When you experience problems that affect the urinary or reproductive systems, the first stop is usually your primary care provider. Depending on symptom presentation and the results of relevant blood work, your provider might feel like a referral to a urologist is necessary for diagnosis and treatment.

Prostate Enlargement

Prostate exams are recommended for men age 40-50 depending on their risk factors. Men of average risk should begin screenings at age 50 and those with higher risks should begin screening at age 40-45. A typical prostate exam involves a digital rectal exam (DRE) and a blood test called the prostate-specific antigen (PSA). During the DRE, the provider can tell if your prostate is enlarged and/or if there are abnormalities in shape or texture. Your provider will want to refer you to a urologist to determine the underlying cause of enlargement. Generally, if the enlargement is due to cancer, your PSA will also be elevated. In most instances, benign prostatic hyperplasia (BPH) is the cause of prostate enlargement.

Erectile Dysfunction

Erectile dysfunction (ED) is a condition where a man is incapable of achieving or maintaining an erection. Since there are many medications on the market to treat ED, it may seem like treatment is straightforward. Several problems can cause ED, and depending on the underlying cause, medications may be ineffective. A urologist may want to do imaging tests to determine blood flow in the penis. If ED occurs because of a blockage in a blood vessel, it will be necessary to unblock the vessel. Other problems such as nerve damage cannot be fixed with medication. If your urologist determines ED is not caused by a more severe problem, they will likely start you on a medication. Since each medication has a different onset and duration, your doctor will discuss what type of medication fits best into your lifestyle.

Urine Changes

The development of an overactive bladder and/or incontinence are common complaints. An overactive bladder causes strong, sudden urges to urinate. The urge may come even when your bladder is not full. Unfortunately, an overactive bladder can result in incontinence if you cannot make it to the bathroom in time. Incontinence can also be a separate issue. Stress incontinence is the most common and may occur after sneezing, laughing, or coughing. These activities cause momentary stress, making urine difficult to control. Impairment in muscles or nerves responsible for retaining urine may also be damaged. For example, multiple sclerosis can cause various urinary symptoms, such as urinary retention or incontinence. Your doctor will want to exclude more serious problems first. Overactive bladder can be helped with some medications. Treating incontinence often requires the use of adult protective undergarments, especially at night.

Some symptoms of urinary or reproductive health problems might be managed by your primary provider. In many instances, your provider will want you to be evaluated by a urologist to rule out more serious or complex causes of medical issues.