Atonic bladder: Loss of bladder muscle tone due to a chronic blockage or delayed urination over many years. An atonic bladder is no longer able to generate an adequate muscle contraction. This leads to poor bladder emptying and persistent urine left in the bladder.
Atrophy: Scarring or shrinkage of an organ. This may be caused by chronic blockage of a kidney (renal atrophy), poor development (congenital testicular atrophy) or inflammation (vaginal atrophy from low estrogen levels).
Azoospermia: Lack of sperm in the semen leading to male infertility. May be due to a blockage along the path from the testicles to the semen (obstructive azoospermia) or due to an inherent issue with production of the sperm in the testicles (non-obstructive). This should not be confused with the colloquial “weak swimmers”, which generally refers to the sperm’s ability to progress toward the egg, rather than the number of sperm.
Balanitis: An infection or inflammation of the penis. Most often seen in uncircumcised men due to an entrapment of bacteria or fungi underneath the foreskin. Can also occur due to random inflammatory conditions. Not to be confused with an erection, which is a perfectly natural inflammation of the penis.
Benign: Non-cancerous medical condition or growth of tissue. In contrast to malignant which refers to a cancerous tissue or growth.
Benign Prostatic Hyperplasia (BPH): Non-cancerous enlargement of the prostate. It is often used to describe any urinary symptoms in men due to prostate enlargement (more accurately described as LUTS or lower urinary tract symptoms).
Bladder Tuck: Term commonly used by women to discuss any vaginal repair to the urethra or bladder. Technically refers to a cystocele repair. e.g. The surgeon did a bladder tuck at the time of my hysterectomy.
Blue Balls: Colloquial term used for the pain and congestion felt in the testicles and epididymis when ejaculation is delayed for a period of time. More commonly seen in teens and men in their 20’s.
Brachytherapy: A type of radiation, often for prostate cancer, in which radioactive seeds are placed into the prostate during an outpatient procedure. The high-energy seeds emit radiation over several months and kill prostate cancer cells. This exposure to radiation is not known to give you superpowers, but you should certainly inform your oncologist if you find that you’re suddenly able to fly.
Chronic Prostatitis: Inflammation of the prostate gland. May refer to repeated urinary tract infections in men which originate in the prostate. Often used to describe chronic male pelvic pain regardless of whether an infection is ever found.
Cryotherapy: A procedure that rapidly freezes (-50°C) cancerous tissue to cause cell damage. A probe is placed through the skin or during a surgery under ultrasound or CT scan guidance. Used to treat prostate and kidney cancer.
Cryptorchidism: A hidden (crypto) testicle (orch). This is the result of either the testicle failing to descend completely into the bottom of the scrotum (sac) during fetal development, or the testicle never formed or died during development.
Cystitis: Inflammation of the bladder most often due to a bacterial infection (e.g. acute bacterial cystitis or the technical term for a bladder infection or UTI). Cystitis may also be caused by radiation, viruses, medications or inflammatory conditions.
Cystocele: Bulging of the bladder through the upper vagina. Presents as a mass or lump a woman can see or feel at the vaginal opening. It’s not always painful, but it can be quite uncomfortable. It is fixed with a “bladder tuck” or re-supporting of the vaginal wall and surrounding tissues.
Cystectomy: Surgical removal (-ecctomy) of the bladder (cyst). A radical cystectomy is complete removal for invasive bladder cancer. A partial or simple cystectomy may be performed for a localized cancer or a non-functioning bladder.
Cystoscopy: A diagnostic procedure where a scope is inserted into the urethra and bladder to determine abnormalities of the lower urinary tract. Usually performed in the office under local anesthesia or mild sedation. Not usually appropriate for sharing on social media, but that would be a judgement call. #cystoscopy.
Cystogram: An imaging test in which the bladder is filled with contrast material to check for a “bladder leak”. Performed after some surgeries (prostate removal) and to rule out a urinary fistula. Usually undertaken by inserting a catheter into the bladder and moving dye through the bladder. Pictures or live video may be taken both during the process and shortly afterward.
Down There: This is a term usually used by embarrassed patients to describe any problem of the male or female genitalia. e.g. “Doc, I’ve got a problem down there that I need help with.” Rest assured, your urologist will not blush if you choose to use either the medical or colloquial names for your genitalia. They may even have heard them called things you haven’t; so don’t be afraid to ask if you want to add some new ones to your vocabulary.
Dyspareunia: Painful sexual activity in women. Most often due to a narrowed, inflamed vaginal opening or pelvic muscle tightness. Causes include: vaginal surgery, pelvic radiation or low estrogen levels post-menopausal. Aside from the physical symptoms, this can also affect your sexual desire, which in turn can impact your general mental wellbeing. Speak to your doctor if you feel discomfort. Remember, despite what the 1950s would have women believe, sexual activity is supposed to be pleasant for everyone involved.
Enuresis: Another term for incontinence. Most commonly used to describe nocturnal enuresis or unintentional bedwetting. Nocturnal enuresis is more common in boys and usually resolves by 18 years old. There can be a variety of causes. Some of these are physical — bladder development, constipation putting pressure on the bladder — while others are psychological in nature.
Erectile Dysfunction: ED is any difficulty in obtaining or maintaining an erection sufficient for sexual intercourse. The #1 cause is a blood vessel blockage (atherosclerosis) from other medical conditions. It can also be caused by nerve damage, medications and low hormone levels. Too many men are so embarrassed about this that they delay speaking to a physician. The conversation doesn’t have to be awkward; remember that everyone involved wants you to have a happy, healthy sex life!
Extracorporeal Shock Wave Lithotripsy (ESWL): A procedure that uses sound waves to break-up kidney stones without inserting any device or tool inside your body. Performed under anesthesia as an outpatient, ESWL uses live x rays to locate and “bust-up” the stone. It’s like having a superpower, except the superpower is science and the capes are optional.
Fellowship: Subspecialty training performed by some doctors after completion of residency. These doctors focus on a particular area of medicine within their field (e.g. urogynecology, urologic oncology, male infertility). Not the same kind of fellowship you’d find Hobbits involved with. Except, maybe, Hobbit urologists.
Fistula: An abnormal connection between two organs that are not normally connected. For example, a colovesical fistula (colon and bladder) due to diverticulitis, or a vesicovaginal fistula (vagina and bladder) due to a pelvic surgery complication. Usually detected via a cystoscopy, and requires surgical repair.
Hematospermia: Blood seen in the semen or ejaculatory fluid. Maybe pink, red or dark brown. While it can be alarming to discover these symptoms, it is almost always benign and requires no further evaluation. Hematospermia usually resolves on its own and is not dangerous.
Hematuria: Blood in the urine that is either microscopic (detected on urine test) or gross (visible to the naked eye). Requires evaluation by a urologist and depending on the specifics may require further testing. The causes are numerous, ranging from simple vigorous physical activity, to more serious bladder cancer or polycystic kidney disease. As such, symptoms should not be ignored.
Hydrocele: An abnormal build-up of fluid around the testicle. A congenital hydrocele is seen in children due to an open sac in the groin area. An adult hydrocele most often occurs for no reason but can be caused by infection or cancer. While symptoms usually take the form of painless swelling of either or both of the testicles, there can be discomfort, and it’s important to consult a doctor to rule out the more serious causes of a hydrocele.
Hydronephrosis: Swelling of the ureter and/or kidney (hydro – water, nephrosis – abnormality of kidney). May be caused by an obstruction (e.g. kidney or ureteral stone) or reflux of urine from the bladder (congenital reflux or blockage of bladder outlet). As a result, the urine is unable to drain from the kidneys, and causes a build up. In severe cases, surgery may be required to fix a blockage or correct the reflux.
Hypospadias: Birth abnormality in which the male urethra opens on the underside of the penis. The urethra in these cases is usually located in one of three areas.
Subcoronal, when the opening is located just below the head of the penis (glans). Midshaft, as the name suggests, sees the opening somewhere along the penis shaft.
Penoscrotal refers to hypospadias where the opening occurs where the scrotum and the penis meet. This is usually repaired by a pediatric urologist.
Impotence: Another term for ED or erectile dysfunction.
Incontinence: Unintentional loss of bladder of bowel contents. Urinary incontinence types include stress, urge and overflow incontinence. Bowel or fecal incontinence can be addressed by a colorectal surgeon or at times a urologist.
Interstitial Cystitis: A poorly understood, chronic inflammatory condition of the bladder. Symptoms include pain with bladder fullness, urinary frequency and urgency. Sometimes known as IC or chronic bladder pain syndrome.
Kegel Exercises: Also known as pelvic floor exercises. Kegels involve squeezing and relaxing the pelvic muscles (perineum) in order to improve stress urinary incontinence and pelvic floor dysfunction. Also a form of exercise you can be doing in public and nobody would know you were doing it. It’s like you’re working out in incognito mode.
Kidneys: Two bean-shaped organs located in the upper back that filter the blood and create urine. The “meat” of the kidney (parenchyma) consists of microscopic filtration systems (glomeruli) and the “plumbing system” (renal pelvis and calyces) carry the urine to the ureter. Veal kidneys are considered to be delicious with Roquefort and walnut butter. Your urologist is unlikely to be able to provide you with human kidney recipes, but it doesn’t hurt to ask.
Kidney Stone: A hard, painful rock that develops in the kidney from excess crystals and/or inadequate urine production (dehydration). Range in size from 1 mm to 2-3 cm. Kidney stones may pass on their own or require surgical removal. The largest known kidney stone was 13cm at its widest point — needless to say it did not pass naturally. Thankfully this kind of nightmare fuel is extremely rare.
Laparoscopy: Minimally invasive surgery performed through keyhole incisions (5-12 mm) in the abdomen using a camera and long, narrow instruments. Robotic surgery for prostate and kidney cancers are types of laparoscopic surgery. Rest assured that these robots are guided by medical professionals, and not attempting to take over the human race one small surgery at a time.
Lithotripsy: Any procedure that breaks up kidney stones. Shock wave lithotripsy (ESWL) is performed with sound waves. Laser lithotripsy is performed with a laser fiber under direct visualization of a stone during ureteroscopy.
Nephrectomy: Removal of the kidney. A radical nephrectomy is removal of the entire kidney and surrounding fat for the treatment of kidney cancer. Can be performed through an open incision or laparoscopically. In some cases, there is also the potential for a Partial Nephrectomy, in which the surgeon removes only the diseased tissue.
Nephrolithiasis: Medical term for kidney (nephro-) stones (lithiasis).Kidney stones can be non-obstructive and not cause pain. When they “pass” down the ureter they cause hydronephrosis and severe pain. While some stones pass without intervention, you should consult a doctor if you are experiencing severe pain, blood in the urine, nausea and vomiting, fever, or chills.
Nephrologist: A kidney specialist who focuses on the function of the kidney. Begins training as a primary care doctor and then completes a fellowship in nephrology. Further specialist pediatric training is required for those who wish to qualify as a pediatric nephrologist.
Neurogenic Bladder: Any abnormal condition of bladder function caused by nerve damage. Can be: congenital (e.g. spina bifida), traumatic (e.g. spinal cord injury) or autoimmune (e.g. multiple sclerosis).
Orchalgia: Fancy doctor term for testicular (orch-) pain (-algia) of any source. Most causes of testicular pain are musculoskeletal or neurologic in nature with no abnormality of the actual testicle. This doesn’t mean that you can go out, swinging them around as if they’re invulnerable. Be kind to your testes.
Orchiectomy: Removal of a testicle. Radical orchiectomy is performed through a groin incision for testicular cancer. Simple orchiectomy is performed through a scrotal incision for benign conditions. If the patient so wishes, a prosthetic testicle can be inserted during an orchiectomy, to retain some of the feel and appearance of their testicles prior to surgery. No bionic testicles though, you can’t be Iron Man-parts just yet.
Orchitis: Infection of the testicle. STDs like gonorrhea may lead to epididymo-orchitis (infection of the testicle and epididymis). Orchitis is also seen with urinary tract infections (E. coli). Resolves if treated with antibiotics quickly, so it’s in your best interest to go and speak to your physician as soon as possible.
Penile Fracture: A rupture of the internal erectile chamber of the penis typically during sexual activity. Symptoms include an audible “pop”, immediate severe swelling and bruising. It requires immediate medical attention to surgically repair the tear. In the future, you and your partner will be laughing about that pop. Feel free to have a little cry about it first, though; you fractured your penis, after all.
Percutaneous Nephrolithotomy (PCNL): A minimally invasive kidney stone surgery performed through small incisions in the back. A tube and instruments are placed directly into the kidney. Typically performed for kidney stones greater than 2 cm or for patients with abnormal anatomy.
Pelvic prolapse: A general term used to describe any bulging from the vaginal opening. Includes a cystocele (bladder bulging), rectocele (rectal bulging), vaginal vault prolapse (bulging after a hysterectomy, and complete uterine prolapse (cervix and uterus bulging). Who knew there were so many options for bulging from your vaginal opening? Now you have something to talk to your kids about over dinner.
Pessary: A plastic ring that is inserted into the vagina for non-surgical treatment of pelvic prolapse. It supports the vaginal wall preventing vaginal bulging. It is placed in the office by a female urology specialist. As the greatest philosopher of our time, Beyonce, once famously told us: “If you didn’t want a pelvic prolapse, you should have put a ring on it.”
Peyronie’s Disease: Also known as PD, Peyronie’s is caused by plaque formation on the erectile chamber of the penis. This leads to penile pain or curvature during an erection. In severe cases of PD, it may cause shortening of the penis or erectile dysfunction. Having a bent penis is no fun for anyone; the novelty of ejaculating around corners soon wears off.
Phimosis: An abnormal tightening of the foreskin that causes pain and/or difficulty retracting the foreskin. Normal to see in children and usually resolves during puberty. Reappears in adulthood due to obesity, diabetes and poor hygiene. Can be treated through the use of topical steroids, though in severe cases a circumcision may be required.
Priapism: An abnormal erection not associated with sexual desire or stimulation. Most commonly painful and caused by medications or sickle cell anemia. Requires immediate medical attention.
Prostate: A gland that starts at the bladder opening, contains the prostatic urethra, and ends at the urethral sphincter. The prostate contributes 15% of the semen volume. It enlarges with age and can cause urinary symptoms (BPH) or develop into cancer.
Prostate cancer: The most common solid organ malignancy in men. Has various forms including slow-growing, insignificant types and very aggressive types that spread and cause death to over 30,000 men a year in the U.S. As a result, it is usually advisable to have yearly prostate exams from the age of 50. However, if you are in an at-risk group (more than one of your relatives experienced prostate cancer at an early age, for instance), you should start screening as early as the age of 40.
Prostate Specific Antigen (PSA): A protein made specifically by the prostate gland. It is used as a screening tool for prostate cancer. When elevated may require further blood/urine testing, MRI or a prostate biopsy.
Prostatitis: Inflammation of the prostate gland. Acute bacterial prostatitis is a serious bacterial infection causing fever and painful urination in men. Requires immediate medical treatment with antibiotics.
Prostrate: Incorrect term for prostate. ProstRate means lying motionless on the floor often when you’re dead. That’s not good. The good news is you can still get a prostrate exam, but we tend to call that an autopsy.
Proteinuria: The presence of protein in the urine which is often a sign of kidney disease. Often requires evaluation by a nephrologist to determine the function of the kidney and underlying cause.
Pyuria: White blood cells in the urine seen on urine samples. Often defined by cloudy, discolored, or different smelling urine. Would also be a great name for a mythical land — does anyone have George R. R. Martin’s phone number?
Pyelonephritis: A bacterial infection of the kidney. Acute pyelonephritis presents with fever, back pain and nausea/vomiting. Usually begins as a bladder infection (bacteria travel up to the kidney) but may also start from an infection elsewhere in the body (bacteria spread via bloodstream).
Pyeloplasty: A surgical procedure to repair a blockage of the kidney where it connects to the ureter (ureteropelvic junction). Usually performed laparoscopically, the surgeon will cut and reconnect the ureter to the kidney relieving any obstruction.
Radiation: An invisible high-energy source that is used to treat cancer. It is focused on the cancerous organ and delivered through multiple sessions using a sophisticated machine. Radiation is commonly used to treat prostate and testicular cancer. Imagine; the same thing that created Godzilla can treat your cancer. What an age we live in!
Radical Prostatectomy: Removal of the entire prostate gland and seminal vesicles for the treatment of prostate cancer. May be performed through an open incision or robotically through small incisions.
Renal Pelvis: Main part of the plumbing system in the kidney that collects urine produced by the kidneys and connects to the ureter (at the ureteropelvic junction). Can be dilated from hydronephrosis or reflux of urine.
Robotic surgery: A minimally invasive surgery typically performed laparoscopically with the use of a robotic surgical system. From a console, the surgeon controls the surgical instruments and the “robot” the entire operation. We cannot emphasize this enough — we wouldn’t let an unsupervised robot perform surgery on you. That’s how apocalypses happen.
Sacral Neuromodulation: A therapy for the treatment of urge urinary incontinence and fecal incontinence. After a trial evaluation, a permanent lead and battery are placed in the upper buttocks area to “rewire” the communication pathway between the brain and the bladder/bowels. That’s right; not only does your incontinence get treated, but you now have bionic buttocks. You might need to get a t-shirt made so your voice doesn’t get tired from telling everyone about it.
Seminal Vesicles: The paired organs that produce 85% of semen. They connect to the prostate and vas deferens. Sperm travel to the seminal vesicles and are stored in the semen until ejaculation occurs.
Sling: A surgical procedure treating stress urinary incontinence. Involving placement of a “hammock” underneath the urethra to provide missing support. Slings can be man made (synthetic) or created from your own tissue (fascia). Yes, you’re right, it does bring a whole new meaning to the term “banana hammock”.
Snip: a slang term for a vasectomy. A snip is performed to ensure men are shooting blanks (no sperm in the semen) such that a natural pregnancy is no longer possible. Despite the name, your urologist is very unlikely to use scissors as part of the procedure — although a weed whacker isn’t out of the question.
Stress Urinary Incontinence: (SUI) Involuntary leakage of urine during coughing, laughing, sneezing, or lifting. When stress is placed on the bladder, the urethra cannot hold the urine in. It is especially common following childbirth or prostate surgery. Usually caused by a weakening of the muscles which provide support to the urethra. As such, it can be treated with pelvic floor exercises or surgery.
Ureter: The urinary tube that connects the kidney to the bladder. When urine is created by the kidney, the ureter carries the urine into the bladder. Distinguished from the ure-THRA which is the tube where urine passes from the bladder outside your body. Trust us, you don’t want to get those two mixed up during dinner party conversations. So embarrassing.
Ureteral Calculus: A kidney stone which has passed into the ureter. A ureteral calculus typically causes an obstruction, leading to hydronephrosis and pain. Other potential symptoms can include nausea, vomiting, and hematuria (blood in the urine). They will either pass spontaneously or require surgical removal. Still, we’re sure you’d agree that this is the least painful type of calculus you’ve ever faced.
Ureterocele: A congenital swelling and obstruction of the ureteral opening. It causes a blockage of the kidney and can present with pain, recurrent urinary tract infections or as an incidental finding on imaging. While this issue is most commonly discovered while the patient is an infant, it can still be found in older children and adults. Can be treated with various types of surgery, depending upon the age of the patient and how the kidney has been affected.
Ureteropelvic Junction (UPJ): Where the ureter joins the renal pelvis. A UPJ Obstruction occurs when there is a blockage of this connection. Can be caused by scar tissue or abnormal location of the kidney blood vessels (crossing vessels).
Ureteroscopy: A surgical procedure under anesthesia where a small scope is placed into the urethra, bladder and up the ureter. Most commonly performed to remove kidney stones or to inspect the inside of the ureter or kidney. Not all types of kidney stones can be easily located using x-ray procedures, as such this provides a more agile and thorough examination.
Urethra: The tube through which urine passes from the bladder during urination. In women it is a short (4 cm) muscular tube. In men the urethra includes the prostate, sphincter muscle and portion that runs behind the scrotum and the underside of the penis.
Urinalysis: A lab test of the urine to identify the presence of blood cells, protein or bacteria. A dipstick urinalysis is performed at the point of care and usually less accurate than a microscopic urinalysis.
Urinary Incontinence: The involuntary loss of urine (enuresis). Characterized as stress incontinence, urge incontinence, overflow incontinence. Affects over 30 millions Americans and can be treated by a urologist.
Urinary Tract Infection (UTI): Any infection of the urinary system. Most commonly due to bacteria. Can be used to describe bladder (cystitis), kidney (pyelonephritis) and prostate (prostatitis) infections.
Urodynamics: Bladder function tests used in the evaluation of complex urinary difficulties. In the office, small catheters are placed in the urethra while the bladder is filled with fluid. Measures bladder size, compliance and urine flow rates.
Urogynecologist: A female urology specialist who has usually completed a Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellowship. May have originally trained as a urologist or obstetrician/gynecologist (OB/GYN).
Urolithiasis: Stones anywhere in the urinary system (from the kidney to the urethra). The most general term to describe all urinary stones. Compared to terms kidney stones (nephrolithiasis), ureteral stones (ureterolithiasis) or bladder stones.
Urologist: A specialist trained in treating conditions of the male and female urinary tract and male genitalia. Urologists have completed a 5-6 year surgical residency and see patients in clinic, ER and inpatient settings. Sometimes misheard as “neurologist”, but trust us, you don’t want a urologist messing around with your brain.
Varicocele: Dilation (enlargement) of the veins draining the testicles. Seen in 15% of men most commonly on the left side. May lead to sperm abnormalities (male infertility) and/or chronic testicular pain. Often doesn’t present obvious symptoms, and as such may go unnoticed until investigations into fertility are undertaken. Can be repaired with surgery.
Vas Deferens: The tube’s sole purpose is to carry sperm (swimmers) from the testicle/epididymis to the seminal vesicles (swimming pool). It is severed during a vasectomy and plays no role in the transport of testosterone.
Vasectomy: A form of permanent sterilization performed in men. Using a variety of techniques, a vasectomy involves an incision in the scrotum after which the vas deferens are disconnected preventing the sperm from reaching the ejaculatory fluid.
Vasectomy (no-needle, no-scalpel): A minimally invasive vasectomy. Local anesthesia is injected via a needleless device. A skin poke is then performed without the use of a scalpel. Leads to less pain and a quicker recovery.
Vasovasostomy: Vasectomy reversal performed for men now desiring to father children via natural conception. The procedure is performed as an outpatient surgery by a fellowship-trained infertility specialist using a surgical microscope. It is considered to be around 95% effective.
Vesicovaginal Fistula: An abnormal connection between the bladder and the vagina. Most commonly seen as a complication to pelvic surgery. Presents with urine leakage from the vagina and requires surgical repair.
