Urology - Urology

It is a branch of clinical medicine and is a relatively new medical specialty. The literal translation of urology is urology, but in reality it treats diseases of the organs related to the secretion and excretion of urine (kidneys, ureters, bladder, and urethra), as well as diseases of the male sexual organs (testicles, epididymis, vas deferens, seminal vesicles, and prostate). For women, diseases of the urinary tract are treated by urology, and diseases of the sexual organs by gynecology. Furthermore, kidney diseases such as nephritis and nephrosis are treated by internal medicine, sexually transmitted diseases other than gonorrhea are treated by dermatology, and hernias and hemorrhoids are treated by surgery.

Before and just after World War II, there were many patients with sexually transmitted diseases, and because these were treated by dermatology and urology, some people mistakenly thought of urology as a department of sexually transmitted diseases, but with the subsequent decline in sexually transmitted diseases and the introduction of American medicine, the new department of urology (surgery) was established as an independent department separated from dermatology. Currently, surgery for the prostate, bladder, kidneys, etc., and treatment of urinary tract infections and stones make up an important part of daily medical care.

In addition, endoscopes have been developed in urology for a long time, and cystoscopes and urethroscopes are widely used to diagnose and treat tumors, stones, foreign bodies, etc. In particular, transurethral electrical resection using an endoscope is becoming more common in Japan to treat benign prostatic hyperplasia, which has seen a rapid increase in cases in recent years, and is popular because it avoids the need for open surgery. Furthermore, with the development of various new instruments, stones are also becoming able to be removed without surgery. Incidentally, in Europe and the United States, urology is treated as part of surgery, in the same way as brain surgery or thoracic surgery, and there are still some places where urology is not an independent department.

[Masaaki Ogoe]

Source: Shogakukan Encyclopedia Nipponica About Encyclopedia Nipponica Information | Legend

臨床医学の一分科で、診療科目としては比較的新しいものである。泌尿器科学urologyを直訳すれば尿学となるが、実際には尿の分泌と排泄(はいせつ)に関係のある臓器（腎臓(じんぞう)、尿管、膀胱(ぼうこう)、尿道）の疾患を診療し、あわせて男性の性器である睾丸(こうがん)、副睾丸、精管、精嚢(せいのう)、前立腺(せん)の疾患も取り扱っている。婦人の場合は、尿路の疾患は泌尿器科、性器の疾患は婦人科で扱う。また腎疾患のうち、腎炎やネフローゼは内科、性病のうちで淋疾(りんしつ)以外は皮膚科、脱腸や痔(じ)は外科でそれぞれ診療することになっている。

　第二次世界大戦前から戦争直後にかけては性病患者が多く、これを皮膚科と泌尿器科で治療していたので泌尿器科は性病科と一部で誤解されていたが、その後の性病の減少とアメリカ医学の導入とともに新しく泌尿器（外）科として、皮膚科より分離独立して発足した。現在では前立腺、膀胱、腎臓などの手術、尿路の感染症や結石の治療が、日常診療の重要な部分を占めている。

　なお、泌尿器科では内視鏡が古くから発達し、膀胱鏡や尿道鏡などが広く用いられ、腫瘍(しゅよう)、結石、異物などの診断ならびに治療に役だっている。ことに近年急激に増えてきた前立腺肥大症の治療に内視鏡を用いた経尿道的電気切除術が日本でも広く行われつつあり、開腹手術をせずにすむので喜ばれている。なお結石も、新しい器械がいろいろできたので、手術をしないでとれるようになりつつある。ちなみに欧米では、泌尿器科は外科の一部として脳外科や胸部外科と同様に取り扱われ、いまだに泌尿器科が独立していないところもある。

［大越正秋］

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