Overview: A urologist will be your key specialist when managing various sexual health concerns, including erectile dysfunction, ejaculatory concerns, and prostate symptoms. However, not all sexual dysfunction is related to urological approaches or treatments. Honesty and going as early as possible will be most important for better results.
What is Urology?
Urology is the medical specialty of the urinary tract and men’s reproductive organs, including the prostate. The two are combined because often a condition that affects the urinary system will also impact the reproductive system, and vice versa. For example, benign prostatic hyperplasia (BPH), also known as an enlarged prostate, may make urination more difficult, and erectile dysfunction is a possible symptom of BPH.
When Will I Be Referred to a Urologist?
Your general practitioner (GP) or primary care provider (PCP) is capable of walking you through the early steps of treatment and diagnosing possible medical concerns. They will determine if a urologist is necessary. Sexual function is a complex system, tied to other complex systems in the body — such as the circulatory and nervous systems — as well as external factors.
Can I Go to a Urologist Directly?
If you’re otherwise in good health, it may make sense to contact a urologist directly. However, you probably will want to contact your PCP for a referral, both to ensure they’re aware of your concerns and to limit confusion if advanced treatments are needed.
The Earlier, the Better
If you’re experiencing sexual dysfunction of any sort, you should book an appointment with your PCP as soon as possible. There are many causes of sexual dysfunction, some of which are symptoms of a more serious issue such as heart disease or diabetes. You’ll want to rule these out before seeing a urologist.
Symptoms That Require an Immediate Visit to the Doctor
If you’re experiencing any of the following, contact your PCP immediately:
- Pain in the lower torso, especially persistent pain that appears suddenly and won’t fade
- Sudden onset of any symptom such as erectile dysfunction or trouble urinating
- Blood in urine or semen
- Swelling, discoloration, or inflammation
- Enlarged lymph nodes
- Any possible positive result from a self-exam, such as a hard lump on the testicle
Common Male Reproductive Disorders and When to See a Urologist
Erectile Dysfunction and Premature Ejaculation
ED and PE are by far the most prevalent urological concerns among men, and thus the ones with the most well-defined and tested treatment path. These common disorders are usually handled by PCPs. You should only go to a urologist for erectile dysfunction once other possibilities have been ruled out.
It’s likely that once your PCP rejects more serious concerns as a possible issue, they’ll first try a combination of short-term treatments, such as PDE5 inhibitors to increase blood flow to the penis, and long-term lifestyle interventions and emotional health approaches. These approaches have been shown to be highly effective and are the least invasive interventions. You may be referred to a urologist if these measures are not successful.
Similarly, multiple causes for PE should be ruled out before being referred to a urologist, often following the same regimen.
Delayed ejaculation (DE) is a different matter. Not all causes of DE are urological in nature; in fact, there are some overlaps with possible causes with ED and DE, especially in the psychological and lifestyle treatment paths.
However, several causes, such as a blockage of the ducts semen passes through or a defect in a duct, should be investigated and ruled out by a urologist, especially if DE has a sudden onset and no other clear cause.
Prostatitis
Prostatitis is any swelling or inflammation of the prostate gland. With bacterial prostatitis, the cause is often urine leaking into the prostate and generally will be treated with antibiotics. However, chronic prostatitis, also called nonbacterial prostatitis, will need to be diagnosed by a urologist and will have a different course of treatment.
Contact a urologist if you’re experiencing:
- Pain located in the perineum (between the testicles and anus), groin, lower back, pelvis, or genitals
- Radiating pain that makes sitting uncomfortable
- Frequent need to urinate
- Difficulty urinating
- Cloudy or discolored urine
- Painful ejaculation
- Any of the above paired with flu-like symptoms
Peyronie’s disease is caused by plaques and scar tissue collecting in the connective tissues of the penis. The best-known symptom is a curvature in the penis that happens over time. Some sufferers may experience an “hourglass” or other deformity of the penis.
Contact a urologist if you’re experiencing:
- Soft erections, or difficulty maintaining an erection
- Painful erections or pain during sex
- Changes to the appearance of your penis, including lumps, divots, or curves
What to Do Before and During a Doctor’s Visit
Once you’ve decided which type of practitioner you need, here’s how to prepare for your visit.
- Write down any symptoms you’ve been experiencing and any questions you have.
- Talk with your partner and ask them if they have any questions or concerns they want you to discuss as well.
- List any medications and supplements you’re taking, both prescribed and over-the-counter, with dosages, active ingredients, any schedules that must be adhered to, and manufacturers. Also, make a note of any medications you’ve been instructed by a doctor not to take.
- Be honest when answering questions. Doctors must keep what’s said in the exam room and on the chart strictly confidential under the requirements of the Health Insurance Portability and Accountability Act (HIPAA).
- Embarrassment, shame, and other negative emotions are common; many men’s sexual issues can strike at concerns about personal identity. Remember that your doctor is there to help you and not to judge you.
- Any treatment process is going to be a multi-pronged strategy including lifestyle changes, so be prepared to discuss diet needs, possible problems with certain forms of exercise, smoking cessation, moderation in alcohol consumption, and any chronic conditions.
Finally, remember that when it comes to your health, you are your own best advocate. Asking questions, requesting referrals to necessary specialists, and being informed will ensure the best possible care. To learn more about erectile dysfunction and the other sexual health topics mentioned in this post, follow the eDrugstore blog.
Dan is a long-time freelance writer focusing on technology, science, health, and medicine, with a lifelong interest in physics, biology, and medicine. His work has taken a particular focus on scientific studies “beyond the headlines,” reading the study to more closely examine the results.