Urology Care for Gay & Bisexual Men: Practical Guidance

This resource is for gay and bisexual men who want urology care that is clinically thorough and straightforward about sexual health when it is relevant. It covers common symptoms, what to expect at appointments, and questions worth asking.

When to seek urgent care

Seek urgent medical review (ED or urgent GP review) if you have:

  • fever or chills with urinary symptoms

  • severe flank pain (especially with nausea/vomiting)

  • visible blood in the urine with clots

  • inability to pass urine

  • severe testicular pain

Common reasons gay and bisexual men see a urologist

Many presentations are the same as for any man. The difference is that sometimes sexual health context changes the differential diagnosis or the management plan.

Common reasons include:

  • urinary frequency, urgency, burning, or recurrent “UTI-like” symptoms

  • pelvic, perineal, or testicular discomfort

  • blood in the urine or semen

  • erectile dysfunction or ejaculation changes

  • kidney stones

  • prostate concerns (PSA, MRI findings, biopsy results, or a prostate cancer diagnosis)

Symptoms that are often mislabelled

Some symptom clusters overlap and are commonly misdiagnosed or repeatedly treated without a clear plan. Examples include:

  • recurrent urinary symptoms with negative cultures

  • pelvic pain labelled as “prostatitis” without clear infection

  • symptoms driven by pelvic floor dysfunction, bladder irritation, or inflammation

A good consultation usually focuses on clarifying:

  • what testing has actually shown (urine cultures, STI testing where appropriate, imaging)

  • the pattern over time

  • triggers, exposures, and symptom context

  • what has and hasn’t responded to treatment

Sexual health and urology: when it matters clinically

You don’t need to volunteer details you’re uncomfortable with. But in some cases, sexual practices can be medically relevant—for example when assessing:

  • urethral symptoms

  • pelvic pain syndromes

  • infections or inflammation

  • symptoms after prostate surgery or radiation

The aim is not judgement. It’s accuracy.

Prostate checks, PSA, and prostate cancer

If your concern is PSA or prostate cancer, the most useful step is usually understanding the pathway (PSA context → MRI → biopsy if indicated → risk stratification → decision-making).

For the broader prostate cancer pathway, see:

Prostate Cancer

If you are specifically seeking information about prostate cancer surgery in gay, trans and gender diverse people, see:

Prostate Cancer Surgery for Gay, Trans and Gender Diverse People

What to bring to your appointment

  • a list of symptoms (when they started, pattern, triggers)

  • relevant prior results (urine cultures, STI tests, imaging, PSA history)

  • current medications (including supplements)

  • your priorities (pain relief, sexual function, fertility, cancer risk clarity, etc.)

Questions worth asking

  • What diagnoses are you considering, and what makes them more or less likely?

  • What tests are actually needed (and which aren’t)?

  • What is the plan if symptoms recur?

  • If this is a chronic symptom pattern, what is the longer-term management strategy?

Clinical note

This page provides general information and does not replace individual medical advice.