Why Do Men Fear the Urologist?

Duh!

And there you have it. For emotionally inarticulate men (that's most of us, in case you're wondering), the single word "duh" may suffice as the unspoken explanation for the fears — legitimate or unfounded — associated with visiting the urologist, a doctor who specializes in examining and treating the medical conditions of the male pelvic region.

In this case, "duh" can be translated, literally or figuratively, as "don't go there." As in: don't go to the urologist if you don't have to. Don't go down "there" with rubber gloves on. And don't go down that conversational road unless you expect to be met with squeamish looks or insecure laughter from your male peers who will, by the way, beg you to stop talking.

Dr. Martin Resnick, professor and chairman of the urology department at Case Western University, is keenly aware of this. "In my observation, women can discuss sexuality and sexual health issues much more openly than men." So does that mean guys avoid the subject altogether? Not exactly. "Certainly men think about it, but women verbalize it."

You'll rarely hear guys engaged in serious, productive talk about testes, urethras or prostate glands. Forget it. It just doesn't happen. There's a reason guys use the word “privates.”

Dr. Resnick says that the problem is rooted in that culprit of old: the fragile male ego. "Men are reticent to go to the doctor—any doctor—to begin with. When you hone it down to the urologist, who is primarily dealing with the genital region, you have a lot of hesitation.

"And if there is a health problem, it's like an attack on the patient's manliness, on his view of himself as an omnipotent male. He feels threatened. A man's image of himself, especially as he gets older, is tied to his sexual health and performance. If he remains sexually virile, perhaps he's not really aging."

So there's the potentially devastating "bad news" factor, but that's not all. For guys, there's no getting around the thought of the urological physical exam. Certainly any adult male who's seen the movie Fletch (Chevy Chase dryly utters, "Using the whole fist, doc?") has a distorted perception of what happens when the doctor dons the latex glove. But is there really anything to worry about?

"It is one of the most commonly cited fears," corroborates Dr. William F. Gee, health policy chair at the American Urological Society. However, Dr. Gee says that the rectal exam (typically done using a finger or ultrasound probe) is "a brief and essential component of a urologic exam in an adult male, and especially in the older male." Rectal exams are typically used to test for nodules or abnormalities on the prostate gland, which may indicate cancer. Dr. Gee says that it's unusual to feel much pain from the procedure.

Perhaps even more alarming to men is urethral catheterization, or the passing of a rubber tube through the opening of the penis (starting to panic yet?), up the urethra, through the prostate and into the bladder to test for residual urine. However, Dr. Gee notes that this procedure is not as commonly performed today (whew!).

"Instead," Gee points out, "we use an ultrasound procedure very similar to the one used on pregnant women." A lubricating jelly is placed on the lower abdomen and an ultrasound probe is moved over the examination area to look for existence of residual urine. Should catheterization be necessary, adds Dr. Gee, an anesthetic lubricating jelly is usually injected into the urethra ahead of time to diminish discomfort.

Then there's the male vasectomy, an outpatient surgical procedure that many couples turn to for birth control. Though the procedure itself may sound uncomfortable—for a whole host of reasons—the vasectomy is actually quite minor by urology standards. Most vasectomies don't even fall into the "going under the knife" category. Urologists often use a special instrument to "poke" a hole in the skin and spread it open, rather than cutting it with a scalpel. This technique usually heals faster than traditional cutting.

Dr. Gee says that patients typically recover from vasectomies in a week or less. Many even return to work the next day. The entire event is relatively quick and painless.

In addition, urologists perform lots of other clinical and surgical procedures that are vital to maintaining optimum sexual and physical health.

So once and for all, Bub, get it into your head: the urologist is your friend. And if you're still feeling anxious or flat-out scared, remember this overriding principle: they’ve literally seen it all. You're in good hands, so to speak.