Both urologists and nephrologists are specially trained doctors, who often work together to treat patients. A urologist is a surgeon, while a nephrologist is not and is a physician. Here, we will explore more about what they do and when to see a urologist versus a nephrologist.
Urologists and nephrologists: the basics
A urologist is a doctor trained in surgery who looks after your urinary system, which includes your kidneys, bladder, ureter (the tube that carries urine from your kidneys to your bladder), prostate (in men) and urethra (the tube that carries urine out of your body).
Urologists focus on the structure and function of your urinary system, that is, the anatomy of your urinary system and how well urine passes through. They often provide treatment using medical interventions, lifestyle changes and, in many cases, interventional procedures or surgery.
A nephrologist is not trained in surgery as they complete their training in medically treating kidney conditions (renal medicine). They specifically look after your kidneys and treat both acute (sudden onset and/or short-term), chronic (long-term) and genetic (inherited) kidney conditions.
Nephrologists do not focus on conditions involving the rest of the urinary system. However, as obstructions (blockages) at any point along the urinary system can negatively impact kidney function, nephrologists often work alongside urologists.
For example, a urologist would treat an obstruction in the urinary system, while a nephrologist would treat damage to the kidney caused by the obstruction. In the case of kidney stones, a urologist would remove the kidney stones, while a nephrologist would investigate why the stones developed and treat the underlying cause.
Common conditions treated by urologists
Urologists treat a wide range of conditions affecting the urinary system, including persistent urinary tract infections (UTIs), kidney stones, urinary incontinence, overactive bladder, bladder cancer and narrowing of the urethra (urethral strictures).
They treat problems relating to the male reproductive system. This includes prostate conditions, such as prostate cancer, inflammation of the prostate (prostatitis) and an enlarged prostate (benign prostatic hyperplasia), as well as erectile dysfunction.
Urologists also treat pelvic organ prolapse, which is more common in women after pregnancy, vaginal childbirth and menopause.
Common conditions treated by nephrologists
Nephrologists treat all conditions that affect the kidneys. This includes chronic kidney disease (CKD), dialysis and transplant, diabetic nephropathy, acute kidney injury and high blood pressure that is not well-managed with standard medication.
They also treat autoimmune conditions that affect the kidneys, such as vasculitis and glomerulonephritis, and inherited kidney diseases, such as Alport syndrome, polycystic kidney disease and reflux nephropathy. Sometimes, they are needed when patients present with other problems, such as cardiovascular disease or side effects to certain medications.
When to see a urologist
You should see a urologist if you notice problems with your ability to pass urine. This may include difficulty starting to urinate, a weaker or ‘stop–start’ stream of urine and/or blood in your urine.
Other symptoms that may need investigating by a urologist include frequent UTIs and pain in your lower abdomen towards your pelvis, which is a sign of a UTI. Other symptoms of UTIs include blood in your urine and/or cloudy urine, as well as:
- A burning sensation or pain when urinating
- A fever or low body temperature (below 36°C)
- Having sudden urges to urinate
- Fatigue
- Needing to urinate more often during the day or night
When to see a nephrologist
Not all kidney conditions cause obvious symptoms. Consequently, your GP may need to refer you for blood tests, which can reveal a problem with your kidney function.
When symptoms do occur, they can include high blood pressure that is difficult to control with standard medication and swelling caused by retaining too much fluid (oedema).
Other general symptoms, which may suggest a kidney problem, include fatigue, poor appetite and itchy skin. It’s important to note that there are many health conditions that can cause these symptoms — a doctor will consider these symptoms in context to determine whether they suggest a kidney problem.
Should you see a urologist or a nephrologist?
When you see a nephrologist or a urologist, your doctor will confirm if they’re the right person to treat you. If they feel your condition would be better managed by another specialist, they’ll refer you to the right department. The advice above is, therefore, a guide to help you choose whether to make an appointment with a urologist or nephrologist. In some cases, you may see both a nephrologist and a urologist for different aspects of your care.
