Urology

Urology also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the male and female urinary-tract system and the male reproductive organs. Organs under the domain of urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra.

The urinary and reproductive tracts are closely linked, and disorders of one often affect the other. Thus, a major spectrum of the conditions managed in urology exists under the domain of genitourinary disorders. Urology combines the management of medical conditions, such as urinary-tract infections and benign prostatic hyperplasia, with the management of surgical conditions such as bladder or prostate cancer, kidney stones, congenital abnormalities, traumatic injury, and stress incontinence.

Urological techniques include minimally invasive robotic and laparoscopic surgery, laser-assisted surgeries, and other scope-guided procedures. Urologists receive training in open and minimally invasive surgical techniques, employing real-time ultrasound guidance, fiber-optic endoscopic equipment, and various lasers in the treatment of multiple benign and malignant conditions. Urology is closely related to oncology, nephrology, gynaecology, andrology, pediatric surgery, colorectal surgery, gastroenterology, and endocrinology.

Urology is one of the most competitive and highly sought surgical specialties for physicians, with new urologists comprising less than 1.5% of United States medical-school graduates each year.

Urologists are physicians which have specialized in the field after completing their general degree in medicine. Upon successful completion of a residency program, many urologists choose to undergo further advanced training in a subspecialty area of expertise through a fellowship lasting an additional 12 to 36 months.

Subspecialties may include: urologic surgery, urologic oncology and urologic oncological surgery, endourology and endourologic surgery, urogynaecology and urogynecologist surgery, reconstructive urologic surgery, minimally-invasive urologic surgery, pediatric urology and pediatric, voiding dysfunction, paruresis, neurourology, and and rourology and sexual medicine. Additionally, some urologists supplement their fellowships with a master's degree (2–3 years) in related topics to prepare them for academic as well as focused clinical employment.

In 2014, there were 126 residency programs that offered 296 categorical positions. Urology is one of the early match programs, with results given to applicants by late January. Applications are accepted starting Sep 1, with some programs accepting applications until early Jan.

It is a relatively competitive specialty to match into, with only 68% to 77% of US seniors matching between 2012 and 2015. The number of positions has grown from 278 in 2012 to 296 in 2015. Matching is significantly more difficult for IMGs and students who have a year or more off before residency - match rates were 27% and 55% respectively in 2012.

The medical school environment may also be a factor. A study in 2012 also showed after an analysis of match rates from schools between 2005 and 2009 that 20 schools sent more than 15 students into urology.

Urologic oncology concerns the surgical treatment of malignant genitourinary diseases such as cancer of the prostate, adrenal glands, bladder, kidneys, ureters, testicles as well as the skin and subcutaneous tissue and muscle and fascia of those areas. The treatment of genitourinary cancer is managed by either a urologist or an oncologist, depending on the treatment type. Most urologic oncologists in Western countries use minimally invasive techniques to manage urologic cancers amenable to surgical management.

Reconstructive urology is a highly specialized field of male urology that restores both structure and function to the genitourinary tract. Prostate procedures, full or partial hysterectomies, trauma, disease, obstructions, blockages, and occasionally.The urinary bladder, ureters and genitalia are other examples of reconstructive urology.

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With Regards,

David Paul

Editorial Assistant

Journal of Clinical Nephrology and Research