Males: When to see a urologist

I've read other threads that talk about guys seeing their urologist on a regular basis. And I often wonder, when should I see one? I don't have a urologist, and have never seen one. Do males only see one if they are having problems in that area? Or are they similar to gynecologists in the sense that women regularly see one even if they don't have any problems. For example, my wife has her gyno which she sees annually as well as a regular PCP internist which she sees.

I'm in my mid-50's. Should I be seeing a urologist on a regular basis just for a routine checkup?

I go once a year for my annual urology checkup and I'm 50. DRE, genital exam and blood work.

A DRE is indicated, but it is not necessary to see an urologist for this exam.

I mean that the controversial question is to make a test of PSA or not.

If you have a parent (father, brother) who had a prostate cancer or if you have a difficulty to urinate, you should make this test. If not, you should inform you about the benefits and the risks of this test and take a decision.

I am sure some of the folks with medical backgrounds will weigh in which should be very insightful. I am 59 and have never seen a urologist. I am fortunate at this stage not to have any prostate problems. I have an annual exam by my primary care physician and she checks my prostate and does do a PSA. If anything does not look right she said she would recommend a urologist. I think your regular doc's job is find stuff and treat it if they can but often they will hand off to a specialists if your problem is serious.

So do we men in our mid to late 50's need to see a urologist for annual checkups- probably not unless a significant problem surfaces; that's how I think I will proceed.

I only saw a urologist when I had hematuria, which turned out to be a malignant tumor in my bladder. Now, I see him every 3 months for a cystoscopy to look for new tumors. Any PCP can do DRE's and order PSA's for routine physicals. Many of them can also do pelvics on women, but many ladies prefer a dedicated OB-GYN for that. So, no men don't NEED a urologist unless they have a specific G.U. problem.

Jimmy Johnson, your profile indicates you are past 50. That's a good time to assess your urological function.

Do you have any difficulty passing urine? Has your stream diminished over the years? Do you have to get up more than once a night to pee? If yes to any of these, then it would be a good idea to make an appointment with a urologist.

As another member has already pointed out, if you have any family history of prostate cancer, ddo see a urologist.

If you have a primary care doc, does he/she do PSA tests with other blood work? While some contend that PSAs don't save lives in the long run, a PSA that is trending up, or up sharply may indicate that something is going on that merits further examination.

And finally how is your erectile function? Is it harder to get it up and keep it up? If so, a visit to the urologist may go a long way in restoring your lost performance. Sorry, they can't make your whole body 25 again.

That's a good time to assess your urological function.

Yeah, that's what I'm really trying to figure out -- when I should draw the line between what my PCP does for me and when I should see a urologist. To answer a few of your questions, yes, my PCP does annually check my PSA (still in the low normal range) and she does a DRE. I do have some difficulty with urination (slow to begin and increased frequency) and have been told in the past that I have some slight prostate enlargement. Yes, there is prostate cancer in my family (father). Erections? OK, not great -- I chalk that up to old age and testosterone deficiency.

Based on all of that, I feel that my PCP is monitoring things for me and haven't felt the need for a urologist yet. What is the best way to approach seeing one -- what do I say is my reason for a visit? Just a basic urological check-up? Or is it best to make an appointment for a specific symptom (urination issues, or perhaps ED)? If I call a urologist and just say that I'd like to schedule a routine urological exam would they know what that even is?

JJ,

Why not let your PCP determine when its best to see a Urologist? Sinnce you said she is doing a fine job, there doesn't appear to be any legitimate reason to see a specialist. I'm sure you PCP was competent to interpret your PSA results and administer a DRE. Consequently, you prostate cancer concerns have been addressed. If your concerned about the quality of your erections, why not schedule an appointment with your PCP and let her work up the issue. On the other hand, if you really feel the urge to have someone new examine your genitals, find a play doc!

Jimmy Johnson, Sounds like you are in pretty good shape. If I were you, I wouldn't be in a big hurry to see a urologist. When the urine flow issue gets to be a concern, go see a urologist. If erections become more of an issue, see the urologist.

For the slight prostate enlargement, a urologist recommended that I try the OTC supplement say palmetto. I get it at Sam's or Costco and the cost isn't bad.

If you are happy with your primary care provider, discuss your issues on your next visit and see if she thinks you should see a urologist. If internal medicine is her field, she may well prefer to treat you herself.

Take care of yourself. You are the only you that you've got.

If I were you, I wouldn't be in a big hurry to see a urologist.

Why not let your PCP determine when its best to see a Urologist?

That all sounds like good advice. I'm already taking Saw Palmetto daily.

Unless you are having symptoms, just let hour PCP handle routine prostate checks. If you are getting up several times a night to pee, then see a urologist.

Providing that the plumbing works well enough (factoring a certain level of expected diminished function with increasef age) then there is no need to call the plumber.

I have never been to a urologist

Much depends on your age, heath and insurance. I go because I have issues that are being followed.

My first ever visit was for a vasectomy. Later for kidney stones. After that, ED later BPH.

Some PCPs will manage common conditions, others will farm you out immediately. If everything is working, no need.

Once a year because I had prostate cancer 15 1/2 years ago. He does all the normal tests including PSA. I am still good to go.

Some insurance companies require that your PCP refer you to a specialist such as a Urologist. Often the visit must also be approved by the insurance company or they will not cover it. I recently went to a Urologist after being referred by my PCP. I noticed on my copy of the Insurance form that the ten minute appointment cost 250 dollars if it were paid by the individual out of pocket. The insurance company pays a much reduced fee. If I had gone on my own as a self referral I would have paid a lot more. I have learned to always go to the PCP first and get a referral.

Everyone has heard the warning at the end of ED commericals about if they have more than a 4 hour erection-well I had a 36 hour erection and finally went to the emergency room before they finally sent me to see a urologist. He said it was only the 2nd case of priapism (medical name for that condition) he had seen in all his years of practice. And he was in his 50's.

In the emergency room they gave me antihistamines to help my erection go gown after consulting with an urologist, but after two shots and about three hours later nothing happened-was more erect than ever. That was primarily because every 20 minutes or so a new nurse came into examine me. Think that was because when everyone heard what my condition was-everyone wasn't to get a look-certainly something you don't see every day. And with all those cute nurses looking and feeling me-more blood was rushing to my penis and it no where to go.

Did you get the blood aspirated by syringe and needle? That's the correct treatment for priapism. I have done this three times in my professional career. The nurses were the ones who were squeamish and several nearly fainted.

So, did they finally cut and aspirate you?

Just curious, does anyone know what the incidence rate of priapism is? I have some Viagra but have yet to take any. It sounds rare given how much is used but I would be curious to know what the odds are.

I have neurogenic bladder among other issues in my urinary area, so see a Urologist at least every 6 months, last year it was almost bi monthly (oh boy!) Things are a little better now, but still searching for ideas and better answers

I have to make an appt. next week to see a new urologist, for erectile dysfunction and excessive urination. As I am a type II diabetic over 50, this hardly came as a surprise.