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What is Urology?
The specialty of urology focuses on the structures of the body that produce urine and remove it from the body, such as the kidneys, ureters, bladder, and urethra. Since related structures in men are responsible for both reproduction and the transportation of urine, urologists specialize in men?s sexual health in addition to disorders of the urinary tract. Urologists treat both men and women, as well as patients ranging in age from newborn to elderly.
Certain urologic conditions are specific to male or female patients. Women are especially prone to stress incontinence, recurrent urinary tract infections, interstitial cystitis (a condition causing pain in the bladder), and urethral diverticuli (a structural issue where a small pouch develops from the urethra into the vagina). Some of these conditions may be adequately treated by a gynecologist, but patients may prefer to see a urologist because of their expertise in the urinary tract system. As for men, male infertility and sexual problems can be treated by a urologist. For example, urologists treat erectile dysfunction with medications or prosthetics. They may also perform surgeries such as vasectomies or vasectomy reversals.
Some other conditions that urologists treat include:
- Kidney stones, which are mineral deposits that can form anywhere in the urinary tract. The stones can be quite painful, and some large stones may be impossible to expel naturally. Fortunately, kidney stone treatments have advanced quite a bit in recent years, and a urologist may recommend a procedure such as shockwave lithotripsy (where sound waves are used to break down the stones), or percutaneous extraction (where telescopic tools are inserted through tiny incisions in the back to remove the stones). There can be some pain associated with these treatments, but they are far less invasive than the older methods of removal.
- Urinary tract infections, which are extremely common. However, if they happen over and over again, there may be an underlying problem within the urinary tract.
- Congenital abnormalities, which refers to problems that are present at birth. Congenital abnormalities affect the genitourinary tract more often than any other system of the body, and they range from mild to severe in appearance and effect. The most common abnormality (in male infants) is cryptorchidism, where a testicle does not descend from the body down into the scrotum. Another common problem is hypospadias, where the opening of the urethra appears on the underside of the penis.
- Renal disease, which is the loss of kidney function. For patients with renal disease, their urologist may be their primary surgeon or a coordinating member of their care team.
- Tumors and malignancies, which are especially common in the case of prostate cancer. Urologists are most often consultants to oncologists in these cases.
The American Urological Association recognizes seven subspecialties of urology:
- Pediatric Urology, the treatment of genitourinary tract disorders in children and infants
- Urologic Oncology, the treatment of cancers within the genitourinary tract
- Renal Transplantation, the treatment of severe kidney disease by replacing a non-functioning kidney with a donor kidney
- Male Infertility, the treatment of infertility due to problems with sperm, semen, or male sexuality
- Calculi, the treatment of kidney stones
- Female Urology, the care of women?s urinary health
- Neurourology, the treatment of urinary disorders caused by problems with the nervous system. For example, certain voiding disorders happen when the bladder does not receive signals appropriately, and erectile dysfunction is sometimes due to nerve loss.
Urinary and sexual problems can be especially distressing for many people. Fortunately, urologists are experts at managing these health conditions.
What is Geriatrics?
Geriatrics is the subspecialty of internal medicine that provides primary care to older adults. Physical health tends to decline with age, and geriatricians work to manage such age-related concerns as chronic illness, frailty, multiple medications, and declining mental health to keep seniors as active and independent as possible.
Some of the most common concerns seen by a geriatrician include:
- Mobility issues, including the need for canes and walkers, as well as preventing falls
- Osteoporosis, a weakening of the bones, which affects as many as a quarter of all men and half of all women over fifty
- Loss of hearing or vision
- Incontinence, or the inability to control one?s bladder
- Memory loss, including dementia and Alzheimer?s disease
A geriatrician may also provide their patients with comprehensive care that includes checking on their social health. Seniors are at increased risk for poverty, loneliness, abuse, and injuries in the home. As part of their health care, a geriatrician may inquire about family support, living conditions, or the ability of a patient to perform daily self-care tasks.
In some cases, a geriatrician may serve as an advisor to other physicians on a specific case or condition. However, most of the time geriatrics is a primary care specialty, and geriatricians provide routine health care to the older patients they work with.