Education And Debate


BMJ 1996; 312 doi: (Published 09 March 1996) Cite this as: BMJ 1996;312:623
  1. Chris Dawson,
  2. Hugh Whitfield

    Scope of urology

    Urological surgery was one of the last surgical disciplines to become recognised as a separate specialty from general surgery in terms of training and practice. Urological disorders account for about one third of all surgical admissions to hospital. Such disorders are common in the community, and though few are life threatening, many may have a profound effect on the quality of life.

    Subspecialties in urology

    • Urodynamic disorders

    • Oncology

    • Stone disease

    • Reconstruction

    • Paediatric urology

    • Andrology

    It is not surprising that specialisation within urology, as in all other medical and surgical disciplines, provides the best quality of care. The confidential inquiry into perioperative deaths (CEPOD) highlighted that prostatectomy, the operation performed most frequently by urologists, is associated with a significantly lower mortality and morbidity when performed by surgeons who carry out more than 50 such procedures a year. All urologists provide care to some extent in all the subspecialties of urology, but most will concentrate on one or two as specific interests. Urological surgical specialisation, however, only becomes fully effective with specialised urological nursing.

    Excised specimen of cancerous bladder showing large tumour mass.

    Urodynamic disorders

    Problems of bladder outflow obstruction secondary to benign prostatic hypertrophy constitute about a third of urological practice. Other urodynamic disorders occur in patients with neurological disorders of many kinds. The management of patients with urinary incontinence is also included under this heading.


    Bladder tumours and prostate cancer are the two commonest malignant diseases presenting to urologists. Most urology departments run a haematuria service as many studies …

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