Do you have urology needs

Who this is for

If you are managing urinary symptoms, prostate or bladder concerns, frequent infections, kidney stones, incontinence, or you have a history of urologic cancer, this guide is for you. It explains what to watch for, which screenings matter, and how an advocate can help you schedule tests, check coverage, and coordinate care with your doctors. For more education across many health topics, explore the Understood Care article library at https://understoodcare.com/articles

What urology covers

Urology focuses on the urinary system and the male reproductive system. That includes the kidneys, ureters, bladder, prostate, urethra, and pelvic floor. Common reasons to see a urologist include blood in the urine, trouble starting or stopping urine, pain with urination, frequent urination, urgency, leaks, urinary retention, recurrent infections, kidney stones, and screening or follow up for prostate or bladder cancer. Many of these conditions are manageable with a clear plan and the right support. See the symptom lists below for specific reasons to seek care.

Essential screenings and surveillance

PSA screening and prostate health

Prostate specific antigen is a blood test that can help detect prostate problems. Medical groups emphasize shared decision making for men between ages fifty five and sixty nine. For men seventy and older, routine PSA screening is not recommended, though decisions should still be individualized. Talk with your clinician about your personal risk and preferences.

Some people are at higher risk. The American Urological Association notes that those with Black ancestry, certain gene changes, or a strong family history may discuss starting screening earlier.

Medicare coverage tip
Medicare Part B covers a PSA screening blood test once every twelve months for people who have reached age fifty. Coverage allows your next screening after at least eleven months have passed following the month of your last Medicare covered PSA test. Many clinics schedule your test around the same date each year to keep timing simple. Advocates help you track the timing so your test is covered and coordinate repeats if your doctor documents a medical reason.

Bladder cancer surveillance

If you have a history of non muscle invasive bladder cancer, regular cystoscopy is the foundation of follow up. Urine based markers are not a substitute for cystoscopy. Imaging of the kidneys and ureters is added based on risk and symptoms, and is scheduled more often for higher risk disease. Your urologist sets the interval, and your advocate helps you stay on schedule and at in network sites.

Bladder ultrasound and post void residual

Bladder ultrasound is commonly used to check for urine left after you go, called post void residual. A high residual can point to problems such as obstruction or weak bladder muscle. Post void residual can be measured by ultrasound or by brief catheterization. Medicare policy treats this as a diagnostic service and sets utilization limits that your care team will follow. Advocates can verify coverage and help you find a facility that can perform the test promptly.

When to see a urologist

Call your clinician soon if you notice any of the following

• Urine that looks red, pink, brown, or cola colored
• Pain or burning with urination, new urgency, frequent urination, cloudy urine, or fever with urinary symptoms
• A weak stream, straining, or the feeling that you cannot empty completely
• Ongoing urine leakage that affects daily life
• Severe side or back pain that comes in waves or is linked with nausea, which can signal a stone
  These are common signs of hematuria, infection, stones, incontinence, or obstruction and should be evaluated.

Seek urgent care now if
You suddenly cannot pass urine, especially with lower belly pain. Acute urinary retention is an emergency.

How an advocate helps with urology care

This section brings the video guidance into a step by step plan you can use today.

Screenings and schedules
Your advocate helps you plan the screenings your doctor recommends. That includes yearly PSA timing and reminders, especially if you have a history of prostate cancer, an enlarged prostate, or prior elevated results. Your advocate works with your clinician to document medical need if a repeat test is required before the usual interval.

Ultrasounds and the right test at the right place
If you need an ultrasound, your advocate confirms the exact study your doctor ordered, checks that the facility is in network, and verifies benefits before you go. For bladder concerns, this can include post void residual measurements to see how well you are emptying. For cancer follow up, your urologist may also order cystoscopy and imaging at set intervals. Your advocate coordinates the schedule so you are not stuck on the phone or the computer all day.

Knowing symptoms and when to see the specialist
Your advocate helps you track symptoms like blood in the urine, fever with urinary symptoms, severe flank pain, or trouble emptying, and can help you decide when to contact your primary care clinician or request a urology referral.

Education, referrals, and follow through
Advocates provide plain language education, collect records from your prior visits, schedule the next steps, and follow up after appointments to adjust the plan as your needs change.

Understanding common urology conditions

Lower urinary tract symptoms and enlarged prostate

Lower urinary tract symptoms include urgency, frequency, leaks, nighttime urination, and a weak stream. An enlarged prostate is a common cause for older men. Treatment ranges from watchful waiting and lifestyle changes to medicines and procedures. Your urologist will tailor options to your goals and health conditions.

Urinary incontinence

Bladder control problems are common and treatable. Pelvic floor muscle training helps many people, and there are additional options if symptoms persist. Seek care if leaks limit activities or affect quality of life.

Urinary tract infection

Pain or burning with urination, urgency, frequency, and suprapubic discomfort can signal a urinary tract infection. Antibiotics treat bacterial UTIs and your clinician chooses the medicine based on your history and the organism. Call your clinician if you have symptoms.

Kidney stones

Stones can cause severe flank pain, nausea, and blood in the urine. Many stones pass with fluids and pain control, while others require procedures. A follow up plan can reduce the chance of another stone.

Coverage pointers for Medicare

• PSA screening blood test is covered once every twelve months starting the day after your fiftieth birthday. Your next Medicare covered PSA is allowed after at least eleven months have passed following the month of your last covered test. Advocates help align your annual timing with these rules.
• Digital rectal exam is also part of prostate cancer screening, with different cost sharing rules. Your clinician can explain any coinsurance that may apply.
• Diagnostic studies like bladder ultrasound or post void residual are covered when medically necessary. Your care team documents the reason, and your advocate checks benefits and site of care to avoid surprises.

Getting ready for your urology visit

Bring

• A concise symptom timeline, including any visible blood in urine, pain with urination, fever, leaks, or retention
• A list of all medicines and supplements
• Prior imaging and laboratory results, including any recent PSA values

Ask

• What is the most likely cause of my symptoms
• Do I need urine testing, imaging, cystoscopy, or a referral for pelvic floor therapy
• What can I do at home to help my symptoms
• When should I call if things get worse

Your advocate can help prepare questions, join a phone or video visit, schedule tests, and check coverage before you go. If you are ready to connect, you can sign up for a dedicated time at https://app.understoodcare.com‍

Urology Care and Medicare: Frequently Asked Questions

• Who is this urology guide for?
  This guide is for anyone dealing with urinary symptoms, prostate or bladder concerns, frequent infections, kidney stones, incontinence, or a history of urologic cancer. It explains what to watch for, which screenings are important, how Medicare may cover tests, and how an advocate can help you schedule care, check coverage, and stay organized.
• What does a urologist treat?
  Urologists care for the kidneys, ureters, bladder, prostate, urethra, and pelvic floor, along with the male reproductive system. Common reasons to see a urologist include blood in the urine, pain or burning with urination, frequent or urgent urination, leaks, a weak stream, difficulty starting or stopping urine, feeling unable to empty, recurrent infections, kidney stones, and screening or follow up for prostate or bladder cancer.
• What is PSA screening and when should I consider it?
  PSA is a blood test that can help detect prostate problems, including prostate cancer. Medical groups generally recommend shared decision making for men between ages fifty five and sixty nine, so you and your clinician can weigh risks and benefits based on your situation. Routine PSA screening is not recommended for most people age seventy and older, but decisions can still be individualized, especially if you have higher risk because of family history, certain gene changes, or Black ancestry.
• How does Medicare cover PSA screening?
  Medicare Part B covers a PSA screening blood test once every twelve months for people who have reached age fifty. Your next Medicare covered PSA is allowed after at least eleven months have passed following the month of your last covered screening test. Many clinics aim to schedule the test about once a year on a regular timetable. If a repeat PSA is needed sooner for a medical reason, your clinician may order it as a diagnostic test, which follows different rules.
• What is bladder cancer surveillance and why is cystoscopy important?
  For people with non muscle invasive bladder cancer, regular cystoscopy is the main tool for follow up. It lets your urologist look directly inside the bladder for any recurrence. Urine tests can provide extra information but do not replace cystoscopy. Imaging of the kidneys and ureters is added based on your risk level and symptoms. Higher risk disease usually involves more frequent surveillance. An advocate can help you keep these visits on schedule and at in network locations.
• What is a bladder ultrasound and post void residual test?
  Bladder ultrasound is often used to measure how much urine remains after you go to the bathroom. This is called post void residual. A high residual can suggest obstruction, weak bladder muscle, or other problems. The measurement can be done by ultrasound or briefly with a catheter. Medicare treats this as a diagnostic service, with limits on how often it is billed. Your care team documents the medical reason for the test and an advocate can verify coverage and help you find a facility that can perform it quickly.
• When should I call a clinician about urinary symptoms?
  You should contact your clinician soon if you notice urine that looks red, pink, brown, or cola colored, pain or burning with urination, new urgency or frequency, cloudy urine, fever with urinary symptoms, a weak stream, straining, feeling you cannot empty completely, or ongoing leaks that interfere with daily life. Severe side or back pain that comes in waves, especially with nausea, can be a sign of a kidney stone and should also be evaluated.
• What symptoms are emergencies and should not wait?
  If you suddenly cannot pass urine, especially with lower belly pain, seek urgent care immediately. Acute urinary retention is an emergency. Fever with urinary symptoms or severe flank pain with nausea should also be treated promptly.
• How can an advocate help with my urology care?
  An advocate helps you understand your next steps and keeps the plan organized. They can track your PSA schedule, help coordinate bladder or kidney imaging, confirm which tests your clinician ordered, check that facilities are in network, and review your benefits before you go. They also help you monitor symptoms, decide when to contact your primary care clinician or urologist, collect records from past visits, and follow up after appointments so the plan stays up to date.
• What are lower urinary tract symptoms and how are they treated?
  Lower urinary tract symptoms include urgency, frequent urination, leaks, nighttime urination, and a weak stream. An enlarged prostate is a common cause for older men, although other conditions can contribute. Treatment may include lifestyle changes, medicines, or procedures depending on how bothersome the symptoms are and what your urologist finds. Your goals and overall health are part of that decision.
• Is urinary incontinence just part of aging?
  Bladder control problems are common but they are not something you simply have to accept. Many people improve with pelvic floor muscle training and bladder strategies. If symptoms continue, there are additional medicines and procedures that may help. You should seek care if leakage limits your activities, sleep, or social life.
• What should I know about urinary tract infections?
  Pain or burning with urination, urgency, frequency, and discomfort in the lower abdomen can signal a urinary tract infection. Your clinician usually confirms the diagnosis with urine testing and treats bacterial infections with antibiotics. If you have symptoms, you should call your clinician rather than treating it on your own.
• What are kidney stones and how are they managed?
  Kidney stones are hard deposits that can cause severe side or back pain, nausea, and sometimes blood in the urine. Some stones pass on their own with fluids and pain control. Others need procedures to break or remove them. After a stone, your clinician may recommend tests and prevention strategies to lower the chance of another one.
• How does Medicare handle diagnostic urology tests like ultrasound?
  Medicare covers diagnostic tests such as bladder ultrasound and post void residual measurements when they are medically necessary. Your urology or primary care team documents the reason for the test. Coverage and any out of pocket cost depend on your plan, deductibles, and coinsurance. An advocate can check your benefits, confirm the site of care, and help you avoid unnecessary surprises.
• How can I prepare for a urology visit?
  Bring a symptom timeline that notes when problems started, how often they occur, and any visible blood in your urine. Include a list of all medicines and supplements you take and any recent imaging or lab results, especially PSA tests. Good questions to ask include what is most likely causing your symptoms, which tests are recommended and why, what you can do at home to help, and when you should call if things get worse. An advocate can help you create this list, join a phone or video visit, and help schedule follow up tests.
• If my last PSA was high, do I have to wait a full year to repeat it?
  Medicare covers one screening PSA every twelve months under the preventive benefit. If your clinician wants to repeat a PSA sooner because of a medical concern, they may order it as a diagnostic test instead. That is billed differently and follows diagnostic coverage rules. An advocate can coordinate with your clinician and your plan so you understand what is covered and what to expect.
• Why do I still need cystoscopy after bladder cancer treatment?
  Even after treatment, non muscle invasive bladder cancer can come back inside the bladder. Cystoscopy lets your urologist look directly at the lining to check for recurrence and treat it early if needed. Urine based tests can add information but do not replace cystoscopy for surveillance in most cases.
• How can I get support to manage all of this?
  If you want help staying on top of tests, results, referrals, and coverage, you can connect with an Understood Care advocate. They can help schedule appointments, check benefits, prepare questions, coordinate records between your clinicians, and keep everything organized so you are not doing it alone.

References

• National Coverage Determination for Prostate Cancer Screening Tests. Centers for Medicare and Medicaid Services. https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=268
• Prostate cancer screenings. Medicare. https://www.medicare.gov/coverage/prostate-cancer-screenings
• Prostate cancer screening. United States Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening
• Early detection of prostate cancer guideline. American Urological Association. https://www.auanet.org/guidelines-and-quality/guidelines/early-detection-of-prostate-cancer-guidelines
• Bladder cancer non muscle invasive guideline. American Urological Association. https://www.auanet.org/guidelines-and-quality/guidelines/bladder-cancer-non-muscle-invasive-guideline
• Post treatment surveillance of bladder cancer. American College of Radiology Appropriateness Criteria. https://acsearch.acr.org/docs/69364/Narrative
• Urinary retention diagnosis. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-retention/diagnosis
• Post void residual urine test. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/16423-postvoid-residual
• Urinary tract infection basics. Centers for Disease Control and Prevention. https://www.cdc.gov/uti/about/index.html
• Urinary tract infection checklist. Centers for Disease Control and Prevention. https://www.cdc.gov/nhsn/pdfs/checklists/uti-checklist-508.pdf
• Blood in urine symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/blood-in-urine/symptoms-causes/syc-20353432
• Blood in urine diagnosis and treatment. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/blood-in-urine/diagnosis-treatment/drc-20353436
• Urinary incontinence symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808
• Lower urinary tract symptoms overview. Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/24248-lower-urinary-tract-symptoms
• Kidney stones overview. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755
• Bladder control problems overview. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems
• Bladder control problems treatment. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems/treatment
• Bladder control problems prevention. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems/prevention
• Enlarged prostate overview. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia
• Kidney stones overview. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones

This content is educational and is not a substitute for medical advice. Always consult your healthcare provider for personalized care.