Men have a reputation for steering clear of the doctor’s office, and they can be extra hesitant about scheduling an appointment for a problem “down there.” But it’s crucial to get care if you’re concerned about something in the genital area. And while some symptoms are signs of a serious condition, many problems can be treated easily. Curtis Crylen, MD, a urologist with Banner Health, said, “Most people walk out saying, ‘That wasn’t as bad as I was worried it might be!’”
When should you schedule a urology exam?
Dr. Crylen said you should make an appointment for a urology exam if you:
- Notice a change in urination, such as difficulty urinating, urinating more frequently in the day or night, blood in the urine, urinary incontinence or pain with urination. These changes could be due to an enlarging prostate, urinary tract infection, narrowing or scar tissue in the urinary tract, or other rare causes, such as cancer.
- Have a family history of prostate, bladder or kidney cancers. In these cases, you should talk to your primary care physician about screening and evaluation and whether you should see a urologist.
- Have signs of kidney stones.
- Have sexual function concerns, including erectile dysfunction.
- Need treatment for curvature of the penis (Peyronie’s disease).
- Need evaluation and treatment for low testosterone levels (low T).
- Have any concerns with the male genitalia, such as foreskin problems, testicular lumps or masses, lesions, sores or pain.
- Would like a vasectomy for permanent male contraception.
- Have a prostate-specific antigen (PSA) level that is too high for your age.
How should you prepare for your appointment?
“No special preparation is required,” Dr. Crylen said. If you can, bring an up-to-date copy of your medical history, a list of any medications or supplements you are taking, and any relevant lab or imaging tests you may have done. You’ll probably want to shower beforehand, since your doctor may need to examine the genital area.
Will you need to give a urine sample?
Probably. “We check a urine sample for almost everyone, and definitely those with urinary tract concerns,” Dr. Crylen said. If you are considering a vasectomy or have concerns about your sexual function, you may not need to provide a sample. “But since almost all urology patients need an evaluation of the urine, it’s best to come to the office prepared to leave a sample,” he said.
What types of questions will the doctor ask?
“Every patient may have different concerns that guide our questioning in a different direction,” Dr. Crylen said. You can expect questions about your urinary symptoms, family history of urologic diseases or cancers, and what outcome you hope to have from your visit. Bowel and bladder functions are closely tied together, so you might be asked about your bowel habits.
If you need surgery to address your issue, your doctor will likely discuss any prior surgeries, anesthesia concerns, general surgical risk factors and treatments with medications such as blood thinners or immunosuppressants that may affect surgical planning and recovery.
What happens during the physical exam?
It depends on why you’re seeing a urologist. “Most men think about—and fear—the prostate exam, and that would probably be recommended for any man experiencing problems with urination or an elevated PSA level,” Dr. Crylen said. Many men may also wonder, “does a urology exam hurt?”.
The digital rectal examination (DRE) is important for assessing the size of the prostate and checking for any concerning nodules or areas of firmness on the prostate, which can be a sign of cancer. “The exam is quick and generally has minimal to no pain, but it can be uncomfortable for men because we need to insert a gloved finger into the rectum to feel the prostate,” he said.
If you have blood in your urine, your doctor may evaluate your lower urinary tract with a small flexible camera and scope they can use to look inside the bladder and urethra to check for causes of bleeding. It’s an in-office exam performed with local anesthesia that typically takes less than 30 seconds.
If your doctor is concerned about worrisome conditions like some cancers, they’ll explain any other tests or evaluations you might need.
What happens next?
It depends on your diagnosis. A lot of urologic concerns can be treated with medication or, sometimes, surgery. Your doctor will walk you through your treatment options, based on your specific health issues.
The bottom line
Men can need urologic exams to help diagnose and treat a lot of different problems with urination and sexual activity. If you need to see a urologist, it can be helpful to know that they might ask questions about your personal and family history, request a urine sample, perform a DRE if needed, and check for causes of any bleeding.
Need urology care?
Schedule an appointment with a urologist near you.