 66.1 occurrences per 100,000 men in Brazil.
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Prostate cancer can be diagnosed early through routine tests, thus increasing the chances of successful treatment. The main method used to investigate the presence of the disease is the famous digital rectal exam, where the doctor assesses the size, shape and texture of the prostate through the insertion of a properly protected and lubricated finger in the rectum.
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Although simple, the touch test is much feared by most men, and it is estimated that less than 50% of them have done it at least once in their lifetime. As a result, most prostate cancers are identified at an advanced stage, drastically reducing the chances of a cure and leading the disease to occupy the second position among the tumors that most cause the death of male patients in Brazil.
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Along with the touch test, measuring the level of PSA (prostate specific antigen) in the blood can also help in screening for prostate cancer. The prostate produces this protein normally, however, when it has some dysfunction, it increases its production. But remember, PSA alone is not enough to diagnose cancer, the digital rectal exam must be performed together.
KIDNEY CALCULATIONS
Popularly known as kidney stones, kidney stones are characterized by the presence of hardened formations in the kidneys or urinary tract. These hardened formations are the result of the accumulation of small salt crystals. The presence of stones in any part of the urinary tract can cause intense pain that starts in the back and radiates to the abdomen and can also culminate in severe nausea.
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Treatment can be medication in order to dilate the urinary tract so that the stone is expelled or surgical. Whatever the treatment, the responsible physician is always the urologist.
URINAL DYSFUNCTION
The term voiding dysfunction refers to problems that affect the functioning of the urinary bladder, such as difficulties in its storage or emptying. Urinary incontinence is one of the main examples of voiding dysfunction, and the causes of the problem need to be investigated to minimize the negative impacts on the patient's quality of life.
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According to a survey by the Brazilian Society of Urology (SBU), one in every 25 people may suffer from voiding disorders throughout their lives. Among women, 40% of them may start to lose urine involuntarily after menopause, while 8% of men who have had their prostate removed may also have the change.
PENIS PROBLEMS
All types of dysfunctions and problems in the penis can also be monitored and treated by the specialist in urology. The most frequent are:
Premature ejaculation;
sexual impotence;
Phimosis;
Penile curvature.
Existem diversos tipos de cálculos, sendo o mais comum, como já citado, os cálculos de cálcio
(dentre eles, o composto mais frequente é o oxalato de cálcio). Além destes, existem os
cálculos de ácido úrico, cálculos de estruvita (estes são muito relacionados à infecções
urinárias) e mais raramente cálculos de cistina, que são gerados por uma mutação genética.
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De todos eles, existe apenas um tipo que é possível “dissolver”, os cálculos de ácido úrico,
porém para que este método seja efetivo, é necessário diagnóstico preciso e seguimento
rigoroso, visto que há possibilidade de falha (já que existem cálculos com mais de um
componente), bem como há possibilidade de deposição de cálcio, tornando a dissolução
ineficaz. Portanto, esta não é uma modalidade de tratamento habitual.
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Os riscos dos cálculos renais incluem infecções urinárias, episódios de cólica renal (que
geralmente são imprevisíveis e apresentam dor intensa), crescimento dos cálculos e em casos
avançados, perda da função do rim.
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Quando os cálculos são pequenos e indolores, (em geral menores que 5mm), e em pequena
quantidade, é possível fazer seguimento, sem necessidade de retirada. A situação muda caso
os cálculos sejam maiores, vários ou em ambos os rins, com histórico de infecção urinária ou
dor, presença de algum tipo de alteração renal associada (como ter apenas 1 rim, rins em
ferradura ou cirurgia renal prévia), ou caso o portador da litíase tenha alguma profissão de
risco, como piloto de aeronave ou mergulhador, o ideal é realizar a retirada dos cálculos,
através de cirurgia endoscópica através das vias urinárias (chamada de nefrolitotripsia
endoscópica), com auxílio de LASER.
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Para evitar novos episódios de litíase renal, é importante a análise dos cálculos
eliminados/retirados (se disponível) e avaliação metabólica completa, para descartar alterações
que possam estar levando à formação dos cálculos. Caso presença de alguma alteração (como
excesso de cálcio ou ácido úrico na urina, ou falta de citrato), é realizado tratamento
medicamentoso adequado. Porém, uma medida que beneficia a todos os pacientes (e mesmo
quem nunca teve litíase renal) é ter uma ingesta de água adequada (idealmente ao menos 2
litros ingeridos por dia, a menos que haja alguma restrição médica para tal), bem como
restringir alimentos ricos em sódio (especialmente alimentos industrializados e embutidos) e
ingesta diária de suco cítrico natural como limão ou laranja.
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Se você já eliminou cálculos pela urina ou tem cálculos renais, agende uma consulta com
nossos urologistas para avaliação e tratamento.