Questions to Ask a Urologist
For patients seeing a urologist at a first referral or a follow-up, and for whoever goes along with them. The list is grouped by why you are there: a prostate or PSA result, kidney stones, bladder problems and leaks, erection problems, a vasectomy consult, and a procedure the urologist has proposed. Take five or six from your group, and use the note under each to judge the answer you get; none of it is medical advice.
The questions
Each question, and why to ask it
Prostate and PSA
What is my PSA number, and how has it changed across my earlier tests?
Why ask it
Ask for every past result with its date, so the two of you are reading a trend and not a single figure. If you hear 'a little high' with no number, ask for the number and write it down.
What besides cancer could be raising my PSA?
Why ask it
A careful answer runs through the ordinary causes for you: the size of the prostate, an infection, a recent catheter or procedure, even what you did in the days before the blood draw. Ask whether repeating the test in a few weeks comes before anything more invasive, and what to avoid beforehand.
Do you need to do a rectal exam today, and what can it tell you that the blood test can't?
Why ask it
Whether an exam is part of the visit depends on the urologist and on why you were referred, and asking at the start saves you wondering through the whole appointment. If it is, it is brief: you can ask for a chaperone, and for each step to be explained before it happens.
My stream is weak and I am up several times a night. Is that my prostate, and how would you confirm it?
Why ask it
Bring a count: how many times a night, how long it takes to get going, whether you feel empty afterward. Expect the flow and what is left in the bladder to be measured before the prostate gets the blame, since a urologist has other causes of broken nights to rule out.
For an enlarged prostate, what are my choices between waiting, medication and a procedure?
Why ask it
A balanced answer puts all three on the table and says what would move you from one to the next. Be wary if a procedure is the only thing discussed when your symptoms are a nuisance and nothing more.
What side effects do the prostate medications have, including dizziness and changes to ejaculation?
Why ask it
These two are easy to leave unmentioned and hard to live with, so raise them before you start. Find out how long to give a drug before judging it, and whether it is safe to stop all at once.
Given my age and family history, how often should my PSA be checked from here on?
Why ask it
Screening advice differs by country and by guideline, so ask which one this urologist follows and why it fits you. Mention any father, brother or uncle with prostate cancer and the age at which it was found.
Would you order an MRI before deciding on a biopsy, and what would it add?
Why ask it
Whether a scan comes first depends on the clinic, the health system and what your insurer or health service pays for, so part of the answer may be about access. Either way, have the urologist say what a clear scan would and would not rule out.
If I need a biopsy, how is it done here, and what are the risks of infection and bleeding?
Why ask it
Find out whether the needle goes in through the rectum or through the skin, what numbing or sedation is offered, and how much blood you may see afterward and for how long. Ask for the temperature that means a same-day call, and save the number before you go home.
Can you walk me through my biopsy report: the grade, how many samples were positive, and whether it looks confined to the prostate?
Why ask it
Request a copy and have the urologist point to each line as they explain it. You are listening for which risk group this puts you in, since that one phrase drives most of the choices that follow.
Is active surveillance a reasonable choice for me, and what would the schedule of tests be?
Why ask it
If it is offered, ask what result would end the watching and start treatment, so the trigger is agreed in advance. If it is ruled out, ask which feature of your results rules it out.
How do surgery and radiation compare for someone like me on leaking, erections and bowel problems?
Why ask it
Push for likelihoods at one year, not 'most men do fine', and ask whose figures they are: this surgeon's or published averages. You can also ask to hear the radiation side from a radiation oncologist before choosing.
Kidney stones
How big is the stone, where exactly is it, and is it likely to pass on its own?
Why ask it
Size in millimeters and position are the two facts everything else hangs on, so get both and ask to see the scan. Then ask for a rough chance of passing a stone like that, since 'we'll see' gives you nothing to plan around.
How long is it safe to wait for it to pass, and what would make you step in sooner?
Why ask it
You want a date, not an open-ended wait: 'if it has not moved by then, we do this.' Check whether a repeat scan is planned to confirm the stone has gone, or whether the pain easing is all anyone will go on.
What can I take for the pain, and is there a medication that might help the stone along?
Why ask it
Say what you have already tried and how well it held. If a pill to relax the ureter is suggested, ask what it can do to your blood pressure when you stand up, and which painkillers are safe for your kidneys.
If it has to come out, would you use shock waves, a scope or surgery through the back, and why that one for my stone?
Why ask it
The reasoning should rest on your stone's size, position and hardness, and on what this hospital actually offers. Ask the chance of being stone-free after one session, because some methods need a second.
Will I have a stent afterward, what does it feel like, and when does it come out?
Why ask it
Stent discomfort catches a lot of people off guard, so hear in advance what is normal and what eases it. Leave with the removal date in your calendar and the name of whoever books it; a stent is not something to lose track of.
Should I strain my urine and bring the stone in for analysis?
Why ask it
If yes, pick up a strainer and a container before you leave. What the stone is made of shapes the prevention advice, so chase the result if nobody mentions it at follow-up.
Do I need a 24-hour urine collection or blood tests to find out why I make stones?
Why ask it
This matters most if it is not your first stone or if stones run in your family. A worrying reply is 'just drink more water' to someone on their third; ask what a fuller workup would look for.
Based on my type of stone, what should I change in what I eat and drink?
Why ask it
Lists online contradict each other because the advice depends on the stone. Come away with a daily fluid target you can measure, and a clear yes or no on cutting back salt, animal protein or particular foods.
With a stone in place, which symptoms mean the emergency room and not a call to the office?
Why ask it
Have the urologist name them for your case and type the list into your phone. Fever or chills, vomiting that stops you keeping fluids down and passing no urine are the ones to ask about by name, along with where to go at night.
Bladder and leaks
I leak when I cough or lift, and sometimes I can't reach the bathroom in time. Which kind of incontinence is this, or is it both?
Why ask it
Describe what sets it off and how much comes out, because the type decides the treatment. Hearing 'it comes with age' or 'it comes with childbirth' and nothing else is your cue to ask what can be done about it.
Would a bladder diary help, and what exactly should I record?
Why ask it
Offer to keep one for a few days before the next visit: what you drink, when you go, how much, and each leak. It turns 'I go all the time' into numbers the urologist can act on.
Which tests do you want me to have, and what will each one tell you?
Why ask it
You may hear a urine test, a bladder scan, a pressure study (urodynamics) or a look inside with a camera, and each should come with a reason tied to your symptoms. Find out what the camera test or the pressure study feels like and how long it takes, so you can decide whether to drive yourself.
How much urine is left in my bladder after I go, and is that a risk to my kidneys?
Why ask it
The scan takes a minute and gives a number in milliliters, so ask for it. If the number is high, the next question is what is blocking or weakening the flow, and whether a catheter, even a temporary one, is being considered.
What can we try before medication or surgery: pelvic floor therapy, bladder training, changes to what I drink?
Why ask it
The reply to hope for is a referral to a pelvic floor physical therapist or a continence nurse, where there is one, and not just a handout. Agree how many weeks to give it before deciding it has not worked.
What are the side effects of the bladder medications, and how soon would we know whether one is working?
Why ask it
Depending on the drug, dry mouth, constipation, blood pressure and, for older patients, memory are the things to raise. Set a review date so you are not left taking something that does little.
If the first treatments don't work, what comes next: bladder Botox, nerve stimulation, a sling?
Why ask it
You are asking for the map, not signing up. For each one, find out how long it lasts, whether it can be undone, and whether this urologist does it or refers you on.
There was blood in my urine. What do you need to rule out, and which tests will do that?
Why ask it
Say whether you saw it yourself or a test found it, and whether it came with pain. Ask whether you need imaging of the kidneys, a look inside the bladder, or both, and if the advice is simply to watch it, ask why that is safe for you.
Why do my urinary tract infections keep coming back, and is each one being confirmed with a culture?
Why ask it
Bring the dates and whatever you were given each time. What you want is a search for a reason, such as incomplete emptying or a stone, before anyone settles on repeated antibiotics.
Erections
What is most likely behind my erection problems, and which tests would help tell?
Why ask it
Be ready to say when it began, whether it was sudden or gradual, and whether morning erections still happen. Those details steer the answer as much as any blood test, and a urologist who asks for them is doing the job well.
Could this be an early sign of heart or blood vessel trouble, and should my regular doctor check me?
Why ask it
It is a fair question at any age, and more so with diabetes, high blood pressure or smoking in the picture. If the urologist says yes, have them put it in the note to your regular doctor so it does not rest on your memory.
Which of the things I take, including blood pressure pills and antidepressants, can affect erections, and could any be swapped?
Why ask it
Hand over the full list, including anything bought online or at the gym. Do not stop a prescription on your own; find out who should make the change, since it may belong to another doctor.
How do the pills work, how should I take them, and are they safe with my heart medication?
Why ask it
Timing, food and how many attempts count as a fair test all change the result, so get those three before deciding a pill has failed. Name every heart drug you take, nitrates above all, before accepting a prescription.
Should my testosterone be checked, and what would treating a low result involve?
Why ask it
Ask what time of day the blood should be drawn and whether one low result is enough to act on. If treatment comes up, find out what it does to fertility and what monitoring comes with it.
If pills don't work or I can't take them, what are the other options?
Why ask it
Expect to hear about a vacuum device, injected medication and an implant, roughly from least to most involved. For each one, find out what you would pay at this clinic and who teaches you to use it in person.
Would it help to bring my partner to a visit, or to see a counselor alongside the medical treatment?
Why ask it
Worry and the body feed each other here, and a urologist who says so is not brushing you off. If you would welcome a referral, get a name; if you would rather keep the visits to yourself, that is fine too.
Vasectomy
How do you do a vasectomy, where is it done, and how long does it take?
Why ask it
Listen for whether it is done with or without a scalpel, what numbing you get and whether you can drive yourself home. If the urologist at the consult is not the one who will operate, ask to know who is.
Should I treat this as permanent, and how realistic is a reversal if my life changes?
Why ask it
The honest answer is to count on it being permanent. Ask what a reversal costs, who pays for it where you live and how its chances change with time, and bring up sperm banking now if you have any doubt.
How soon can we stop using other birth control, and how is the semen test done?
Why ask it
Expect to be told you are not sterile on the day. Get the number of weeks, how the sample is collected and delivered, and who calls with the result, and keep using contraception until the office gives the all-clear.
What is recovery like: time off work, lifting, exercise and sex?
Why ask it
Give your actual job and sport so the answer is not the generic one. Then ask what swelling or bruising is ordinary in the first week, and how much of it should prompt a call.
What are the risks, including pain that lingers, and how often does a vasectomy fail?
Why ask it
Expect bleeding, infection, a long-term ache and failure to be mentioned without your having to press. If lasting pain is waved away as something that never happens, ask again, and ask what is done for the patients who get it.
Will a vasectomy change my erections, sex drive, hormones or what ejaculation is like?
Why ask it
Plenty of men carry this worry into the room and never voice it. Put it plainly and let the urologist explain what the operation does and does not touch, in terms you could repeat to your partner.
What do I need to do beforehand, such as shaving, stopping blood thinners or arranging a ride?
Why ask it
Get the instructions in writing and check them against your medication list, aspirin and supplements included. Find out what to have at home too: supportive underwear, an ice pack, a painkiller they approve of.
What will it cost me, and is there a waiting period or a consent form I should know about?
Why ask it
Coverage, waiting periods and consent rules differ by country, state and insurer, so ask how it works at this clinic. Make sure the price you are quoted includes the consult and the follow-up semen test.
A procedure
What problem is this procedure meant to fix, and what happens if I hold off for now?
Why ask it
You should be able to repeat the answer in one sentence when you get home. Ask how long holding off is safe and what sign would mean the wait is over.
How many of these do you do in a year, and what are your own rates of the complications I'm worried about?
Why ask it
Name the complication you fear, whether it is leaking, loss of erections or a return to the operating room. Surgeons who track their results answer with numbers; a vague answer is a reason to ask where else it is done.
Will it be done through a scope, with a robot or through an open incision, and why that approach for me?
Why ask it
The reason should be about your anatomy and your condition, not only what the hospital owns. It is worth knowing what would make them change approach partway through, and how that would alter recovery.
Is this done in the office, a surgery center or a hospital, and under what kind of anesthesia?
Why ask it
The setting changes the cost, the time off and whether someone has to take you home. If you have had trouble with anesthesia before, or have sleep apnea, say so now and not on the morning.
Will I go home with a catheter, and who teaches me to look after it?
Why ask it
Cover how many days, how to empty and clean the bag, and what to do if it stops draining at night. You should be shown by a nurse before discharge, not just handed a sheet, and leave with a number that is answered after hours.
Which of my medications, blood thinners especially, should I stop beforehand, and when do I restart them?
Why ask it
Get exact dates for each drug, and check whether the doctor who prescribed the blood thinner needs to agree. Write them on the same sheet as your fasting instructions.
What should I expect for urinating, bladder control and sexual function in the first weeks, and again at a year?
Why ask it
Two time points stop a rough first month from looking like the final result. Ask what is done if control or function has not returned by the later date, and whether pelvic floor therapy should start before the operation.
Once I am home, what is normal, such as pink urine or burning, and what means I should call or come in?
Why ask it
Have it given to you as two lists and photograph the discharge sheet. Clots, being unable to urinate and fever are the three to pin down, along with how much blood is too much.
When is the follow-up, and what will you check to decide whether it worked?
Why ask it
Success might be measured by a scan, a flow test, a PSA or simply how you feel, and you should know which. Book the visit before you leave and find out how any pathology result will reach you.
Would you support a second opinion before I go ahead, and can you send my scans and reports?
Why ask it
For anything irreversible this is ordinary, and a confident urologist says yes without bristling. Ask how long the decision can wait while you get one, and confirm the images go as well as the written reports.
Getting more out of a urology appointment
Practical guidance for the conversation itself
Before the appointment
Bring the numbers and the pictures
Gather past PSA results with their dates, earlier scan reports and, if another hospital took the images, a disc or a portal login. A urologist who can see the trend and the actual scan can often settle in one visit what would otherwise take two.
Ask whether to arrive with a full bladder
Many urology visits start with a urine sample or a flow test, and both go badly if you have just been. When you book, ask whether to come with a comfortably full bladder, and tell the desk on arrival if you can't hold on.
Turn symptoms into counts
Write down how many times you get up at night, how many pads you use in a day, how often the pain comes and what it scores out of ten. If the office sends a symptom questionnaire, fill it in at home where you can think.
List everything you take
Include blood thinners, water pills, supplements and anything bought online, with doses. Several of the questions on this page only get a useful answer when that list is on the desk.
Choose the questions to ask your urologist
Go to the group that matches your referral and mark five or six. Put the one you are most nervous about first, so it is not left for the doorway.
Saying the awkward things out loud
Use plain words
Urologists hear about leaks, erections and blood in the urine all day. Say what happens in your own words; you do not need the medical term, and a hint is easy to miss in a short visit.
Lead with it
If the embarrassing problem is the real reason you came, say so in the first minute. 'The thing I most want help with is this' gives the urologist time to deal with it properly.
Ask about a chaperone or a particular clinician
If you would be more at ease with a chaperone in the room for an exam, or with a urologist of a particular gender, raise it when you book. What can be arranged depends on the clinic, so ask how it works there.
Decide who is in the room
A partner can help you remember the answers and has a stake in decisions about a vasectomy or prostate treatment. You can also ask for a few minutes alone with the urologist, which is a normal request.
Weighing a procedure
Get the options side by side
Ask the urologist to set out each choice, including waiting, with what it is likely to do for you and what it may cost you in side effects. Write them in columns; a decision is easier to see on paper than to hold in your head.
Ask for their own results
Published averages and one surgeon's results are different things. It is reasonable to ask how many of these procedures they do and how their patients fare on the outcomes you care about.
Find out how long you have
Ask how long the decision can safely wait before you assume it has to be made in the room. Use the time to read the report, talk to whoever shares your life and, for something irreversible, hear a second view.
Sort out cost before you commit
What is covered, what needs approval in advance and what you pay yourself depend on your country, insurer and hospital. Ask the office who can give you an estimate in writing, and ask before the date is booked.
After the visit
Write the plan the same day
Note what was found, what happens next, who books it and by when. If any of it is fuzzy, send a message through the portal or call the nurse line while the visit is fresh.
Know how results reach you
Ask whether PSA, pathology or stone analysis results arrive by phone, letter or portal, and how long they take. If the date passes in silence, call; do not read silence as good news.
Keep your own file
Store every PSA figure, scan report and operation note in one folder or one note on your phone. Urology problems are often followed for years, sometimes by more than one clinic, and you may be the only one holding the whole record.
Agree when to call
Before you leave, have the urologist say which symptoms can wait for the next visit, which need a call and which need urgent care, and get the after-hours number. A web page cannot tell you that; your own clinician can.