The Urologist: a surgical specialist who needs plenty of clinical skills

The Urologist is the surgical specialist who deals with the pathologies of female andmale urinary tract (kidneys, ureters, bladder and urethra) and of the male reproductive and genital organs (prostate, seminal vesicles, vas deferens, penis, testicle and scrotum).

In Brazil, Graduation in Urology demands at least 11 years of study and formal training (6 years in Medical School, 2 years in General Surgery and 3 years in Urology), sometimes with additional years for sub-specialization.

The performance of this specialty is regulated by the Brazilian Society of Urology (SBU) (www.sbu.org.br), a renowned Urological Institution, responsible, among others, for the Brazilian Urological Congress, the 3rd largest and most prestigious (after the American Urological Association and the European Urological Association Meetings) Urological Meeting worldwide.

Although Urology is classified as a surgical specialty, many clinical skills are also needed to help in the prevention, diagnosis and treatment (clinical or surgical) of urological conditions. Accordingly, in Brazil, the Urologist has both surgical and clinical competences.

A wide scope of actuation

The Urologist is responsible for the 1st intervention in 95% of Urological cancers (prostate, bladder, kidney, testicular and penile cancers). Urological cancer is responsible for up to one third of Urological consultations.

Voiding difficulty in males is usually related to benign conditions of the prostate or bladder. This complaint is responsible for approximately 25% of patients seeking urological attention.

Renal and ureteral stones are a common problem today, and it is expected that 1 out of 6 people will experience a renal colic during his or her lifetime. The treatment of urinary calculi usually demands a professional that masters minimally-invasive techniques, such as urological endoscopy and extracorporeal lithotripsy.

Female urinary incontinence is a frequent condition, although it is usually under-reported by patients, since incontinence episodes are often quite embarrassing. It becomes more frequent in post-menopausal women, but it may afflict young active females as well. The work-up and treatment of female incontinence usually demands a Urologist, who can perform a detailed clinical evaluation, Urodynamics as necessary and, when indicated, minimally-invasive techniques that are very effective in the treatment of some types of incontinence.

Concerning infants and children, the urinary system is the most common site for congenital malformations and alterations (often kidney, bladder or genital congenital conditions). Fifty to 75% of alterations reported on obstetrical ultrasound are on the urinary system. These alterations may cause recurrent urinary tract infections, eventually jeopardizing renal function, or long-term issues to the patient (fertility, in the case of undescended testis; alterations in corporal image, in the case of penile malformations). A Pediatric Urologist is usually needed for the work-up and treatment of these conditions.

There is evidence that in incidence of infertility is rising recently. Approximately 15% of couples will have difficulty in conceiving a baby, and male pathologies are the factor for infertility in up to 50% of couples. As a result, the investigation of the male partner should ideally be included in the investigation of a couple’s infertility.

The incidence of male sexual dysfunction is also rising, partly because of current lifestyle changes. On the other hand, the understanding of the pathophysiology and alternatives for treatment also rose on the last years, improving the armamentarium of the urologist to deal with this problem.

As we briefly tried to expose above, due to advances in our understanding of the urogenital system and due to continuous improvement of the surgical techniques, especially of minimally-invasive techniques, Urology has become one of the mostversatile surgical specialties today.
How to find the right urologist for me?

We believe that several factors are responsible for the better assistance of our patients:

1. To have a solid medical background: the Medical School and the Hospital of Residency are essencial in forming a solid base over which a good professional can develop himself.
2. Continous Education: Medicine evolves fast and commitment with the new advances is essencial for offering the best care possible.
3. Individualization and Humanization of treatment: that means to treat patients as individuals, never as the disease itself; a good professional must be able to listen and to understand patients’ individual expectations and needs, stablishing a strong relation of trust between doctor and patient and offering the best for each individual patient.

Dr. Schneider had a solid Medical Education and Training on the best Hospitals of Brazil, North America and Europe and can give consultations in English. He can also give consultations in German language.