Wikipedia

Urology

Urology (from Greek οὖρον ouron "urine" and -λογία -logia "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary system and the male reproductive organs. Organs under the domain of urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs (testes, epididymides, vasa deferentia, seminal vesicles, prostate, and penis).

Urologist
Urologist performing a TURBT
Occupation
Occupation type
Specialty
Activity sectors
Medicine, surgery
Description
Education required
Fields of
employment
Hospitals, clinics

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 (i.e., non-surgical) 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.[1]

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.[2][3] Urology is closely related to (and urologists often collaborate with the practitioners of) 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.[4][5]

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, urogynecology and urogynecologic surgery, reconstructive urologic surgery (a form of reconstructive surgery), minimally-invasive urologic surgery, pediatric urology and pediatric urologic surgery (including adolescent urology, the treatment of premature or delayed puberty, and the treatment of congenital urological syndromes, malformations, and deformations), transplant urology (the field of transplant medicine and surgery concerned with transplantation of organs such as the kidneys, bladder tissue, ureters, and, recently, penises), voiding dysfunction, paruresis, neurourology, and androurology and sexual medicine. Additionally, some urologists supplement their fellowships with a master's degree (2–3 years) or with a Ph.D. (4–6 years) in related topics to prepare them for academic as well as focused clinical employment.

Treatment Spectrum

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Urology is a specialized medical and surgical field dedicated to the comprehensive management of the urinary tract – including the kidneys, ureters, bladder, and urethra – in both men and women, as well as the male reproductive organs. The specialty encompasses conservative (non-surgical, mostly pharmacological), minimally invasive, and surgical treatments, including endourological, laparoscopic, and open procedures, as well as lithotripsy and laser-based techniques for removing stones or cutting and vaporizing pathological tissue.[6]

Conservative treatment options in urology include pharmacological therapy for a wide range of conditions, such as:

Conservative treatment in urology is not limited to pharmacological therapy. It also includes lifestyle modifications and non-invasive interventions such as dietary changes, pelvic floor muscle training, and weight management.

Surgical treatment in urology includes a wide range of operative interventions, such as:

These surgical approaches are part of standard urological practice and are reflected in clinical guidelines issued by leading international societies, including the European Association of Urology and the American Urological Association.[7][8]

In Urology, minimally invasive and endoscopic procedures are increasingly used as alternatives to traditional open surgery, reflected in current guidelines of leading international urological societies, including the European Association of Urology and the American Urological Association.[9][10][11][12] Depending on the individual case, these procedures can often be performed as outpatient interventions without general anesthesia, offering reduced patient burden and pain, and shorter recovery times compared with conventional invasive interventions.[13] These procedures are primarily part of Endourology (see below) and include:

Training

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United States

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As of 2022, there are 146 residency programs that offered 356 categorical positions.[18] Urology is one of the early match programs, with results given to applicants by early February (6 weeks before NRMP match). Applications are accepted starting Sep 1, with some programs accepting applications until early Jan.[19]

It is a relatively competitive specialty to match into, with only 65.6% of US seniors matching in the 2022 match cycle.[20] The number of positions has grown from 278 in 2012 to 356 in 2022. 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.[21]

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 (1 standard deviation above the median), with Northwestern University sending 44 students over those five years.[22]

After urology residency, there are seven subspecialties recognized by the AUA (American Urological Association):

  • Oncology
  • Calculi
  • Female Urology
  • Infertility
  • Pediatrics
  • Transplant (renal)
  • Neurourology[23]

Australia

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Training is completed through the Royal Australasian College of Surgeons[24] (RACS). The program requires six years of full-time training (for those who commenced prior to 2016), or five years for those who commenced after 2016.[25] The program is accredited by the Australian Medical Council.[24][26]

Nepal

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In Nepal, the formal urologist degree awarded is MCh (Magister Chirurgiae).[27] This is a three years course post masters and includes thesis and a mandatory publication. This degree is awarded after completing MBBS (four and half year plus a one-year rotatory internship) and MS (Mastery of surgery) in general surgery (three years course). Till now[when?] two universities Tribhuvan University and Kathmandu University as well as two Autonomous institutes BP Koirala Institute of health sciences and National Academy of Medical Sciences (Bir Hospital) run the MCh Urology programme.[28][29] This degree is equivalent to Clinical PhD and called as "Chikitsa Bidhyabaridhi" by Tribhuvan University (Government University) and is considered to be the highest degree among the surgical discipline degrees.

Ethiopia

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In Ethiopia, in 2001, there were only five qualified urologists. All trained abroad, in countries like India, Tanzania and Hungary. Before this chapter all urology cases were managed by general surgeons. The only urological unit in the country was at Tikur Anbessa Tertiary Hospital. The services provided included ESWL and endo-urology. The urology training program was started in 2009 with a curriculum for general surgeons which had a three-year training program. Up to 2019, six urologists have graduated by this program for general surgeons. The first residency program started accepting general practitioners in 2010 for a five-year program.[30] The first two years were trainings in general surgery, the next three years were dedicated urology training program, which included the same three-year training as of the general surgeons three year curriculum. It started with two residents who graduated in 2015 with a certificate in specialty of urology. Up to 2019, seventeen urologists have graduated from this five-year residency program. From the start these programs in 2009 up to 2019, a total of 23 urologists have been trained in Tikur Anbessa Tertioary Hospital. As of 2020, there were 26 trainees in the programme. All of the urologists who graduated from Tikur Anbessa Tertioary Hospital were as of 2020 working in different parts of the country.[30]

Subdisciplines

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As a medical discipline that involves the care of many organs and physiological systems, urology can be broken down into several subdisciplines. At many larger academic centers and university hospitals that excel in patient care and clinical research, urologists often specialize in a particular sub discipline.

Endourology

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Endourology is the branch of urology that deals with the closed manipulation of the urinary tract.[31] It has evolved to encompass a broad range of minimally invasive and endoscopic urologic procedures. As opposed to open surgery, endourology is performed using small cameras and instruments inserted into the urinary tract. Transurethral surgery has long been a cornerstone of endourology as most of the urinary tract can be accessed via the urethra, enabling prostate surgery, surgery of tumors of the urothelium, stone surgery, and simple urethral and ureteral procedures. The addition of laparoscopy and robotic surgery has further subdivided this branch of urology.

In recent years, endourologic techniques have continued to evolve, particularly through the increasing use of laser-assisted procedures in contemporary urologic practice.[32] These include laser lithotripsy for urinary stone disease, laser-based treatment of urothelial tumors, and laser enucleation procedures such as holmium laser enucleation of the prostate (HoLEP) and thulium laser enucleation of the prostate (ThuLEP) for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia.[33][34][35][36][37][38] The growing role of these minimally invasive approaches is also reflected in guidelines published by leading international urological societies, including the American Urological Association and the European Association of Urology.[39][40][41][42]

Laparoscopy

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Laparoscopy is a rapidly evolving branch of urology and has replaced some open surgical procedures.

Robotic surgery

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Robotic surgery of the prostate, kidney, and ureter has been expanding this field. Today, many prostatectomies in the United States are carried out by robotic assistance. This has created controversy, however, as robotics greatly increase the cost of surgery and the benefit for the patient may or may not be proportional to the extra cost. Moreover, current (2011) market situation for robotic equipment is a de facto monopoly of one publicly held corporation which further fuels the cost-effectiveness controversy.[43]

Urologic oncology

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Urologic oncology is the branch of medicine that focuses on the surgical treatment of malignant genitourinary diseases. This includes cancers of the prostate, adrenal glands, bladder, kidneys, ureters, testicles, and penis, as well as the skin, subcutaneous tissue, muscle, and fascia of these areas, a domain that partially overlaps with dermatologic oncology and related oncology subspecialties. Management of genitourinary cancers may be handled by a urologist or an oncologist, depending on whether the treatment is surgical or medical. In Western countries, most urologic oncologists employ minimally invasive techniques, such as laparoscopy, endourology, or robotic-assisted surgery, to treat cancers that are suitable for surgical intervention.

Neurourology

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Neurourology concerns nervous system control of the genitourinary system, and of conditions causing abnormal urination. Neurological diseases and disorders such as a stroke, multiple sclerosis, Parkinson's disease, and spinal cord injury can disrupt the lower urinary tract and result in conditions such as urinary incontinence, detrusor overactivity, urinary retention, and detrusor sphincter dyssynergia. Urodynamic studies play an important diagnostic role in neurourology. Therapy for nervous system disorders includes clean intermittent self-catheterization of the bladder, anticholinergic drugs, injection of Botulinum toxin into the bladder wall and advanced and less commonly used therapies such as sacral neuromodulation. Less marked neurological abnormalities can cause urological disorders as well—for example, abnormalities of the sensory nervous system are thought by many researchers to play a role in disorders of painful or frequent urination (e.g. painful bladder syndrome also known as interstitial cystitis).

Pediatric urology

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Pediatric urology concerns urologic disorders in children. Such disorders include cryptorchidism (undescended testes), congenital abnormalities of the genitourinary tract, enuresis, underdeveloped genitalia (due to delayed growth or delayed puberty, often an endocrinological problem), and vesicoureteral reflux.

Andrology

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Andrology is the medical specialty focused on male health, particularly conditions affecting the male reproductive system and urological problems that are unique to men, such as prostate cancer, male fertility problems, and surgery of the male reproductive system. It is the counterpart to gynaecology, which addresses female-specific medical issues, especially those related to reproductive and urologic health.

Reconstructive urology

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Reconstructive urology is a highly specialized branch of male urology focused on restoring both the structure and function of the genitourinary tract. Reconstructive procedures may be required following prostate surgeries, full or partial hysterectomies, trauma (such as automobile accidents, gunshot wounds, industrial accidents, or straddle injuries), disease, obstructions, or blockages like urethral strictures, and occasionally even childbirth. Areas commonly addressed in reconstructive urology include the urinary bladder, ureters (the tubes connecting the kidneys to the bladder), and the genitalia, among others, depending on the nature and extent of the injury or condition.

Female urology

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Female urology is a branch of urology dealing with overactive bladder, pelvic organ prolapse, and urinary incontinence. Many of these physicians also practice neurourology and reconstructive urology as mentioned above. Female urologists complete a 1–3-year fellowship after completion of a 5–6-year urology residency.[44] Thorough knowledge of the female pelvic floor together with intimate understanding of the physiology and pathology of voiding are necessary to diagnose and treat these disorders. Depending on the cause of the individual problem, a medical or surgical treatment can be the solution. Their field of practice heavily overlaps with that of urogynecologists, physicians in a sub-discipline of gynecology, who have done a three-year fellowship after a four-year OBGYN residency.[44]

Journals and organizations

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There are a number of peer-reviewed journals and publications about urology, including The Journal of Urology, European Urology, the African Journal of Urology, British Journal of Urology International, BMC Urology, Indian Journal of Urology, Nature Reviews Urology, and Urology.

There are national organizations such as the American Urological Association, the American Association of Clinical Urologists,[45] European Association of Urology, the Large Urology Group Practice Association (LUGPA),[45] and The Society for Basic Urologic Research. Urology is also included under the auspices of the International Continence Society.

Teaching organizations include the European Board of Urology, as well as the Vattikuti Urology Institute in Detroit, which also hosts an annual International Robotic Urology Symposium devoted to new technologies. The American non-profit IVUMed teaches urology in developing countries.

List of urological topics

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See also

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References

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  1. ↑ "Urology". American Medical Association. Retrieved 28 April 2020.
  2. ↑ "Urologist in Noida". Full Details Information. 27 March 2019.
  3. ↑ Marks AJ; Teichman JM (2007). "Lasers in clinical urology: State of the art and new horizons". World Journal of Urology. 25 (3): 227–233. doi:10.1007/s00345-007-0163-x. PMID 17393172. S2CID 23167891.
  4. ↑ Ahmed K; Jawad M; Dasgupta P; Darzi A; et al. (2010). "Assessment and maintenance of competence in urology". Nat Rev Urol. 7 (7): 403–13. doi:10.1038/nrurol.2010.81. PMID 20567253. S2CID 24794856.
  5. ↑ "Facts: Applicants, Matriculants, Enrollment, Graduates, MD/PhD, and Residency Applicants Data - Data and Analysis". AAMC. Retrieved 2013-09-01.
  6. ↑ "Guidelines - American Urological Association". www.auanet.org. Retrieved 2026-05-19.
  7. ↑ "EAU Guidelines - Uroweb". uroweb.org. Retrieved 2026-05-19.
  8. ↑ "Guidelines - American Urological Association". www.auanet.org. Retrieved 2026-05-19.
  9. ↑ "Surgical Management of Kidney and Ureteral Stones: AUA Guideline (2025) - American Urological Association". www.auanet.org. Retrieved 2026-05-19.
  10. ↑ "Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline (2026) - American Urological Association". www.auanet.org. Retrieved 2026-05-19.
  11. ↑ Kronenberg, Peter; Cerrato, Clara; Juliebø-Jones, Patrick; Herrmann, Thomas; Tokas, Theodoros; Somani, Bhaskar K. (December 2023). "Advances in lasers for the minimally invasive treatment of upper and lower urinary tract conditions: a systematic review". World Journal of Urology. 41 (12): 3817–3827. doi:10.1007/s00345-023-04669-5. ISSN 1433-8726. PMID 37906263.
  12. ↑ "EAU Guidelines on Urolithiasis - INTRODUCTION - Uroweb". uroweb.org. Retrieved 2026-05-19.
  13. ↑ "Optimizing Outcomes in Urologic Surgery: Postoperative - American Urological Association". www.auanet.org. Retrieved 2026-05-19.
  14. ↑ "Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline (2026) - American Urological Association". www.auanet.org. Retrieved 2026-05-19.
  15. ↑ "EAU Guidelines on Urolithiasis - INTRODUCTION - Uroweb". uroweb.org. Retrieved 2026-05-19.
  16. ↑ Carter, Michelle (2025-05-19). "How-to manual supports urology teams to increase use of transurethral laser ablation (TULA) for bladder cancer". Getting It Right First Time - GIRFT. Retrieved 2026-05-19.
  17. ↑ "EAU Guidelines on Prostate Cancer - Uroweb". uroweb.org. Retrieved 2026-05-19.
  18. ↑ "Urology and Specialty Matches". Retrieved 2022-09-05.
  19. ↑ "American Urological Association - Accredited U.S. Urology Residency Programs". Auanet.org. Archived from the original on 2016-10-03. Retrieved 2016-09-28.
  20. ↑ Guckien, Zoe; Singh, Nikhi P.; Boyd, Carter J.; Rais-Bahrami, Soroush (2022). "Urology Residency Match: Trends and Costs". Journal of Urology. 208 (4): 767–770. doi:10.1097/JU.0000000000002839. PMID 35748668. S2CID 249988399. Retrieved 2022-09-05.
  21. ↑ "Urology Residency Guide - Urology Match". Urologymatch.com. Archived from the original on 2016-10-01. Retrieved 2016-09-28.
  22. ↑ Kutikov, A; Bonslaver, J; Casey, J. T.; Degrado, J; Dusseault, B. N.; Fox, J. A.; Lashley-Rogers, D; Richardson, I; Smaldone, M. C.; Steinberg, P. L.; Trivedi, D. B.; Routh, J. C. (2010). "The Gatekeeper Disparity: Why Do Some Medical Schools Send More Medical Students into Urology?". The Journal of Urology. 185 (2): 647–652. doi:10.1016/j.juro.2010.09.113. PMC 3058515. PMID 21168862.
  23. ↑ "Urology - An Overview - Urology Match". Urologymatch.com. Archived from the original on 2022-08-19. Retrieved 2016-09-28.
  24. 1 2 (RACS), Royal Australasian College of Surgeons. "Urology". Surgeons.org. Retrieved 2018-01-24.
  25. ↑ "Overview - Urological Society of Australia and New Zealand". Usanz.org.au. Retrieved 2018-01-24.
  26. ↑ "Urology". Australian Medical Association. 2016-02-17. Retrieved 2018-01-24.
  27. ↑ "Department of Urology and Kidney Transplant Surgery". TUTH. Tribhuvan University Teaching Hospital. Archived from the original on 28 June 2020. Retrieved 6 February 2021.
  28. ↑ "NAMS".
  29. ↑ "About IOM | Institute of Medicine". Archived from the original on 2020-10-01. Retrieved 2020-09-23.
  30. 1 2 "College of Health Sciences | Addis Ababa University Sites site". Aau.edu.et.[dead link]
  31. ↑ "Website of the Endourologic Society". Endourology.org. Retrieved 2013-09-01.
  32. ↑ "EAU Guidelines on Urolithiasis - INTRODUCTION - Uroweb". uroweb.org. Retrieved 2026-05-19.
  33. ↑ "EAU Guidelines on Urolithiasis - INTRODUCTION - Uroweb". uroweb.org. Retrieved 2026-05-19.
  34. ↑ "Kidney Stones: Medical Mangement Guideline - American Urological Association". www.auanet.org. Retrieved 2026-05-19.
  35. ↑ "Non-muscle-invasive Bladder Cancer - Introduction - Uroweb". uroweb.org. Retrieved 2026-05-19.
  36. ↑ Carter, Michelle (2025-05-19). "How-to manual supports urology teams to increase use of transurethral laser ablation (TULA) for bladder cancer". Getting It Right First Time - GIRFT. Retrieved 2026-05-19.
  37. ↑ "EAU Guidelines on the Management of Non-neurogenic Male LUTS - INTRODUCTION - Uroweb". uroweb.org. Retrieved 2026-05-19.
  38. ↑ "Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline (2026) - American Urological Association". www.auanet.org. Retrieved 2026-05-19.
  39. ↑ "EAU Guidelines on Urolithiasis - INTRODUCTION - Uroweb". uroweb.org. Retrieved 2026-05-19.
  40. ↑ "Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline (2026) - American Urological Association". www.auanet.org. Retrieved 2026-05-19.
  41. ↑ "Surgical Management of Kidney and Ureteral Stones: AUA Guideline (2025) - American Urological Association". www.auanet.org. Retrieved 2026-05-19.
  42. ↑ Carter, Michelle (2025-05-19). "How-to manual supports urology teams to increase use of transurethral laser ablation (TULA) for bladder cancer". Getting It Right First Time - GIRFT. Retrieved 2026-05-19.
  43. ↑ "Intuitive Surgical, Inc". Intuitivesurgical.com. Retrieved 2013-09-01.
  44. 1 2 "Fellowships | Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction". Sufuorg.com. Retrieved 10 June 2022.
  45. 1 2 "Clinical Urologists Group Supports Genomic Testing for Prostate Cancer". Clinicalomics.com. 6 March 2018. Retrieved 9 March 2018. The Association, which represents nearly 4,000 member urologists nationwide, said in the one-page statement.... The AACU's statement has won support from the Large Urology Group Practice Association (LUGPA), which represents more than 2,300 physicians who make up more than 25% of the nation's practicing urologists.
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