Who’s your urologist?
I recognise that many people do not know what a urologist is and does. In addition, people confuse the specialty of urology with others, such as nephrology. As a urologist I am happy to elaborate on my area of expertise.
Urology is a surgical subspecialty that focuses on the management of mostly surgical disorders involving the urinary tract in males and females along with the reproductive tract in males. Though this branch of medicine has been formally recognised more recently than others, history suggests that urological conditions have been in existence and treated for centuries.
Circumcision, which is a common procedure performed by urologists, has been a covenant ritual in Hebrew culture from as early as the days of Abraham. In addition, bladder stones which are frequently surgically treated by urologists have been reported in ancient Egyptian literature. Prior to the 19th century, many urological conditions were treated by general surgeons. However, in later years the subspecialty training of urologists allowed for a dedicated team of doctors who would appropriately manage the genito-urinary system. Adult and paediatric urologists were further trained to manage these conditions in the different population groups. The specialty has grown tremendously over the decades with the introduction of minimally invasive surgeries, improvement in surgical technique, discovery of new technology for diagnosis and treatment as well as application of high-quality research.
Professor Ludlow Lawson Douglas may be best described as the forerunner of urology in Jamaica and the English-speaking Caribbean. He has distinguished himself internationally in the field of urology, having performed one of the earliest kidney transplants in Jamaica and the Caribbean in 1970 and commenced the local training of urologists at The University of the West Indies (UWI) in the 1990s. To date, the doctor of medicine programme at The UWI has trained 21 urologists across the Caribbean. The programme continues to train local urologists and collaborates with the Caribbean Urological Association and the American Urological Association.
Jamaica has 23 practising urologists with 16 in Kingston and St Andrew, one in Mandeville and six in St James. All urologists are members of a local body, the Jamaica Urological Society, which seeks to educate the population and maintain high practice standards in the country. Urologists may be consulted in the public health care system at: The University Hospital of the West Indies, Kingston Public Hospital, Mandeville Regional Hospital and Cornwall Regional Hospital. The services offered may be emergency or elective. Many patients may be referred for consultation with a urologist by their general practitioner. However, many urologists are happy to consult with patients who are self-referred. I advise patients to seek help if they develop urinary symptoms or any other symptom that suggests a urinary tract problem.
Some conditions commonly treated by urologists:
Prostate cancer
Benign prostatic hyperplasia
(non-cancerous enlargement of the prostate)
Urinary tract infections
Urinary tract stones
Urinary tract obstruction
Cancers of the kidney, bladder, penis and testis
Trauma of the urinary tract
Urinary incontinence
Overactive bladder
Male infertility
Disorders of erections such as erectile dysfunction and priapism
Disorders of ejaculation such as premature ejaculation
Testosterone deficiency and bloody urine
Urologists are also involved in the management of end-stage kidney disease by performing kidney transplants.
Dr Belinda Morrison-Blidgen is consultant urologist and senior lecturer at The University of the West Indies
E-mail: Belinda.morrison02@uwimona.edu.jm