home Audience 1 How is the first examination by a urologist? Visiting a doctor of the opposite sex. The doctor tells how she examined a naked man.

How is the first examination by a urologist? Visiting a doctor of the opposite sex. The doctor tells how she examined a naked man.

While almost everyone knows that a gynecologist treats diseases of the female body, not many know what a male doctor is called. Moreover, most men themselves do not know who to turn to if they have diseases of the genitourinary system. Moreover, the majority of the male population does not monitor the condition of their genitals at all, ignoring many signs and symptoms that appear.

As a rule, representatives of the stronger half begin to become interested in which doctor is male only when serious illnesses or severe painful symptoms appear. Even in such situations, not all men go to the doctor, but try to treat themselves.

Which doctor should I contact for treatment of genital organs?

There are many diseases associated with disorders of potency, urination, erectile function, etc. All these diseases are dealt with by a male doctor. The main problem is that, feeling discomfort and even painful sensations, men refuse to go to a specialist. That is why in most cases men with serious diseases in an advanced stage of development come to the doctor.

Men, as a rule, are not accustomed to taking care of their genitals. And in general, they are not always attentive to their health. Many people refuse to visit doctors because of a sense of responsibility to their family, because a visit to a specialist means having to take a day off or sick leave. If a man is the breadwinner in the family, then this may be a reason for him to refuse to go to the hospital.

However, sometimes the issue becomes so acute that a man begins to look for a male doctor, who is a kind of colleague of a gynecologist, only in the field of male organs.

Depending on the nature of the problem that a man has, he can choose one of two doctors:

As a rule, you can find a urologist or andrologist in almost any clinic. In addition, you can contact these specialists for help at specialized family planning centers. It should be noted that in private clinics, appointments and treatment by such specialists are quite expensive, however, problems with the genital organs can cost a man much more, so it is better to solve all problems in a timely manner.

What exactly does a urologist treat?

A urologist treats diseases of the urinary tract, as well as problems with reproductive function. Confusion often arises here, since many people believe that a urologist is only a male doctor. In fact, a urologist is a specialist who treats the organs involved in the creation and elimination of urine. Women can also come to see him. Since in men the urinary and reproductive organs are very closely connected, sometimes the urologist also treats problems in the reproductive organs.

A urologist should be contacted when a man has problems with urination, pain, changes or does not completely empty the bladder, etc. A specialist in urology will help solve all these problems.

What does an andrologist do?

An andrologist is a doctor who treats the male reproductive system. You should contact him if a man has problems in the groin and perineum, severe pain in these areas, burning when urinating, etc. Similar symptoms include swelling of the testicles, changes in shape, redness, etc.

In addition, the andrologist deals with problems with potency and restoration of erectile function. This specialist is often consulted regarding male fertility issues. An andrologist helps cure impotence and generally improve the quality of a man’s sex life. The most common reasons why men turn to an andrologist are impotence and male infertility.

The list of narrow specializations of doctors can lead the patient into slight confusion. Therefore, for any pathologies, you visit your local physician so that he can figure out where to refer you next. It is not difficult to suspect pathologies of the genitourinary system and the kidneys themselves. The marker for this is unsatisfactory urine tests and certain complaints. For a detailed examination and clarification of the diagnosis, you receive a referral to a urologist.

A urologist should not be considered exclusively male (this is a common opinion). A doctor of this specialization deals with pathologies of the genitourinary system, regardless of the person’s gender. Perhaps only pediatric urologists who treat young patients can be classified as a separate group. The division of all doctors into adults and children is due to the physiological and anatomical characteristics of the child’s body.

Here is a list of diseases that are within the competence of a urologist:

All inflammatory processes of the genitourinary system - cystitis, urethritis.
Urolithiasis disease.
Injuries and neoplasms localized in the area of the bladder and urinary tract.
Pathologies and defects of the genital organs in men.
Pathologies of the prostate gland.
Diseases of the kidneys and adrenal glands.
Infertility.

The science of urology belongs to the category of surgical specializations. Therefore, you can receive emergency surgical care directly at an appointment with a urologist.

Classification of doctors

All urological specialties are divided into additional, narrower groups:

Urogenicology. The doctor treats urogynecological diseases in women. There are a large number of pathologies that can be equally considered urological and gynecological.
Andrology. An andrologist treats pathologies in men. This includes not only inflammatory diseases, but also congenital defects of the male reproductive system.
Pediatric urology. Consultation with a pediatric urologist is necessary for congenital defects of the genitourinary system, etc.
Oncourology. Its goal is to find and cure oncological processes of the genitourinary system.
Phthisiourology. Treats urological pathologies of tuberculosis nature.
Geriatric urology. A fairly extensive and complex area of urological science. Her contingent is elderly patients.
Emergency urology. The doctor specializes in providing emergency surgical care in the genitourinary area.

Preparing for your appointment

A urological appointment requires a little preparation, which varies slightly for women and men. In addition to a general visual examination and history taking, the doctor also performs other diagnostic procedures. We will tell you how an examination by a urologist goes a little lower, but for now we will focus your attention on the preparation that is required before an appointment with a urologist.

How to prepare as a woman

The same as when visiting a gynecologist. A gynecological chair is used to examine women. Therefore, do not forget to bring a diaper with you for examination. The day before your visit to the doctor, you should exclude sexual contact.

You should not douche before examining a urologist. There is no need to perform genital hygiene using disinfectant solutions (furacilin, chlorhexidine). The doctor will need to take tests, and after using medicinal solutions, the indicators may be unreliable.

How to prepare for a man

For men, in addition to the hygienic toilet of the genital organs, the following is required:

Avoid sexual intercourse for 2 days before being examined.
Cleansing enema. Cleaning the rectum is necessary so that the doctor can perform a digital examination of the prostate gland through the rectum. Do not be scared or embarrassed by the erection that occurs during such an examination - this is normal. It's worse if an erection does not occur. A cleansing enema can be replaced by taking a laxative the day before.

Appointment with a urologist

We understand that anxiety in front of a doctor’s office is common for men and women. What does the urologist do at the appointment, is the examination painful, what tests are required, how does the doctor carry out the diagnosis? These thoughts haunt you and do not allow you to enter the office calm and relaxed. And this is necessary.

Advice. If you are too worried, take any calming drops before visiting the doctor.

Nothing terrible happens in the urologist's office. The examination begins with a normal conversation. Answer the doctor's questions in detail, this will help with an accurate diagnosis. If there are chronic diseases, the doctor needs to know what medications the patient takes on a regular basis. Don't forget to mention them. Along the way, the doctor studies your outpatient card, looks at the tests, the results of which should be pasted into it. If it is an initial appointment and you have not had any tests, the doctor will definitely prescribe them. Patients take some tests directly in the office.

The next stage is a palpation (manual) examination of the abdomen and kidneys. It is performed on a couch, sometimes standing.

The doctor uses a gynecological chair to examine the female genital organs. In men, the doctor visually and palpably examines the external genitalia, after which he begins to examine the prostate gland. Anatomically, the prostate gland of men is adjacent to the bladder on one side and touches the rectum on the other. Therefore, the only possible way to determine the size and density of an organ is to examine it through the anus. To do this, the patient is asked to lean on the couch, leaning forward. The doctor inserts a finger into the rectum and feels the prostate. For information, the same method is used to massage the prostate in men; samples of secretions from the prostate gland are also taken using finger pressure on the gland.

Examination of the prostate in men can cause pain only in the presence of acute prostatitis. In other cases, the procedure is painless.

How to choose a good specialist

In order to get an appointment with a urologist, you just need to make an appointment with him at the clinic’s reception desk. If another specialist recommends that a patient undergo a urological examination, he will prescribe additional tests for you. Many patients take them in paid laboratories in order to get results faster. Let's tell you a little medical secret. Any doctor, including a urologist, with whom you have to make an appointment, trusts the laboratory of the institution in which he works more. If you need any additional analysis using rare or expensive reagents, the urologist himself will advise you to sign up for tests in a private laboratory of a good level, in his opinion.

What if you don’t live in a metropolis, and you can’t find a urologist in your latitude? How to make an appointment, and most importantly, where to find a good specialist?

Finding a doctor these days is not difficult. The addresses of clinics and private medical institutions are easy to find on the Internet, and you can also make an appointment without leaving your home. But you want to get examined by a good doctor, and not the one whose phone number caught your eye first! Therefore, we will risk giving you some advice to guarantee high-quality and competent service.

The easiest way to find a good urologist is in a large clinic that has a urology department.
Insurance agents who provide individual health insurance can make an appointment with a high-class doctor. They usually know the doctors well, not only personally, but also receive feedback from patients who have already used urological services.

We would not really recommend using the advice of colleagues and friends. Their experience was not necessarily successful; the psychological aspect of the reception is of great importance. If you still go to a urologist in a private institution, first check the availability of a license and diplomas of appropriate education. Serious honey. institutions do not hide them.

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Introduction

The examination of the male genital organs differs from the examination of other organs or systems in that it is not difficult to examine and palpate the male genital organs. However, many doctors perform only the most superficial examination of the genitals. This is a mistake, because a significant number of the most common malignant diseases of the male genital organs can be detected already during a physical examination.

Testicular cancer, the most common type of malignant tumor in men aged 25-30 years, is easily detected by palpation. Prostate cancer can also be easily detected by palpation. In this regard, the male external genitalia must be examined carefully and gently. If significant pathological changes or abnormalities in the development of this area are detected, the patient should be referred to a urologist.

1. Pubic area

Examination of the external genitalia can be performed with the patient in a vertical or horizontal position.

It should be noted the nature of hair growth in the pubic area; in adolescents, characterize the stage of sexual development according to Tanner.

It is necessary to describe obvious pathological changes in the skin in this area (the presence of venereal warts, rashes or signs of scabies). To detect a pathologically enlarged bladder (which indicates inadequate emptying), an examination of the suprapubic region should be performed by inspection, percussion and palpation.

2. Penis

The penis consists of two paired, erectile corpora cavernosa, and a smaller, unpaired, erectile spongy body (corpus spongiosum penis), located ventrally in the midline and surrounding the urethra.

The distal part of the penis is covered, like a cap, with a conical-shaped formation - the glans penis. The proximal, rounded edge of the head is called the crown. During examination, the presence or absence of the foreskin (preputium penis) should be noted. In adults, the foreskin should be easily retracted behind the glans, exposing the surface of the inner layer of the foreskin and the glans. Any difficulty indicates the presence of acute or chronic inflammation or scarring of the foreskin.

Phimosis is a situation in which exposure of the head is impossible due to narrowing of the foreskin ring or its scarring. The elasticity of the foreskin tissue in children changes until about 5 years of age, after which it acquires mobility close to that of adults. Any attempt to remove the head of the penis from the preputial sac by force is categorically unacceptable.

Paraphimosis is a situation in which the foreskin cannot be pushed onto the glans penis, as a result of compression and swelling of the glans penis.

Hypospadias is the location of the external opening of the urethra on the ventral surface of the penis.

Epispadias is the location of the external urethral opening on the dorsal surface of the penis.

By lightly squeezing the external opening of the urethra in the anteroposterior direction, you can examine the scaphoid fossa. This technique is especially important in young men, who are more likely to contract a sexually transmitted infection. Any discharge from the external opening of the urethra must be examined bacteriologically to exclude infection.

After examining the distal part of the penis, its shaft should be examined and palpated. Any curvature and asymmetry of the corpora cavernosa and head should be noted. Painful erections due to ventral flexion of the shaft of the penis are often associated with hypospadias.

3. Scrotum

The skin of the scrotum is normally wrinkled and very elastic. If thickening, induration or a decrease in its elasticity appears, the presence of a pathological process in the skin should be suspected. At the same time, some conditions (congestive heart failure, liver failure) may manifest as swelling of the scrotum without any pathological process in the skin.

The size of the scrotum depends on the physique and tone of the underlying muscles (tunika dartos) at rest. The scrotal cavity is divided into two communicating spaces by a median septum. Within each of the mentioned spaces (hemiscrotum) there are a testicle, an epididymis and a spermatic cord. Normally, all of the mentioned formations move freely within the hemiscrotum.

Some benign neoplasms on the skin are observed quite often. Candida albicans infection is very common, located on the scrotum and in the area of the femoral crease. This infection usually occurs in combination with diabetes mellitus, against the background of the use of antibiotics, immunosuppression, and when the skin of the genital organs becomes more “hospitable” for infection with increased humidity and sweating. A clear sign of skin candidiasis is bright red hyperemia. Tinea cruris is also a common fungal infection of the genital skin. This disease causes dark, red-brown spots to appear on the front of the thighs. If a thin red spot is visible in the area of the most active area of inflammation along its periphery, then you can think about ringworm. Candidiasis and tinea cruris can be treated with conventional antifungal drugs, such as naftifine hydrochloride and imidazole derivatives, although tinea cruris responds poorly to nystatin.

Pathological formations not associated with infection are often observed on the skin. An epidermoid cyst can be located on any part of the body, but its favorite location is the skin of the scrotum. These cysts stain the skin whitish, they are dense, 1-2 cm in diameter, and can be multiple. No specific treatment is required unless the patient seeks treatment for cosmetic reasons. Benign angiokeratomas are also often found. This lesion of the superficial tissues of the scrotum is observed in 20% of adult men and consists of papular hemangiomas measuring 1-2 mm, colored from red to purple. Scattered over the surface of the scrotum. They are usually asymptomatic and do not require treatment. However, if bleeding occurs, electrocoagulation and laser beam treatment are indicated.

During examination, the testicles must be carefully palpated between 1 and 2 fingers. The size, shape and consistency of the testicle should be described. The shape of the testicle is ovoid, its dimensions are about 4 cm or more in length and 2.5 cm in width. The consistency of the testicles is dense and somewhat elastic. They are symmetrical in shape, size and consistency. When examining the testicles in adolescents and men suffering from infertility, it is especially important to characterize the size of this paired organ.

Orchidometry instruments are available (ASSI, Westburn, NY) that can be used to quantify and comparatively assess testicular volume. The testicles must have a smooth surface, they must occupy a certain position in the scrotum. If the testicle is not palpable, then the inguinal canal should be examined to rule out cryptorchidism. The presence of abnormalities on the even, smooth surface of the testicles or detected excess tissue is an indication for urgent referral of the patient to a urologist to exclude a tumor.

When palpating the testicles, difficulties may occur due to an enlarged scrotum; this may be due to the presence of hydrocele (hydrocele). The testicle is covered with visceral and parietal layers of peritoneum (tunica vaginalis testis).

The accumulation of fluid between these two layers leads to the formation of dropsy. Transillumination in a darkened room (using a flashlight or other similar light source) allows you to differentiate a fluid-filled formation (positive transillumination effect) from a dense mass of tissue. Sometimes, upon auscultation of an enlarged scrotum, a peristaltic noise can be detected, which will indicate the presence of an inguinoscrotal hernia.

examination urological genital prostate

5. Epididymis

Examination of the epididymis is directly related to examination of the testicle, since the epididymis is usually located on the upper and posterior surface. The epididymis on both sides are located symmetrically and are accessible to direct palpation. The consistency of the epiidemis is softer than the testicle, and upon palpation it feels like a raised edge of the testis located posteriorly. The epididymis should be examined with extreme caution due to its great sensitivity.

Anatomically, the appendage can be divided into three segments: head, body and tail. Each of the segments corresponds to the upper, middle and lower parts of the formation. Enlargement of the epididymis or pain on palpation is usually associated with an inflammatory process (epididymitis). A cystic formation in the tissue of the epididymis, such as a spermatocele, transmits light and therefore can be detected by transillumination.

6. Spermatic cord

After completing the examination of the epididymis, it is necessary to palpate the spermatic cord. If the patient is in a horizontal position, then it is necessary for him to stand up, since this part of the examination is more convenient to carry out in a vertical position. Typically, palpation begins from the middle of the distance between the outer ring of the inguinal canal and the testicle. It is not difficult to recognize the vas deferens (ductus deferens). It is cord-like in shape and consistency and is a bit like braided electrical wire, but more elastic and slightly larger in diameter. If the vas deferens cannot be palpated, then further special studies are indicated.

Other components of the spermatic cord are felt upon palpation as a small ball of round helminths. Indeed, greatly enlarged and varicose veins of the vas deferens can create such an impression. However, in most cases, a varicocele feels like a more tender formation. For more accurate identification, each spermatic cord is taken between the first three fingers of one hand. After palpation separation of the spermatic cord from other tissues, any increase in its vascular component is clearly felt. The patient is then asked to perform a Valsalva maneuver (take a deep breath, hold your breath, and strain). An increase in the palpable spermatic cord indicates the presence of a small varicocele. If the patient has a pronounced cremasteric reflex, the test result may be less clear. Although varicocele most often develops on the left side, a bilateral process is also quite possible.

Elastic, fleshy inclusions in the tissue of the cord may be a lipoma or, less commonly, liposarcoma. Cystic formations of the cord that can be transilluminated are most often small, local hydroceles. If the patient does not complain, then such findings do not require treatment. If the diagnosis is unclear, the patient should be referred to a urologist. The examination of the scrotum is completed after excluding an inguinal hernia. The second finger of the hand is moved along the surface of the skin of the scrotum and along the spermatic cord proximally to the external inguinal ring. After a clear sensation of the external inguinal ring, the patient is asked to cough and perform a Valsalva maneuver. A feeling of bulging or pushing at this moment indicates the presence of an inguinal hernia. As a result, during the examination of the scrotum, the testicle, its epididymis, the spermatic cord and, finally, the external inguinal ring are sequentially palpated. Testicular enlargement is usually caused by a malignant tumor and requires careful differential diagnosis. Excess tissue in the area of the epididymis of the fovea or spermatic cord is a benign formation, but, nevertheless, requires consultation with a urologist. Patients over 16 years of age should be given instructions for self-examination. Acute pain in the scrotum and other emergency situations will be discussed separately in other sections.

7. Prostate gland

A complete examination of the male external genitalia includes examination per rectum with palpation of the prostate gland. It is recommended that all men over 50 years of age undergo an annual rectal examination to examine the prostate gland, as well as screening for the presence of prostate-specific antigen (PSA). In young men, the prostate gland reaches 3.5 cm in diameter and 2.5 cm in length with a weight of 18-20 g. In configuration, it is similar to a chestnut. The prostate gland is usually enlarged in men over 50 years of age, although the normal size of the gland varies greatly at different ages. Normally, the consistency of the prostate gland is comparable to the consistency of the thenar, when 1 finger is opposed to 5.

During a digital examination of the prostate gland, the patient may be in different positions. The lateral decubitus position (legs bent at the knees and hips and pulled toward the chest) provides an opportunity for a full examination. Another position is possible, when the patient stands with his back to the doctor with a 90° bend at the waist, resting his elbows on the examination table. The doctor puts on a surgical glove and dips the 2nd finger in a water-soluble lubricant. Spreads the patient's buttocks and initially examines the anus. Then the 2nd gloved finger is placed in the anus and gently presses on it. This technique promotes relaxation of the anal sphincter, which allows for rectal examination in the most favorable conditions and allows the doctor to assess the tone of the anal sphincter. After relaxing the latter, the lubricated finger is passed to the vault of the rectum above the prostate gland. The finger should be inserted as deeply as possible to palpate the free posterior surface of the prostate gland.

Typically, the examination begins with palpation of the apex (located closer to the anal sphincter) of the gland and continues at its base. Wide movements of the finger allow the doctor to assess the size and characteristic features of the lateral lobes of the gland and its central groove. When describing the detected changes, their location should be indicated (right, left, apex, base, midline or lateral). The seminal vesicles arise from the base of the gland and are not normally palpable. When palpating the prostate gland, its size is determined. Although urologists tend to express the size of the prostate gland in grams or in relative units from 0 to 4, it is still better to estimate the size in centimeters, specifying its width and length. In addition to the size of the organ, its symmetry should also be characterized. Asymmetry should be highlighted, as should the suspicion of malignant growth, inflammation or infection, which may arise if any irregularities or compaction are detected in the gland. With acute inflammation of the prostate gland, pathological softness (tissue softer than normal) and pain on palpation may be felt. The presence of fluctuation indicates the occurrence of an abscess. Vigorous massage for acute inflammation of the prostate gland is contraindicated.

Before removing the finger, it is necessary to make a wide circular movement along the rectal vault to exclude any pathological changes. After the examination, the patient should be offered a large gauze pad to remove excess lubricant from the perineum. Upon completion of the examination of the prostate gland, discharge from the penis and prostatic juice must be examined microscopically.

8. Urinalysis

Urinalysis is an important part of the urological examination.

In non-concentrated urine, pH, glucose, protein, nitrites and leukocyte esterase are determined by immersing a tester stick into it. After this, the urine sample is centrifuged for 3-5 minutes at a speed of 2500 rpm. The supernatant is poured out, and the remainder is mixed with a small amount of urine remaining in the tube. Then microscopy is carried out at low and high magnification (Table 1-2).

In one field of view (FOF) of the microscope at high magnification, the number of leukocytes, erythrocytes, bacteria, salt crystals, yeast and casts is identified and counted. Bacteriological examination of urine is carried out in cases where other urine tests or clinical data suggest that the patient has a urinary tract infection. If the wand test is positive for both nitrates and leukocyte esterase, then this is a strong argument in favor of the patient having a urinary tract infection. The same can be said when 4-5 bacteria are detected in the centrifuged urine residue in the PZ.

9. Self-examination of the scrotum and testicles

Examination of the male external genitalia is an important part of any comprehensive physical examination of a patient presenting with urologic symptoms. It is advisable to carry it out not only with a doctor. Every man aged 20-35 should have his own testicles examined monthly. Every year, a urologist should conduct a digital examination of the rectum in men over 50 years of age, and in those with an unfavorable family history of prostate cancer, in men aged 40 years and older.

Regular (monthly) testicular self-examination is important because testicular cancer often affects young men, but if detected early, the disease is usually curable. The examination is simple and takes a few minutes.

The testicles in the scrotum feel like small, firm, hard-boiled eggs without a shell. On their posterior surface and apex is the epididymis, which is felt separately, like a ridge rising along the posterior surface of the testicle. The appendage has two parts: the body and the tail, which is sometimes felt separately. The spermatic cord is attached to the upper pole of the testicle and extends upward into the inguinal canal. It consists of muscle fibers, blood vessels and the vas deferens. The cord has a spongy structure, with the exception of the vas deferens, which is dense to the touch (like a twig) and feels like “pasta”.

First of all, inspect the entire scrotum and the surface of the surrounding skin, note the presence of any rash, other painful formations, or tumors. Then gently feel the scrotum and its contents. After several such examinations, you will become familiar with the feel of the healthy tissues that make up the testicles, their epididymis, the vas deferens, and any abnormality will be immediately detected. Any changes you see or feel should be brought to the attention of your doctor.

It is advisable to conduct such a self-examination once in a doctor's office so that he can answer any questions that may arise.

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Very often, when both men and women fall ill, they turn to a doctor of the opposite sex, without attaching any importance to this, even if the right doctor of the same sex is available. However, according to Shariah norms, a woman is allowed to visit a male doctor, just as a man is allowed to visit a female doctor, only under certain conditions.

The time has passed when women were consulted, treated and gave birth with the assistance and assistance of women practicing medicine, when births were attended by midwives, a kind of “midwives” and the search for such “midwives” was not particularly difficult. Whereas in our time, many men have chosen as a profession precisely those specialties that relate to the female body and physiology - obstetrics and gynecology. Looking ahead, let's say that visiting a doctor of the opposite sex unless absolutely necessary is unacceptable and prohibited, especially a urologist, gynecologist and obstetrician. Because today it is not particularly difficult to find the right specialist of your gender. Whereas just a hundred years ago there was no question of a woman being examined by a male gynecologist or having a male obstetrician attend the birth.

As you know, Shariah forbids us to look at the awrat of the opposite sex (for women, the entire body is considered the awrat, with the exception of the oval of the face and hands, and for men, the part of the body from the navel to the knees). Imam an-Nawawi in the book “Minhaju-t-alibin” writes that it is forbidden to look, and, therefore, to touch, but both are allowed if necessary, for example, during treatment.

Imam al-Shirbini says: “As for when there is an urgent need for examination and touch, they are permissible, such as during treatment, even if it concerns the genitals. Because there is a huge difficulty in banning something like this. A man is allowed to be treated by a female doctor and vice versa, but examination and treatment (when it comes to a woman) must be carried out in the presence of a close relative with whom marriage is prohibited according to Sharia, a husband or a reliable, trusted woman. Of course, if we follow the opinion that the solitude of one man with two women is permissible, and this opinion is preferred by the majority of Muslim scholars.

It is also a condition that there is no woman practicing in this field. Another condition is that he (a male doctor) should not be a zimi (a non-Muslim living in a Muslim state), if there is a Muslim doctor. If we do not find anyone other than a non-Muslim woman and a Muslim to treat a woman, we should give preference to a non-Muslim woman, because her gaze and touch are not as severe in the prohibition as those of a man, since she (the non-Muslim woman) is allowed to look at those parts of the body of a Muslim woman. which are revealed in everyday life, during work.

Imam al-Bulkini ordered the sequence of those who are allowed to come for examination and treatment. If the patient is a woman, then her treatment should be carried out by a Muslim woman, if there is not one, then a Muslim boy who has not reached the age of adolescence, then a non-Muslim boy who has not reached the age of adolescence, then an unbeliever woman, then her (the patient), a mahram (close the relative with whom she is prohibited from marrying) is a Muslim, then her non-Muslim mahram, then an outsider Muslim and only then an outsider non-Muslim. The book “al-Kafi” also says that the doctor must be trusted and if there is such a thing, it is not allowed to go to an untrusted one. Imam al-Mawardi added two more conditions: 1) that during examination and treatment there should be confidence that adultery will not be committed, 2) that no part of the body should be exposed more than necessary.

In the book “Mughnil-mukhtaj” it is written: “Looking at and touching a stranger is prohibited only when there is no extreme need for it. And when there is a need for this, it is permitted. The following situations are considered necessary (in the first three situations, only watching is allowed):

1) During the conclusion of trade transactions;

2) During testimony and testimony in court;

3) During the teaching of religious sciences, both mandatory and desirable;

4) During treatment and care for the patient, because prohibiting this would aggravate the situation, and Islam is a religion of ease and relieving difficulties. Because the Koran says: “And the Almighty did not make difficulties in religion”(Surah al-Hajj, verse 78).

الدِّينِ مِنْ حَرَجٍ

A male doctor is allowed to look at everything if he needs it for treatment. A hadith narrated by Muslim says: “For every disease there is a cure”(Sahihu Muslim, 4084).

لِكُلِّ دَاءٍ دَوَاءٌ (صحيح مسلم 4084)

The desirability of treatment is evidenced by the following hadith, transmitted by the companion of the Prophet (PBUH) Jabir (may Allah be pleased with him): “Ummu Salama asked permission from the Messenger of Allah (PBUH) to do bloodletting, then the Prophet (PBUH) commanded Abu Zaibat (may Allah be pleased with him) bloodletting her.” A man is allowed to treat a woman when there is a need for it, and there is no woman capable of healing, just as a woman is allowed to treat a man when there is an urgent need for it, and there is no man capable of healing. However, a man is not allowed to treat a woman except in the presence of her mahram, husband or trusted woman. And when a pious and God-fearing doctor is found, it is not allowed to go to another. At the same time, when Shariah allows looking and touching a representative of the other sex for the purpose of treatment, this is allowed only as necessary (that is, you cannot look and touch more than necessary), because looking during an examination is allowed only because of urgent need or need, and an urgent need or need is determined only in the amount necessary to relieve labor and achieve the goal.

During treatment, the doctor is allowed to look only at that part of the woman’s body that is necessary to examine, as well as in the presence, for example, of a mahram, husband, trusted woman, and also in the absence of a woman capable of treating, because the gaze of a representative of the same sex to a representative the same sex is lighter in severity of prohibition and sin and has less harmful consequences.

Ibn Hajar in the book “Fathul-Bari” writes: “As for this issue, it is allowed to be treated by strangers if necessary, and the limits of permissibility, permissibility (look, touch) are determined as necessary in examination, touching by hand, etc.”

The book “Mabadi al-Muashira az-Zawjiyya” says: “Under no circumstances is a doctor allowed, even if he is a gynecologist or obstetrician, to look at the intimate parts of a woman’s body in the presence of a female doctor in the same field. Then, when a male doctor examines, treats (a woman) or delivers a child due to the absence of a female doctor, he undertakes to hide from the female body those areas that are not necessary to expose and examine.”

When compiling the article, the following literature was used:

“Mabadi al-muashira az-zawjia”;

“Al-fikhul-islamiy”;

“Al-mutamad fil-fiqhi al-Shafii”;

“Al-fikhul-manhajiy”;

"Mugnil-mukhtaj";

"Minhaju-t-Talibin."

Many male patients are embarrassed to seek advice from specialists due to the sensitivity of the examination. At an appointment with a urologist, you can identify the main inflammatory diseases that threaten your health. How to prepare for the examination and why annual prostate checks are needed - read our article.

Subspecialists help to most accurately diagnose the cause of the patient’s anxiety. If you have problems with hormones, you should visit an andrologist or endocrinologist; women turn to a gynecologist, men - to a urologist.

However, you should not refer the specialist only to a male doctor. A urologist is a universal doctor who helps to identify and cope with urinary tract pathologies for men and women. When contacting a general practitioner, he will refer a patient with symptoms of pain in the penis, appendages and problems with urination to a urologist.

A special mention can be made of a pediatrician. There is a urologist for adults and for children. This division is due to physiological and anatomical differences in the structure of organisms.

The science of urology belongs to the category of surgical specializations. Therefore, you can receive emergency surgical care directly at an appointment with such a specialist. The urologist also performs some types of physiotherapeutic procedures directly during the examination.

Scheduled inspections

To maintain the health of the pelvic organs, it is recommended to undergo annual preventive examinations. Women without need and without visible symptoms of the disease do not need to visit a urologist.

In men, most diseases occur in a latent form. This is the first reason why you should visit a specialist regularly. Such a check will help detect the development of the disease at the initial stage and stop it.

What is included in the scheduled annual inspection:

taking urine and blood tests;
rectal examination of the prostate;
additionally: checking the kidneys, bladder, lymph nodes.

Most urological diseases in the early stages do not manifest any visible symptoms, and very often the time for their timely treatment is missed. Therefore, we recommend that healthy men without complaints contact a urologist for an examination for the first time at the age of 14 and then annually.

According to indications

If a man or woman has previously been diagnosed with developmental pathologies of the urinary tract, then they will have to visit the urology office more often. To control the development of the disease and prolong the stage of remission of the disease, strictly follow the doctor’s recommendations.

Indications for visiting a doctor:

chronic diseases of the genitourinary system;
secondary manifestation of prostatitis in men;
problems with urination of any form;
neoplasms on the prostate gland, bladder, kidneys;
cancer diseases;
congenital structural defects and developmental anomalies.

In this case, you will have to contact a urologist more often than once a year. It is recommended to undergo testing, including laboratory diagnostics, at least once every 3-4 months.

What complaints do people go to a urologist with?

If men need to undergo an examination of the genitourinary system by a urologist, then women more often turn to a gynecologist with such a problem. But there are complaints common to both boys and girls. In this case, you should not risk your health and urgently need to make an appointment.

The main complaints with which people seek advice and treatment from a urologist:

It is important to monitor your health, even if there are no open problems with the urinary organs. Sometimes, due to age-related changes, issues with potency and urination appear. In this case, the urologist will help you choose maintenance therapy.

List of urological diseases

Among the diseases of the excretory system there are exclusively male pathologies and general diseases. Universal ones include cystitis and urethritis, which also occur in women. Due to the anatomical differences in the structure of the genital organs, specific pathologies arise in men.

List of the most common urological diseases in men:

Erectile disfunction. These are problems with penile hardness, when the area of the cavernous penis is not filled with arterial blood to the extent to ensure a full erection. Most often, the disease appears in men over 45 years of age, smokers and patients with diabetes.
. Problems with the prostate gland are observed in 70% of older men on the planet. This can cause the glandular tissue to enlarge, interfering with normal urination and, in some cases, causing decreased fertility.
Phimosis. This is a narrowing of the foreskin. In boys under 3 years of age, the head is hidden behind the fold of the penis; it begins to emerge by the age of six. At the initial stage, the patient feels pain due to the inability to freely retract the foreskin. The latter will require surgery to free the head.
Balanoposthitis. This is an inflammatory process on the head of the genital organ. Suspicious rashes and ulcers appear on the mucous membrane and skin. The disease can be either a consequence of an untreated infection or a cause of the development of phimosis (narrowing of the foreskin).

This list can be continued for a long time. Developmental defects are less common; in some cases, priapism occurs - a prolonged erection. Often, diseases of the urinary organs become a consequence of drug treatment.

Common diseases that occur in men and women:

Enuresis. This is urinary incontinence, which can be partial or complete. It occurs in both sexes and can occur at any age. In women, it often occurs after childbirth and goes away without treatment after a few days. The cause in most cases is nervous tension or defects in the anatomical structure.
Cystitis. This is an inflammation of the bladder, which is manifested by a burning sensation in the urethra when urinating. In its acute form it can cause severe pain. This pathology especially often worries girls of preschool and primary school age.
. An inflammatory process occurring on the mucous membrane of the urinary tract. The symptoms are similar to cystitis, the treatment regimen is also practically the same.
Pyelonephritis. This is a bacterial disease caused by microorganisms entering the kidneys, which causes an inflammatory process. The danger of this disease is that the infection can spread through the urinary tract.

Do not self-medicate. Therapy is prescribed only based on the results of laboratory tests and depending on the identified pathogen. Antibacterial agents are selected depending on the sensitivity of microorganisms to drugs.

Independent experiments on the body can only worsen the situation. Remember that most urological diseases are sexually transmitted. It is recommended to use a condom during sexual intercourse to avoid infection.

Preparing for your appointment

An examination of a man or woman by a urologist usually takes no more than 15-20 minutes. During this time, the doctor will question the patient, examine the organs of the urinary system, and possibly perform an ultrasound.

General requirements before examination by a urologist:

avoiding sexual intercourse 24 hours before visiting a urologist;
refusal to take painkillers for an accurate diagnosis;
refusal to pre-use antibacterial agents.

The use of analgesics may interfere with localization of pain. The doctor will not be able to make the correct diagnosis. For a similar reason, you cannot perform genital hygiene before examination using disinfectants (Chlorhexidine, Furacilin). The result of bacteriological culture in this case will be incorrect.

In some cases, a gynecological chair is used to examine women. Therefore, do not forget to bring a diaper with you for examination. The day before your visit to the doctor, you should avoid sexual intercourse to avoid extraneous lubricant secretions.

The man needs to cleanse his rectum so that the doctor can perform a digital examination of the prostate. Do not be scared or embarrassed by the erection that occurs during such an examination - this is normal. It's worse if an erection does not occur. A cleansing enema can be replaced by taking a laxative the day before.

How is an examination by a urologist performed?

Many patients are concerned about what they do at an appointment with a urologist. Many men avoid prostate testing because rectal palpation hurts their masculinity and degrades their dignity.

Examination of the prostate gland is purely a medical matter. More problems with embarrassment occur in adolescent patients. Some experts recommend taking a few drops of an herbal valerian-based sedative before a routine examination.

At the same time, the doctor studies your outpatient card, looks at tests, the results of which should be pasted into it. If the appointment is primary, the urologist will definitely prescribe, some of which can be taken directly in the office.

Men

Examination of men differs from palpation of internal organs of women. Follow the requests of the doctors; you can inform them in advance that the examination is primary.

How a man is received:

Palpation. The patient lies down on the couch, and the doctor manually examines the internal organs of the abdominal cavity and kidneys. Severely enlarged organs can be detected at this stage of palpation examination. The specialist also examines the condition of the internal and external genital organs. These are the scrotum, penis, prostate gland and inguinal lymph nodes.
Rectal examination of the prostate gland. Can be performed standing or in a knee-elbow position. The doctor inserts a finger into the rectal area to feel the condition of the prostate; in some cases, an ultrasound probe is used for this.
Collection of tests. If a bacterial infection is suspected, a urologist can take a general smear from the urethra, which will help identify the presence of microorganisms. A sample of the prostate is also taken during the examination, if necessary.

Examination of the prostate in men can cause pain only in the presence of acute prostatitis. In other cases, the procedure is painless. Put aside your embarrassment, since preserving your health is more important than your damaged male honor.

Women

In some cases, in the urologist’s office you may notice the presence of a gynecological chair. But in very rare cases, a specialist examines a woman’s genital organs. The appointment is a little different from a men's health check.

Stages of urological examination of women:

Conversation. The patient reports her problems, describes the symptoms that bother her. The doctor also examines the woman’s medical history and the presence of other diseases. You should tell your urologist about all suspicious manifestations of abnormalities in the urinary system.
Palpation. The doctor will ask you to lie down or conduct an examination in a standing position. Palpation of the pelvic organs occurs: bladder, kidneys. The condition of the lymph nodes is also examined.
Instrumental research. If necessary, the urologist uses modern diagnostic tools such as ultrasound, laboratory tests, instrumental and endoscopic methods.

In the same way as in men, urethral secretions are collected. The main difference is the lack of examination of the female genital organs and prostate gland, since women do not have a prostate. Instrumental diagnostics are carried out only in case of obvious manifestation of symptoms and medical suspicion of the presence of a pathogenic development of the disease.

Sometimes, at an appointment with a urologist, men become isolated and cannot talk about sensitive problems. One of the most common reasons for this is when a man is examined by a woman's urologist.

Even though medical issues are being resolved in the specialist’s office, the man is seized with panic. From a psychological point of view, the patient does not want to show his weaknesses.

Advice for a man if the urologist is a woman:

Think about your health. First of all, you did not come to flirt, get acquainted or start a family in the urology office, but to solve your problem.
The doctor saw something different. Remember that a urologist examines a huge number of patients every day, and in 20 minutes another shy man will see her.
Medical ethics. A doctor does not have the right to talk about small penis size and disseminate information about the presence of diseases.

Calm down and go into the doctor's office with confidence. If a urologist is a woman, this does not mean that she is a bad specialist. Trust her medical instincts, do not discriminate based on gender, and follow your doctor's instructions.

Knowing what a urologist checks for men, you can prepare both physically and psychologically in advance. Also at the appointment, the urologist may use additional instrumental diagnostic methods. The most common types are described in the table.

Additional urological procedures	Description and types
Endoscopic methods	A method that allows you to examine the urethra. Methods such as urethroscopy, fiber optics, cystoscopy, nephroscopy, pyeloscopy are used
Physical research	Methods that help to most accurately determine the condition of internal organs. These include ultrasound, plain radiography, excretory urography, infusion urography, retrograde ureteropyelography, antegrade pyeloureterography
Instrumental diagnostics	Method for diagnosing diseases of the urethra in men and women. Examination of the bladder using a catheter, bougienage of the urethra, puncture biopsy - removal of a piece of tissue for examination

The list of diagnostic methods does not end here. If it is impossible to examine part of the internal organs, surgery is prescribed. Surgery will help make a diagnosis and even become an emergency treatment method.

How to choose a specialist

The choice of a specialist depends not only on the availability of a urologist in a free clinic, but also on the financial situation of the patient. You can make an appointment at a private center to get faster lab test results.

Not all types of diagnostics can be performed free of charge at a local clinic. You can make an appointment with a local urologist, and additionally undergo a urinary tract examination at a medical center for a fee.

The cost of seeing a urologist will cost from 500 rubles, and testing will cost from 1,500 rubles. In the central regions of Russia, the cost of doctor’s services is even higher.

Finding a good doctor is not difficult; you can simply find information about a specialist on the Internet. Each private center has its own website, which describes the achievements of its employees, and there are pages with reviews.

Some tips to choose the best doctor:

Choose a specialized medical center. It is better if it is a urological clinic or a private medical office, in which every corner is collected for the diagnosis and treatment of urinary tract diseases.
Research reviews. Ask a neighbor or friend for advice, find a page on the forum dedicated to seeing a specific specialist.
Estimate the percentage of recovered patients. The higher the effectiveness of treatment, the more responsible the urologist is in performing his work.
Novelty of the medical institution. With new equipment, the chance to accurately diagnose the presence of certain diseases increases.

Some men choose doctors only of the stronger sex, embarrassed by a female examination. Others prefer older, experienced professionals. The choice also depends on personal preference. The main thing is to take the first step by asking for help.

Video

How an examination by a urologist takes place - learn more from the video.