Seeing a Urologist as a Gay or Bisexual Man or Person with a Prostate: What to Expect
This article forms part of Dr Deanne Soares’ patient education series, supporting people living with urological symptoms or undergoing assessment for urological conditions.
Seeing a urologist for the first time can feel uncomfortable — particularly when symptoms involve the prostate, urinary tract, or sexual health, and when past healthcare experiences have not always felt inclusive or respectful.
Gay and bisexual men, as well as other people with prostates (including some trans women), may have specific questions about how urological care applies to them, what information is relevant to share, and what will actually happen during an appointment.
This article explains when a urologist is involved, what a consultation typically includes, and how urological care is approached in a way that is clinically appropriate, respectful, and free of assumptions.
Patient summary
Key points to know:
Urologists assess urinary, prostate and testicular concerns
Care should be respectful and inclusive, without assumptions
Not all symptoms are sexually transmitted
Most STI screening is managed by GPs or sexual health clinics
Specialist assessment helps clarify when further treatment is needed
When gay and bisexual men are referred to a urologist
Urologists assess conditions affecting the urinary tract, prostate and, in some cases, the reproductive system.
Referral may occur for reasons including:
Urinary symptoms, such as weak stream, hesitancy, urgency, frequency, burning, or blood in the urine
Prostate-related concerns, including benign prostate enlargement (BPH), prostatitis, abnormal PSA results, or suspicion of prostate cancer
Testicular or scrotal issues, such as pain, lumps, swelling, or fertility-related concerns
Persistent or unexplained symptoms where initial treatment has not resolved the issue
These issues are common and often manageable, particularly when assessed early.
Prostate health and sexual practices: what matters clinically
The prostate sits just below the bladder and surrounds the urethra. It plays a role in semen production and may also be involved in sexual sensation for some people, including during receptive anal sex.
From a medical perspective, the prostate can also be affected by conditions such as:
prostatitis (inflammation or infection)
benign prostate enlargement (BPH)
prostate cancer
These conditions are not caused by sexual orientation, but how symptoms are experienced or discussed may differ depending on sexual practices and past healthcare experiences.
A good urology consultation allows space to discuss relevant history only where it matters clinically, and physical examinations are explained in advance and conducted professionally, with dignity and privacy.
Urinary symptoms and when specialist input helps
Symptoms such as burning, urgency, frequency, incomplete emptying or pelvic discomfort are sometimes attributed to lifestyle factors or assumed to be minor infections.
In gay and bisexual men, these symptoms may be related to:
prostatitis
pelvic floor tension or dysfunction
bladder or prostate conditions
less commonly, sexually transmitted infections affecting the urethra or prostate
If symptoms persist, recur, or do not respond to initial treatment, specialist assessment can help clarify the cause and guide appropriate management.
Sexually transmitted infections and urology: setting clear boundaries
It is important to be clear about scope.
Most routine STI screening and sexual health care is best managed by a GP or a dedicated sexual health clinic.
A urologist becomes involved when:
symptoms persist despite treatment
anatomy may be affected
diagnoses are unclear
there are complications involving the prostate, bladder, or testicles
This distinction ensures care is appropriate, efficient, and well coordinated.
What happens during a urology appointment
The discussion
The consultation begins with a detailed conversation about:
symptoms and their impact
duration and pattern
relevant medical history and medications
Sexual history is discussed only insofar as it is clinically relevant, and without assumptions.
The examination
Depending on the issue, an examination may include:
abdominal or genital examination
prostate examination where appropriate
Examinations are brief, explained beforehand, and conducted respectfully.
Investigations
Not every appointment requires testing. When indicated, investigations may include:
urine testing
blood tests (including PSA where relevant)
ultrasound or other imaging
flow studies or cystoscopy in selected cases
Tests are chosen to answer specific clinical questions, not as a routine checklist.
Preventive care: what is relevant
Preventive urological care may include:
discussion of prostate health and PSA testing at appropriate ages or risk levels
HPV vaccination where indicated
addressing changes in urinary or sexual function early, rather than waiting
Preventive care is individualised and based on overall health, family history, and priorities.
Feeling safe in a healthcare setting matters
Some people have had prior healthcare experiences where disclosure felt unsafe or uncomfortable.
Inclusive urological care means:
communication without assumptions
respect for identity and relationships
trauma-aware examinations
clear explanation of why questions or examinations are relevant
Your urologist should be part of your care team — not a barrier to care.
Final thoughts
Seeing a urologist does not commit you to treatment, surgery, or invasive investigation.
For many people, it is simply a structured, respectful assessment that clarifies what is happening and what — if anything — needs to be done.
Good urological care prioritises clarity, proportional investigation, and shared decision-making.
About the author
Dr Deanne Soares is a Melbourne-based urologist who assesses and manages a wide range of urological conditions, with an emphasis on thoughtful, individualised care.
