Dear Dr. Joe, When Should A Man See a Urologist?

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This week, Dr. Joe DeOrio, a urologist in Chicago, tackles questions about male sexuality. To ask Dr. Joe your own question, click here.

Dear Dr. Joe,

At what age should a man start seeing a urologist? And how often? Only when problems arise? Or regularly, the way that a woman sees a gyno?

— Don’t Know Uro

Dear DKU,

I’ve always joked that everyone needs to see the urologist. Most of my friends got a good chuckle out of it…until they were wearing a paper gown in my office. Truth is, it’s likely that you’ll avoid your friendly neighborhood endocrinologist, neurologist, and rheumatologist. But chances are, at some time or another, you’re gonna see me.

The reason is that urologists treat some pretty common problems. Lots of people have kidney stones. Just as many women deal with some form of incontinence during their lifetime, the majority of men will eventually have an issue with their prostates.

Having said that, I am not a primary care doctor. Translation: I don’t take care of your heart, I’m not going to manage your diabetes, and I won’t evaluate your emphysema. It is true that many gynecologists assume this primary care role, often managing such things as cholesterol levels, high blood pressure, and other issues for their female patients. Urologists, on the other hand, do not. We focus our practice on strictly urological issues—that is, problems that relate directly to the urinary and reproductive system.

All men should have routine visits with a primary care doctor, either an internist or family practitioner. While most of us can typically escape injury while avoiding the doctor in our 20’s, it’s probably a good idea to start getting routine checkups in our 30’s. From a urology standpoint, the American Urological Association currently recommends that all men, regardless of ethnicity, have routine prostate cancer screening annually, starting at age 40. What does that involve? A digital rectal examination and a serum PSA test. And no, digital does not refer to something fancy and electronic: it refers to digit, or finger –- that fleshy, 3-inch protuberance between my thumb and middle finger. It’s not that bad and doesn’t take more than 10 seconds, but you’ll have to bend over –- singing “Moon River” is optional. A serum PSA is a simple blood test that measures a protein produced by the prostate. Elevated levels in the blood may indicate a cancer.

If you’d like to see me for your prostate cancer screening, I’m certainly happy to perform those tests for you. Oftentimes, however, your primary care doctor will perform this evaluation as part of your annual physical. If he or she finds an abnormality, then you would need to see me.

So, to answer your question: you could start seeing an urologist at age 40 for your routine prostate examinations, and you should see an urologist at any age for issues specifically related to the genitourinary tract. For any other routine health care maintenance issue, see your primary care doctor.

— Dr. Joe

Dr. Joe earned his undergraduate degree in Molecular Biology from Princeton University. After attending the Loyola University Stritch School of Medicine, he completed his residency training in urological surgery at the Los Angeles County Medical Center. He lives and works in Chicago, IL. Keep an eye out for his upcoming blog at docjoe.net.