The Role of the Urologist and

    Gynecologist

By Jamie Lober

When men think of their best ally for good health, the urologist should come to mind. When women think of an advocate for wellness over the lifespan, the gynecologist should be at the top of their list. When you know what each provider has to offer and how you can benefit from building a relationship with them, you are more likely to get better control of your sexual health.

The American Urological Association describes urology as a surgical specialty that deals with diseases of the male and female urinary tract and the male reproductive organs. Since the urologist sees such a broad scope of clinical problems, he has a strong background in pediatrics, gynecology, internal medicine and other specialties as well. Cancer, infertility, urinary tract stones, voiding disorders and urinary incontinence are just a few of the common issues that are presented to the urologist on a daily basis. To address prevalent troubles like urinary incontinence, the urologist is able to offer therapies that are both surgical and non-surgical.

In the field of urology, male sexual dysfunction and infertility are not unusual. Impotence is now managed with prosthetic devices as well as with the use of an artificial urinary sphincter. There have also been continual improvements related to the medical management of infertility that put the urologist’s knowledge of endocrinology and reproductive physiology to good use. As a result of advances in technology, urology is a rapidly-growing area of study. Refinements associated with urethral and renal endoscopic surgery have significantly enhanced the therapy of urinary tract stones and a lot of past approaches are now obsolete. Lasers are expected to play an increasingly large role down the road and research has concentrated on their application in laparoscopic surgery.

The most popular topic of discussion related to urology is the new guidelines for early detection of prostate cancer. Prostate-specific antigen screening is not recommended for men under age forty because of the low incidence rate and potential harms of screening. It is also not advised for men between ages forty and fifty-four who are considered to be at average risk. Men who are African American or have a family history of prostate cancer tend to have a higher risk and should discuss screening options with their doctor. For men ages fifty-five to sixty-nine years-old, it is encouraged to weigh the risks versus benefits of prostate cancer screening and to make an individualized decision based on your values and risk factors. It is a good idea to screen every two years instead of annually as well. Finally, men over seventy years-old should not be screened even though some men over seventy years-old who are in excellent health may reap some benefits from it.

The gynecologist tends to see younger patients than the urologist. The American College of Obstetricians and Gynecologists recommends that the first visit is scheduled between thirteen and fifteen years-old. The purpose is to find out what to expect at future visits and share information about your family, menstrual periods and sexual activities, all of which is kept confidential. Sometimes exams are performed, such as a general physical exam and external genital exam. Unless you have abnormal bleeding or pain, a pelvic exam is not necessary. If you are sexually active, the gynecologist may opt to test you for sexually transmitted diseases which can usually be done through a urine sample. Vaccinations are also discussed to ensure that you are current.

It is normal for girls to be nervous the first time they see the gynecologist, but, over time, they are able to build a lasting relationship. The gynecologist should be someone that you can trust and confide in as well as a source of valuable information about your body and wellbeing. At twenty-one years-old, girls should have a Pap test which looks for abnormal changes in the cervix that could potentially lead to cancer. It involves taking a sample of cells with a small brush and, while it may be uncomfortable, it should not be painful. Regardless of your age, you should address any concerns or questions about sexual health with the gynecologist and know that you can always bring a parent, friend or partner with you if it makes you feel more at ease. Issues that often come up that are part of growth and development include cramps and problems with menstrual periods, birth control, sexually transmitted diseases, emotional ups and downs, sex and sexuality, weight and acne. Alcohol, drugs and smoking are also common areas of interest as the gynecologist serves as an outstanding counsel on lifestyle choices, promoting ideals such as eating a balanced diet, exercising often, avoiding smoking, drinking and drugs, using condoms to protect yourself from sexually transmitted diseases and keeping up to date with exams and vaccinations.

Women often ask the gynecologist about strategies for cancer prevention, particularly for lung, breast, skin, ovary, uterus, cervix, vulva and vagina cancer that are most common among women. The American College of Obstetricians and Gynecologists lists a change in bowel or bladder habits; a sore that does not heal; unusual bleeding or discharge; thickening or a lump in the breast or other part of the body; indigestion or difficulty swallowing; a change in a wart or mole; and a nagging cough or hoarseness as warning signs that something may be wrong. Thanks to screening tests, women can catch cancer at early stages and have a better prognosis.

The gynecologist encourages annual mammograms for women forty and up. The Pap test should be done every three years if you are between ages twenty-one and twenty-nine and every five years if you are above thirty. If you have had either three negative Pap test results in a row or two negative co-test results in a row, you do not need to continue cervical cancer screening after age sixty-five. Colonoscopy and fecal occult blood test should be done every ten years for women age fifty and up. Lifestyle choices can reduce the risk of cancer as well, such as not smoking, limiting fat intake especially saturated fat and trans fat, eating foods with high fiber content, getting regular health checkups, exercising for at least thirty minutes each day, limiting your time in the sun and wearing sunscreen, limiting your number of sexual partners and limiting alcohol consumption.

Last but not least, the urologist and gynecologist ask that patients get to know their bodies and what is normal for them. That way they are better equipped to point out any problems as they arise instead of when they turn into something more serious. There are self-exams that you can do but they do not replace the need to see a doctor. Women can do a vulvar self-exam once a month looking for changes, a breast self-exam and a skin self-exam to see if the size, shape or color of any moles has changed. The key to good long-term wellness whether you are male or female is to have the urologist or gynecologist at your side throughout different ages and stages of life.

Jamie Lober, author of “Pink Power”, has a passion for health promotion and disease prevention. She can be reached at jamie@getpinkpower.com