About the Urology specialty
A urologist treats problems with the urinary tract, from the kidneys and ureters down to the bladder and urethra, plus the male reproductive organs and the adrenal glands. That means kidney stones, urinary tract infections that keep coming back, an enlarged prostate, bladder control problems, erectile dysfunction, male infertility, and cancers of the kidney, bladder, prostate, or testicles. It’s a surgical specialty: unlike most physicians who refer surgical cases elsewhere, urologists both diagnose the problem and operate on it themselves, from a same-day cystoscopy (a thin camera passed into the bladder through the urethra) to a multi-hour robotic prostatectomy.
Becoming one takes at least five years of residency after medical school. The American Board of Urology requires at least 48 months of that time to be urology training, including at least a year serving as chief resident; the first year typically mixes general surgery rotations with early urology exposure. Certification then requires passing a written qualifying exam and, later, an oral certifying exam once the new urologist has spent at least 16 months practicing in a single community. Some go further with a two-year fellowship: pediatric urology for congenital and childhood conditions, or urogynecology and reconstructive pelvic surgery for complex pelvic floor disorders in women.
When to see one
Primary care doctors typically refer patients to urology for visible blood in the urine, a kidney stone that won’t pass, PSA results that warrant a closer look, or bladder symptoms that haven’t responded to first-line treatment. Men experiencing erectile dysfunction or fertility problems, and anyone with a testicular lump, should also expect a urology visit rather than ongoing management by a generalist.
Urologist vs. nephrologist
The two specialties overlap on one organ, the kidney, but train and practice differently. Urology is a surgical residency; nephrology is a two-year fellowship built on top of a three-year internal medicine residency and certified separately by the American Board of Internal Medicine. In practice, that split shows up in the caseload: a nephrologist manages chronic kidney disease, dialysis, and hypertension caused by failing kidneys through medication and monitoring, while a urologist removes the stone blocking that same kidney or resects the tumor sitting in it. A patient with a kidney mass, for instance, might see a nephrologist for function and a urologist for the surgery: two different sets of skills applied to the same organ.
Sources
By the NPI Portal editorial team · Reviewed and updated 2026-07-10