Most people have two kidneys and they are found up under the ribcage toward the back. They are intimately associated with the adrenal glands which sit directly on top of each kidney. The kidneys themselves serve as filtering units for the bloodstream. At any given time, about one quarter of a person's total blood volume is circulating through the kidneys. When everything is functioning properly, the kidneys filter the blood, keeping the valuable components of the blood within the bloodstream and filtering out the extra water and unneeded substances into the urine. This filtered liquid collects in the center of the kidneys and periodically runs down the ureters. The ureters are the drainpipes from the kidneys into the bladder. If for some reason the kidneys cannot perform their function as filtering units because of congenital problems, obstructions, stones, infection, or tumors, urologists are consulted to treat these conditions.
Urological treatment may consist of either medical treatment or surgical treatment. What sets urologists apart from other specialists that deal with the kidneys, such as nephrologists, is that urologists are trained as surgeons.
When urologists are asked to evaluate patients, they often will examine a urine specimen to see if it contains blood or signs of infection. Often some type of radiographic examination is also ordered, such as ultrasound or a CT scan. When these types of investigation are not adequate for diagnosis, the urologist may choose to look directly into the urinary tract using a scope and special types of x-rays.
If a patient is found to have a condition requiring surgery, such as a tumor of the kidney, the urologist would be the one to perform the surgery necessary to remove part or all of the kidney, or in some rare instances, the ureter also. When nephrectomy (kidney removal) is needed for benign or cancerous kidney tumors, this can often be accomplished laparoscapically or robotically.
If kidney stones are discovered, treatment may be surgical, but rarely requires an incision these days. There are multiple methods of breaking up and/or removing stones, such as shock wave treatments or laser treatments.
Pediatric patients are most often seen by urologists
for congenital problems such as obstruction of the kidney or malformations of the lower urinary tract.
The accepted community standard now is for these abnormalities to be treated by urologists who specialize in the area of pediatric urology.