Which Problems Are Treated by a Urologist? A Complete Guide (2026)

1. Kidney Stones (Nephrolithiasis)

Kidney stones are one of the most common reasons patients visit a urologist in Bangalore and across southern India. They form when minerals in the urine – most frequently calcium oxalate – crystallise and clump together inside the kidney. Small stones can pass spontaneously; larger ones require intervention.

Symptoms: Severe one-sided flank pain radiating to the groin, nausea and vomiting, blood in the urine, frequent urination, and burning during urination. Stones sitting quietly in the kidney can be completely symptom-free until they move.

When to see a urologist: Any stone causing pain, obstruction, or recurrent symptoms. Also, anyone who has formed a stone once and wants to prevent future stones – a metabolic workup after the first episode significantly reduces recurrence.

How urologists treat kidney stones:

• • Medical expulsion therapy – for small stones likely to pass, alpha-blocker medication relaxes the ureter and helps the stone move
  • Ureteroscopy with laser lithotripsy – a thin camera is passed through the urethra and ureter; a Holmium laser fragments the stone into passable pieces. Day procedure, no incision
  • PCNL (Percutaneous Nephrolithotomy) – a small puncture directly into the kidney for large or complex stones; minimal incision, highly effective
  • ESWL (Extracorporeal Shock Wave Lithotripsy) – shockwaves applied externally to fragment selected stones

According to the Indian Council of Medical Research (ICMR), stone recurrence without preventive intervention reaches approximately 50% within five years. A urologist-led metabolic stone workup identifies exactly why stones formed and personalises prevention.

2. Urinary Tract Infections – Recurrent and Complicated

A single, uncomplicated UTI in a healthy young woman is typically managed by a general physician. A urologist becomes essential in the following situations:

• • Recurrent UTIs – three or more episodes in a 12-month period, indicating an underlying structural, hormonal, or microbiome cause that needs investigation
  • UTIs in men – any UTI in a male patient should be investigated for an underlying structural cause such as BPH, urethral stricture, or bladder dysfunction
  • UTIs in children – particularly in boys, or girls under three, recurrent UTIs warrant investigation for vesicoureteral reflux or other congenital abnormalities
  • UTIs that do not respond to antibiotics – suggesting antibiotic-resistant bacteria or an untreated structural cause
  • UTIs complicated by kidney involvement (pyelonephritis) – especially when hospitalisation or intravenous treatment is required
  • UTIs associated with a kidney stone – stones can harbour bacteria and make infection impossible to clear without treating the stone first

A urologist investigating recurrent UTIs typically uses urine culture and sensitivity testing, ultrasound, flexible cystoscopy, and sometimes a CT urogram to identify why infections keep recurring.

3. Benign Prostatic Hyperplasia (BPH)

BPH – the non-cancerous enlargement of the prostate gland – is one of the most common urological conditions in men, affecting the majority of those over 60 and a significant proportion over 50. As the prostate enlarges, it narrows the urethra and obstructs urine flow.

Symptoms of BPH:

• • Weak or slow urinary stream
  • Difficulty starting urination (hesitancy)
  • Feeling that the bladder has not fully emptied after urinating
  • Frequent urination – particularly at night (nocturia)
  • Sudden, urgent need to urinate
  • Dribbling at the end of urination

BPH is not cancer and does not cause cancer, but it is progressive. Left unmanaged, it can lead to urinary retention (complete inability to urinate – a medical emergency), bladder damage, recurrent UTIs, bladder stones, and eventually kidney damage from chronic obstruction.

Treatment options a urologist will discuss:

• • Lifestyle modification – reducing evening fluid intake, avoiding caffeine and alcohol, timed voiding
  • Medication – alpha-blockers (tamsulosin, alfuzosin) relax the prostate muscle; 5-alpha reductase inhibitors (finasteride, dutasteride) reduce prostate size over months. Often used in combination
  • Minimally invasive surgical procedures – TURP (Transurethral Resection of the Prostate) is the surgical gold standard; laser prostatectomy (HoLEP or GreenLight) is increasingly preferred; UroLift and Rezum are newer options for selected patients
  • Catheterisation – for acute urinary retention while awaiting definitive treatment

4. Prostate Cancer

Prostate cancer is the most common cancer in men over 50 in many countries, and its incidence in India is rising. Crucially, early prostate cancer has no symptoms – it is detected through PSA (Prostate-Specific Antigen) blood testing, interpreted in the context of age, prostate size, and PSA trajectory, and confirmed by biopsy.

The Urological Society of India (USI) recommends that men over 50 discuss PSA screening with their doctor annually, and men with a family history of prostate cancer begin this discussion at 45.

Why early detection matters: Localised prostate cancer – confined to the prostate – has a five-year survival rate exceeding 95%. Advanced prostate cancer that has spread beyond the prostate is significantly harder to treat. The window between detectable PSA elevation and symptomatic advanced disease is where treatment makes the most difference.

How urologists manage prostate cancer:

• • Active surveillance – for low-risk, slow-growing tumours; regular monitoring with PSA, MRI, and repeat biopsies
  • Radical prostatectomy – surgical removal of the prostate, performed laparoscopically or robotically in modern centres
  • Radiation therapy – external beam radiation or brachytherapy (radioactive seeds placed in the prostate), in collaboration with a radiation oncologist
  • Hormone therapy – androgen deprivation therapy to slow growth in advanced or recurrent disease
  • Chemotherapy and targeted agents – for metastatic or castration-resistant prostate cancer, in collaboration with a medical oncologist

5. Bladder Cancer

Bladder cancer is the most common urological cancer worldwide and the fourth most common cancer in men. The most important symptom – and frequently the only symptom in early disease – is painless haematuria: blood in the urine without pain.

This bears repeating: blood in the urine that appears and then resolves on its own, without any other symptoms, is not reassuring. It is the characteristic presentation of bladder cancer, and it requires investigation every time it occurs. According to the Urological Society of India (USI), haematuria is one of the most underinvestigated urological symptoms in India.

Risk factors for bladder cancer: Cigarette smoking is the single strongest modifiable risk factor, responsible for approximately 50% of bladder cancer cases. Occupational exposure to aromatic amines (dyes, rubber, leather industries), chronic urinary infections, and previous pelvic radiation also increase risk.

How urologists diagnose and treat bladder cancer:

• • Cystoscopy and biopsy – a camera into the bladder directly visualises and samples any suspicious lesion. This is the definitive diagnostic procedure
  • TURBT (Transurethral Resection of Bladder Tumour) – endoscopic removal of superficial bladder tumours through the urethra; no external incision. Also provides the tissue sample for staging and grading
  • Intravesical therapy – BCG (Bacillus Calmette-Guérin) or mitomycin C instilled directly into the bladder after TURBT to reduce recurrence risk
  • Radical cystectomy – removal of the bladder for muscle-invasive cancer, with creation of a urinary diversion
  • Immunotherapy and chemotherapy – for advanced or metastatic bladder cancer, in collaboration with a medical oncologist

6. Kidney Cancer (Renal Cell Carcinoma)

Kidney cancer is frequently discovered incidentally – found on an ultrasound or CT scan done for an unrelated reason – because early kidney tumours often cause no symptoms. When symptoms do occur, they include blood in the urine, a flank mass, or persistent flank pain. The classic triad of all three together represents advanced disease.

Risk factors include smoking, obesity, hypertension, and a family history of kidney cancer.

How urologists treat kidney cancer:

• • Partial nephrectomy – removal of the tumour while preserving as much normal kidney as possible. The preferred approach for tumours under 7 cm. Performed laparoscopically or robotically
  • Radical nephrectomy – removal of the entire kidney for larger or more complex tumours. Also typically laparoscopic
  • Ablative therapies – radiofrequency ablation or cryoablation for small tumours in patients who are not surgical candidates
  • Active surveillance – for very small tumours (under 2 cm) in elderly or comorbid patients
  • Targeted therapy and immunotherapy – for metastatic renal cell carcinoma, managed jointly with a medical oncologist

7. Testicular Cancer

Testicular cancer is the most common solid tumour in men between 15 and 35 years of age – and one of the most curable cancers when caught early, with overall cure rates above 95%. The most common presentation is a painless lump or swelling in one testicle, sometimes accompanied by a dull ache in the lower abdomen or scrotum.

Monthly self-examination of the testes – feeling for any new lump, change in size, or change in firmness – is the most effective early detection tool. Any new testicular lump should be evaluated by a urologist within days.

Diagnosis and treatment:

• • Scrotal ultrasound – the first-line investigation; highly accurate at distinguishing testicular tumours from other scrotal conditions
  • Tumour markers – AFP, beta-hCG, and LDH are blood tests that help diagnose and monitor testicular cancer
  • Radical orchiectomy – surgical removal of the affected testis through the groin (not the scrotum). This is both diagnostic and curative for localised disease
  • Surveillance, chemotherapy, or radiation – depending on the cancer type (seminoma vs non-seminoma) and stage, managed with an oncology team

8. Urinary Incontinence

Urinary incontinence – the involuntary leakage of urine – affects millions of adults in India and is profoundly underreported. Many patients accept it as an inevitable part of ageing or the aftermath of childbirth. It is not. It is a treatable medical condition with effective, specific management options.

Types of urinary incontinence:

Stress incontinence – leakage triggered by physical activity that raises abdominal pressure: coughing, sneezing, laughing, lifting, or exercise. Most common in women after childbirth or menopause. The underlying cause is weakness of the pelvic floor and urethral sphincter.

Urge incontinence – a sudden, intense, uncontrollable urge to urinate that leads to leakage before reaching the toilet. Associated with overactive bladder (OAB). Affects both men and women; more common with increasing age.

Mixed incontinence – features of both stress and urge incontinence combined.

Overflow incontinence – the bladder never fully empties, leading to constant dribbling. In men, usually caused by BPH or urethral stricture. In both sexes, can result from nerve damage (neurogenic bladder).

Urologist-led treatment options:

• • Pelvic floor physiotherapy – the first-line treatment for stress and mixed incontinence
  • Bladder training and timed voiding
  • Medication – antimuscarinics or beta-3 agonists for overactive bladder; alpha-blockers for overflow due to BPH
  • Mid-urethral sling procedure – a minimally invasive surgical option for stress incontinence in women with excellent long-term outcomes
  • Botulinum toxin injections into the bladder wall – for refractory overactive bladder
  • Sacral neuromodulation – a nerve stimulation device for complex incontinence and urinary retention

9. Interstitial Cystitis and Painful Bladder Syndrome

Interstitial cystitis (IC) is a chronic condition causing persistent pelvic pain, urinary urgency, frequency, and discomfort – without any detectable bacterial infection. Urine cultures come back negative. Antibiotics do not help. And patients are frequently told their symptoms are anxiety-related or unexplained.

IC is real, increasingly recognised, and manageable. It predominantly affects women and is significantly underdiagnosed. Diagnosis is made by a urologist through cystoscopy, careful symptom assessment, and exclusion of other causes.

Management includes dietary modification (avoiding caffeine, citrus, alcohol, and spicy foods), bladder training, oral medications, and intravesical instillations – treatments delivered directly into the bladder. The goal is long-term symptom control and quality-of-life improvement.

10. Male Infertility

Approximately 50% of infertility cases in couples involve a male factor – a figure that is still not widely appreciated. Urologists who specialise in male reproductive health evaluate and treat:

• • Low sperm count (oligospermia) or absent sperm (azoospermia)
  • Varicocele – dilated veins in the scrotum that raise testicular temperature and impair sperm production; surgically correctable and one of the most common treatable causes of male infertility
  • Obstructive azoospermia – blockage in the reproductive tract preventing sperm from being ejaculated, sometimes correctable with microsurgery
  • Hormonal causes – low testosterone or elevated prolactin affecting sperm production
  • Ejaculatory dysfunction – retrograde ejaculation or failure of ejaculation

Investigations include: Semen analysis (the cornerstone of male infertility evaluation), hormone profile, scrotal ultrasound, and genetic testing where indicated.

Surgical options: Varicocelectomy (repair of varicocele), vasectomy reversal (vasovasostomy), microsurgical sperm retrieval (TESE/PESA) for men with azoospermia who wish to use sperm in IVF/ICSI.

11. Erectile Dysfunction

Erectile dysfunction (ED) – the inability to achieve or maintain an erection sufficient for satisfactory sexual activity – is extremely common, affecting an estimated 10–15% of men in their 40s and rising in prevalence with age. It is also profoundly undertreated because of social stigma.

ED is not simply a quality-of-life issue. It is frequently a vascular marker – men with ED have a significantly elevated risk of cardiovascular disease, and ED may precede a cardiac event by two to five years. A urologist evaluating ED does not just prescribe a pill – they assess for underlying cardiovascular risk, diabetes, hormonal causes, and psychological factors.

Treatment options: Lifestyle modification (exercise, weight loss, smoking cessation), oral medications (PDE5 inhibitors), hormonal treatment if testosterone is deficient, vacuum erection devices, intracavernosal injections, and penile prosthesis surgery for cases unresponsive to other treatments.

12. Urethral Stricture

A urethral stricture is a narrowing of the urethra caused by scar tissue. It is a predominantly male condition and results from previous infection (particularly gonorrhoea), trauma, catheterisation, or previous urological procedures. Symptoms include a progressively weakening urinary stream, difficulty initiating urination, a split or sprayed stream, and the sensation of incomplete emptying.

Untreated, urethral stricture can lead to urinary retention, recurrent UTIs, bladder damage, and kidney complications.

Treatment: Urethral dilation (widening using progressively larger dilators – a temporising measure), urethrotomy (internal incision of the stricture using a cystoscope), or urethroplasty (open surgical reconstruction using tissue grafts – the definitive, most durable treatment for longer or recurrent strictures).

13. Overactive Bladder (OAB)

Overactive bladder is characterised by a sudden, compelling urge to urinate that is difficult to control, often with frequency (urinating eight or more times in 24 hours) and nocturia (waking at night to urinate). It may or may not include urge incontinence.

OAB affects both men and women and significantly impacts quality of life – restricting social activities, disrupting sleep, and affecting emotional wellbeing. It is neither a normal part of ageing nor an untreatable one.

A urologist evaluating OAB will use a bladder diary, urodynamic testing, and cystoscopy to confirm the diagnosis and exclude other causes before recommending treatment. Options range from bladder training and dietary changes to oral medication, botulinum toxin bladder injections, and sacral neuromodulation.

14. Hydronephrosis (Swollen Kidney)

Hydronephrosis is the swelling of the kidney due to an obstruction preventing urine from draining normally. It can be caused by a kidney stone blocking the ureter, a ureteropelvic junction (UPJ) obstruction (a congenital or acquired narrowing at the junction of the kidney and ureter), an enlarged prostate compressing the lower urinary tract, a tumour, or scar tissue.

Hydronephrosis can develop slowly and silently – causing gradual kidney damage without pain – or acutely, with severe flank pain. It is diagnosed by ultrasound and managed by a urologist once the cause is identified. Treatment addresses the underlying cause – removing or bypassing the obstruction.

15. Paediatric Urological Conditions

Children are not simply small adults when it comes to urological conditions. Several important urological problems are specific to or predominantly found in childhood:

Undescended testis (cryptorchidism) – one or both testes have not descended into the scrotum by birth. Surgical correction (orchidopexy) is recommended before 18 months of age to protect fertility and reduce cancer risk.

Vesicoureteral reflux (VUR) – urine flowing backward from the bladder into the ureters and kidneys. Can cause recurrent kidney infections and renal scarring if untreated. Diagnosed by voiding cystourethrogram (VCUG) and managed medically or surgically depending on severity.

Hypospadias – a congenital condition where the urethral opening is on the underside of the penis rather than the tip. Corrected surgically, usually between 6 and 18 months of age.

Ureteropelvic junction obstruction – a narrowing at the junction of the kidney and ureter causing hydronephrosis. Surgically corrected by pyeloplasty when significant.

Posterior urethral valves – abnormal tissue flaps in the male urethra obstructing urine flow; a urological emergency in newborn boys.

Paediatric urological conditions require prompt evaluation because untreated problems during childhood can cause permanent kidney damage, affect fertility, and have long-term developmental consequences.

16. Neurogenic Bladder

Neurogenic bladder refers to bladder dysfunction caused by damage to the nervous system rather than a primary urological problem. It occurs in patients with spinal cord injury, multiple sclerosis, Parkinson’s disease, diabetes (diabetic autonomic neuropathy), and after major pelvic surgery.

The bladder may be overactive (causing urgency and incontinence) or underactive (failing to empty, leading to retention and overflow). Both patterns can cause recurrent UTIs and kidney damage if not managed correctly.

A urologist manages neurogenic bladder using urodynamic testing to characterise the dysfunction, and treats it with clean intermittent catheterisation, medications, botulinum toxin injections, or surgical bladder augmentation depending on the cause and severity. The National Health Mission, India includes neurogenic bladder management within its guidelines for spinal injury rehabilitation.

17. Adrenal Tumours

The adrenal glands sit on top of each kidney and are within urological surgical territory. Urologists – particularly those with laparoscopic expertise – perform adrenalectomy (removal of adrenal gland tumours). Conditions treated include:

• • Adrenal adenomas causing Conn’s syndrome (primary hyperaldosteronism – a cause of uncontrolled hypertension)
  • Phaeochromocytoma – a tumour secreting adrenaline-like hormones, causing severe episodic hypertension
  • Adrenocortical carcinoma – a rare adrenal cancer
  • Adrenal metastases from other primary cancers

These are typically diagnosed by endocrinologists and managed in a multidisciplinary setting, with the urologist performing the surgical component.