Urology

GlobalRPh Urology, Lower Urinary Tract, Sexual Medicine and GU Clinical Resources

Urology Clinical Resource Center

Clinician-focused resources for lower urinary tract symptoms and BPH, overactive bladder and urinary incontinence, urinary tract infection, hematuria, kidney stone disease, sexual medicine, male infertility, testosterone deficiency, chronic pelvic pain, neurogenic bladder, genitourinary oncology, urinary indices, medication references, and current GlobalRPh Urology reviews.

BPH / LUTS OAB / incontinence UTI / stewardship Internal Medicine Sections

Primary audience: physicians, pharmacists, nurses, advanced practice clinicians, urology professionals, and other healthcare professionals involved in lower urinary tract, genitourinary, sexual-medicine, stone-disease, infection, and urologic-oncology care.

Clinical reference index

Urology clinical domains

Clinical framework

Urologic symptoms require syndrome definition, objective assessment, and appropriate exclusion of urgent pathology

Frequency, urgency, dysuria, nocturia, weak stream, retention, hematuria, incontinence, pelvic pain, erectile dysfunction, and sexual symptoms are not diagnoses by themselves. Similar symptoms may arise from benign prostatic obstruction, overactive bladder, infection, malignancy, stones, neurologic disease, medications, diabetes, pelvic-floor dysfunction, genitourinary syndrome of menopause, or other conditions.

We organize our Urology resources by clinical syndrome rather than by an undifferentiated list of questionnaires and drug tables. Validated scores remain useful for quantifying symptoms and response to treatment, but diagnosis and management require history, examination, laboratory and imaging data when appropriate, medication review, red-flag assessment, and guideline-based clinical judgment.

Symptoms are not diagnosis IPSS, SHIM, OABSS, AMS, and ADAM quantify symptom burden or screening risk but do not establish the underlying disease.

Exclude high-risk disease Gross hematuria, infection with obstruction, acute retention, testicular torsion, severe renal dysfunction, and suspected malignancy require timely evaluation.

Use objective measures selectively Urinalysis, culture, PVR, uroflowmetry, PSA, imaging, cystoscopy, urodynamics, semen analysis, and endocrine testing should answer a clinical question.

Reassess function and burden Track symptoms, quality of life, infections, renal effects, sexual function, medication adverse effects, and need for procedural referral.

1. Define the syndrome Storage symptoms, voiding symptoms, pain, infection, bleeding, sexual dysfunction, obstruction, or stone disease.

2. Identify red flags Malignancy risk, fever/sepsis, upper-tract obstruction, renal injury, neurologic deficit, severe retention, or acute scrotal emergency.

3. Select evidence-based management Use disease-specific guidance, current labeling, procedural options, and patient priorities.

4. Monitor longitudinally Symptoms, quality of life, adverse effects, laboratory findings, recurrence, progression, and treatment goals.

Questionnaires support care Symptom scores are most useful for baseline quantification and treatment response when interpreted within a complete clinical evaluation.

Diagnostic stewardship matters Positive urine tests without a compatible clinical syndrome can drive unnecessary antibiotic therapy, especially in older or catheterized patients.

Urology overlaps many specialties Nephrology, infectious disease, endocrinology, oncology, geriatrics, neurology, gynecology, and primary care frequently share management.

New AUA guidance in 2026

Management of LUTS Attributed to BPH

AUA released a new BPH/LUTS guideline in 2026. We use it as the current clinical framework for symptom assessment, medical therapy, procedural selection, prostate anatomy/volume considerations, and shared decision-making rather than relying on older drug tables or symptom scores alone.

Open the 2026 AUA BPH Guideline

Updated prostate detection framework

Early Detection of Prostate Cancer – 2026 Amendment

The AUA/SUO prostate-cancer early-detection guideline was amended in 2026 and now provides a current framework for PSA-based screening, risk assessment, MRI, biomarkers, initial and repeat biopsy, and minimizing detection of clinically insignificant disease.

Open AUA Urologic Guidelines

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GlobalRPh urology calculators and symptom instruments

LUTS, erectile function, overactive bladder, incontinence, testosterone symptoms, proteinuria, and urinary indices

We retain all calculator links from the existing portal while clarifying whether each instrument measures symptoms, screens for a possible condition, or performs a physiologic calculation.

Lower urinary tract symptoms

Sexual / androgen symptom instruments

Urine / kidney crossover calculations

Important correction: The IPSS quantifies male lower urinary tract symptom severity and quality-of-life impact; it does not by itself diagnose BPH. Likewise, AMS and ADAM questionnaires identify symptoms potentially compatible with androgen deficiency but do not diagnose testosterone deficiency. Biochemical confirmation and clinical evaluation are required.

Benign prostatic hyperplasia and male lower urinary tract symptoms

Symptom burden, obstruction risk, prostate characteristics, medical therapy, and procedural treatment

Male LUTS may reflect BPH, bladder dysfunction, nocturnal polyuria, infection, medication effects, neurologic disease, urethral pathology, or malignancy. IPSS is useful for symptom quantification but should be integrated with history, urinalysis, examination, medication review, and selected objective testing.

Current BPH guidance

GlobalRPh BPH drug reference

We retain the existing BPH drug page for continuity while updating alpha blockers, 5-alpha-reductase inhibitors, tadalafil, combination therapy, adverse effects, orthostasis, ejaculatory effects, and current labeling.

Procedural escalation

Persistent bothersome symptoms despite appropriate conservative / medical management
Refractory urinary retention
Recurrent infection, bladder stones, or renal/upper-tract consequences attributed to obstruction
Patient preference for procedural treatment or medication avoidance
Procedure selection based on prostate anatomy, size, sexual priorities, comorbidity, and evidence

Overactive bladder and urinary incontinence

Storage symptoms, behavioral therapy, pharmacotherapy, minimally invasive treatment, and phenotype-specific evaluation

Urgency, frequency, nocturia, and urgency urinary incontinence can occur with idiopathic OAB, infection, polyuria, medication effects, neurologic disease, pelvic-floor dysfunction, obstruction, genitourinary syndrome of menopause, or other conditions. Evaluation should therefore identify clinically relevant alternative causes before escalating treatment.

Current OAB guidance

GlobalRPh OAB / bladder drug resources

Stress / post-prostate treatment incontinence

Antimuscarinic burden can contribute to dry mouth, constipation, blurred vision, urinary retention, and cognitive adverse effects, particularly in older adults or patients receiving other anticholinergic medications. Drug selection should account for cognition, PVR/retention risk, blood pressure, kidney/liver function, and interactions.

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Urinary tract infection and diagnostic stewardship

Symptomatic infection, asymptomatic bacteriuria, urine culture, recurrent UTI, resistance, and complicated infection

UTI is a clinical diagnosis supported by testing when testing can alter management. Pyuria, bacteriuria, leukocyte esterase, nitrite positivity, or a positive culture does not independently establish symptomatic infection in the absence of attributable urinary or systemic findings.

GlobalRPh 2026 UTI reviews

Recurrent UTI guidance

Complicated infection / obstruction

Pyelonephritis or systemic illness
Obstruction, infected stone, hydronephrosis, or urinary retention
Catheter / instrumentation context
Pregnancy, immunocompromise, renal dysfunction, or resistant organisms
Need for culture, imaging, drainage, or hospital-level care based on severity

Most asymptomatic bacteriuria should not be treated. Important exceptions include pregnancy and selected invasive urologic procedures associated with mucosal trauma. Nonspecific symptoms in older adults should not automatically be attributed to a positive urinalysis or culture without a compatible clinical syndrome.

Hematuria

Risk-stratified evaluation of microhematuria and prompt assessment of visible blood

Hematuria can arise from infection, stones, BPH, urothelial malignancy, renal parenchymal disease, anticoagulation-associated bleeding, instrumentation, exercise, or other causes. Anticoagulant or antiplatelet therapy does not by itself eliminate the need for an appropriate hematuria evaluation.

Current microhematuria guideline

AUA/SUFU Microhematuria Guideline – Amended 2025

The 2025 amendment uses risk stratification to guide evaluation and follow-up rather than applying the same imaging and cystoscopy pathway to every patient.

Clinical variables

Visible versus microscopic hematuria
Age, sex, smoking and other urothelial-cancer risk factors
Degree and persistence of hematuria
Infection, stones, recent instrumentation, menstruation, or benign explanations
Proteinuria, casts, kidney dysfunction, or other features suggesting nephrologic disease

GlobalRPh supporting resources

Kidney and ureteral stone disease

Acute renal colic, obstruction and infection, stone passage, metabolic prevention, and procedural treatment

Stone management depends on size, location, obstruction, infection, renal function, anatomy, symptom burden, pregnancy status, solitary kidney, prior stone history, and the likelihood of spontaneous passage. Obstruction with infection is a urologic emergency requiring drainage and antimicrobial therapy.

AUA stone resources

GlobalRPh stone reviews

Prevention / metabolic evaluation

Fluid intake and urine-volume goals tailored to recurrent-stone risk
Stone analysis when available
Serum and urine metabolic evaluation for appropriate recurrent/high-risk patients
Dietary sodium, calcium, oxalate, animal-protein, and citrate considerations by phenotype
Medication prevention based on stone type and metabolic findings

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Erectile dysfunction and testosterone deficiency

Sexual function, cardiovascular risk, endocrine assessment, fertility implications, and treatment monitoring

Erectile dysfunction can reflect vascular disease, diabetes, neurologic disease, medication effects, hypogonadism, pelvic surgery, psychological factors, relationship factors, or mixed causes. ED may also be a marker of underlying cardiometabolic disease and should not be evaluated solely as a medication-selection problem.

ED assessment / treatment

Testosterone deficiency

Clinical distinctions

Symptoms compatible with low testosterone are nonspecific
Diagnosis requires appropriate biochemical confirmation plus clinical context
Exogenous testosterone can suppress spermatogenesis and affect fertility planning
Hematocrit, prostate considerations, sleep apnea, cardiovascular history, and treatment response require monitoring

The current AMS and ADAM calculator pages use language that can overstate diagnostic performance. We plan to revise them so they are explicitly presented as symptom-screening instruments. A positive score should prompt appropriate clinical and laboratory assessment rather than automatic testosterone treatment.

Male infertility and reproductive urology

Semen analysis, endocrine evaluation, genetic testing, varicocele, obstruction, and fertility-preserving treatment

Male infertility evaluation should occur within the context of the couple or reproductive plan and may require semen analysis, examination, endocrine testing, genetic evaluation, medication review, reproductive exposures, and coordinated care with reproductive specialists.

Current male infertility guidance

Medication / endocrine crossover

Fertility-preserving principle

Testosterone-replacement decisions should account for current or future fertility goals because exogenous testosterone can suppress gonadotropins and spermatogenesis. Alternative approaches may be considered under appropriate specialist supervision for selected patients.

Male chronic pelvic pain and bladder pain syndromes

Chronic prostatitis/CPPS, chronic scrotal content pain, interstitial cystitis/bladder pain, pelvic-floor dysfunction, and multimodal care

Chronic pelvic and bladder pain often requires a multimodal evaluation because infection, pelvic-floor dysfunction, neuropathic pain, musculoskeletal disease, bladder pain syndrome, sexual dysfunction, psychosocial burden, and prior procedures can coexist. Repeated empiric antibiotic therapy without evidence of infection can delay more appropriate treatment.

Male chronic pelvic pain – 2025

AUA Male Chronic Pelvic Pain Guideline – 2025

Interstitial cystitis / bladder pain

Genitourinary syndrome of menopause

AUA/SUFU/AUGS GSM Guideline – 2025

GSM can contribute to dysuria, urgency, recurrent UTI symptoms, dyspareunia, and vaginal/urinary discomfort and should be considered in the differential diagnosis when clinically appropriate.

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Neurogenic lower urinary tract dysfunction

Risk stratification, bladder storage/emptying, upper-tract protection, catheter strategy, and neurologic crossover

Neurogenic bladder management should prioritize renal and upper-tract preservation, safe bladder pressures, adequate emptying, continence goals, infection prevention, catheter complications, skin integrity, functional ability, and patient/caregiver capacity.

Current AUA/SUFU resource

Adult Neurogenic Lower Urinary Tract Dysfunction Guideline

GlobalRPh bladder resources

Monitoring priorities

Retention and post-void residual
High storage pressures / upper-tract risk when relevant
Catheter-associated complications and symptomatic infection
Renal function and imaging based on risk category
Medication adverse effects and autonomic/neurologic comorbidity

Genitourinary oncology

Prostate, bladder, kidney, testicular, and upper-tract urothelial cancer crossover

The Urology portal should facilitate early detection, urologic evaluation, surgery/procedures, and survivorship while avoiding duplication of systemic oncology treatment tables maintained in the GlobalRPh Oncology section.

Prostate cancer – current AUA pathways

GlobalRPh prostate resources

Bladder / kidney / testicular oncology

Our prostate-cancer drug table remains a historical GlobalRPh resource and should not be used as a current systemic-treatment algorithm. Contemporary prostate, bladder, kidney, testicular, and urothelial-cancer treatment requires current staging, molecular/biomarker context, imaging, regulatory status, and oncology/urology guidance.

Urologic pharmacotherapy

GlobalRPh bladder, BPH, dysuria, erectile dysfunction, prostate cancer, and urinary-condition drug references

We retain all medication-table destinations from the existing Urology portal while separating them from current clinical algorithms and identifying pages that require product, labeling, safety, or guideline updates.

Lower urinary tract pharmacotherapy

Sexual / oncologic references

Urine appearance / medication causes

Alphabetical GlobalRPh drug index

a b c d e f g h i j k l m n o p q r s t u v w x y z

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GlobalRPh Urology article library

Current and established urology reviews

The live portal surfaces only five older articles. We now prioritize the current Urology category, including 2026 UTI diagnostic stewardship, male hypogonadism, BPH, and urologic technology, while retaining established stone and bladder articles for continuity.

2026

2025 and established content

Urology Article Archive Urology Calculator Archive GlobalRPh Video Library

GlobalRPh urology video development

Priority clinician education topics

The live Urology portal has an empty video section. We identify focused clinician topics for future development rather than populating the section with unrelated content.

Lower urinary tract / infection topics

2026 AUA BPH/LUTS guideline and treatment selection
IPSS: symptom measurement versus diagnosis
2024 AUA/SUFU overactive bladder guideline
UTI versus asymptomatic bacteriuria
2025 recurrent UTI pathway
2025 microhematuria risk stratification

Sexual / stone / oncology topics

ED as a urologic and cardiometabolic symptom
Testosterone deficiency: symptoms, laboratory confirmation, and fertility
Kidney-stone acute management and metabolic prevention
2025 male chronic pelvic pain guideline
2026 prostate-cancer early detection
Male infertility evaluation and fertility-preserving hormone management

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Clinical content modernization

Priority updates within the GlobalRPh Urology library

Our Urology section contains validated questionnaires, useful medication references, and longstanding calculators, but several pages use older diagnostic language, older product information, or older evidence frameworks. We plan to retain useful tools while updating clinical interpretation and current guidance.

Priority resource reviews

IPSS: remove language that the score can rapidly diagnose BPH; present it as a validated LUTS symptom-severity and quality-of-life instrument and link directly to the 2026 AUA BPH guideline.
AMS and ADAM: revise statements that imply questionnaires diagnose low testosterone; require symptom context, repeat morning testosterone confirmation as appropriate, etiologic evaluation, and current AUA testosterone-deficiency guidance.
SHIM / IIEF-5: update ED evaluation, cardiovascular risk, testosterone testing when indicated, medication contributors, PDE5 contraindications/interactions, and referral pathways while preserving the validated questionnaire.
BPH Drug Table: rebuild around the 2026 AUA BPH guideline with alpha blockers, 5-alpha-reductase inhibitors, tadalafil, combination therapy, adverse effects, prostate characteristics, PVR/retention, and procedural escalation.
OAB / Bladder Spasm Drug Table: update antimuscarinics, beta-3 agonists, combination therapy, cognitive/anticholinergic burden, blood-pressure considerations, kidney/liver dosing, botulinum toxin, tibial-nerve stimulation, and sacral neuromodulation.
Urinary Incontinence Tool: reorganize by stress, urgency, mixed, overflow, functional, neurogenic, and post-prostate-treatment patterns using current AUA/SUFU guidance.
Recurrent UTI: create a structured 2025 AUA/CUA/SUFU pathway for diagnostic confirmation, culture, antibiotic stewardship, non-antibiotic prevention, vaginal estrogen where indicated, prophylaxis, and referral.
Dysuria: separate infectious cystitis from urethritis/STI, vaginitis/GSM, stones, bladder pain syndrome, irritant exposure, and other noninfectious causes.
Microhematuria: develop a 2025 AUA/SUFU risk-stratification tool that links patient risk category to appropriate evaluation and follow-up.
Kidney Stones: build acute renal-colic and prevention pathways, including infected obstruction, imaging, medical expulsive therapy where appropriate, surgical referral, stone analysis, metabolic evaluation, fluid/diet, and pharmacologic prevention.
Urinary Indices / FENa: preserve the calculations but move them primarily to Nephrology, add limitations in CKD, diuretic exposure, sepsis, glomerular disease, and non-steady-state AKI, and avoid presenting FENa as a stand-alone diagnosis of prerenal versus intrinsic AKI.
24-Hour Protein Estimate: retain the published gender-specific formula but clarify its derivation cohort, units, external-validation limits, and preferred modern CKD proteinuria/albuminuria assessment pathways.
Erectile Dysfunction Drug Table: update current PDE5 products, nitrate and riociguat contraindications, alpha-blocker considerations, organ-function dosing, intracavernosal/intraurethral therapy, vacuum devices, prostheses, and cardiovascular risk assessment.
Male Infertility: build a dedicated pathway using the 2024 AUA/ASRM amendment, including semen analysis, endocrine and genetic testing, varicocele, obstruction, fertility-preserving hormonal therapy, and assisted reproduction crossover.
Male Chronic Pelvic Pain: create a dedicated resource based on the 2025 AUA guideline that integrates pelvic floor, neuropathic, urinary, sexual, musculoskeletal, psychosocial, and infection-related domains.
Genitourinary Syndrome of Menopause: add a 2025 AUA/SUFU/AUGS pathway for urinary symptoms, recurrent UTI, dyspareunia, vaginal symptoms, and appropriate local/systemic therapy considerations.
Neurogenic Lower Urinary Tract Dysfunction: build risk-stratified follow-up, PVR/catheter management, urodynamics when indicated, upper-tract protection, recurrent infection, medication therapy, botulinum toxin, and reconstructive referral.
Prostate Cancer Drug Table: coordinate with Oncology to replace the historical table with current early detection, localized, biochemical recurrence, metastatic hormone-sensitive, nonmetastatic CRPC, metastatic CRPC, molecular testing, ADT toxicity, and current treatment pathways.
Urine Discoloration: update medication and dietary causes and add a clear warning that red/brown urine, hematuria, hemoglobinuria, myoglobinuria, bilirubin, and infection require clinical differentiation.
Urology Video Library: create a dedicated professional category so the currently empty portal section becomes clinically useful.

BPH / LUTS 2026 tool IPSS, medication contributors, prostate characteristics, PVR, drug selection, sexual effects, and procedural referral.

Microhematuria pathway 2025 risk stratification with evaluation, imaging/cystoscopy prompts, nephrology crossover, and follow-up.

Recurrent UTI tool Diagnostic confirmation, cultures, prevention, vaginal estrogen, antibiotic prophylaxis, and stewardship.

Stone disease center Acute colic, infected obstruction, passage probability, stone analysis, metabolic workup, and recurrence prevention.

Male sexual health 2.0 SHIM, testosterone confirmation, cardiovascular risk, fertility goals, medication contributors, and treatment pathways.

OAB / incontinence selector Symptom phenotype, red flags, behavioral therapy, pharmacotherapy, minimally invasive treatment, and referral.

Current external clinical standards

Authoritative urologic guidance integrated with GlobalRPh resources

Urologic practice changes through new procedures, imaging, biomarkers, medications, diagnostic frameworks, and safety data. We therefore link current professional guidance beside our calculators and drug tables while progressively updating individual GlobalRPh resources.

AUA BPH / LUTS Guideline – 2026 Current evaluation and management framework for lower urinary tract symptoms attributed to benign prostatic hyperplasia. Open BPH Guideline

AUA/SUFU Idiopathic Overactive Bladder – 2024 Diagnosis and treatment framework for idiopathic non-neurogenic overactive bladder. Open OAB Guideline

AUA/SUFU Microhematuria – Amended 2025 Risk-stratified framework for diagnosis, evaluation, and follow-up of microhematuria. Open Microhematuria Guideline

AUA/CUA/SUFU Recurrent UTI – Amended 2025 Evidence-based care for recurrent uncomplicated urinary tract infection in women. Open Recurrent UTI Guideline

AUA Male Chronic Pelvic Pain – 2025 Evaluation and management of chronic prostatitis/chronic pelvic pain syndrome and chronic scrotal content pain. Open Pelvic Pain Guideline

AUA/SUFU/AUGS Genitourinary Syndrome of Menopause – 2025 Current diagnosis and treatment guidance for genitourinary syndrome of menopause. Open GSM Guideline

AUA/SUO Early Detection of Prostate Cancer – 2026 Current PSA screening, risk assessment, MRI/biomarker, and biopsy decision framework. Open AUA Guideline Index

AUA/ASRM Male Infertility – Amended 2024 Evaluation and treatment of male infertility, including semen, endocrine, genetic, and reproductive-management pathways. Open Male Infertility Guideline

AUA Testosterone Deficiency Guideline Diagnosis, treatment, and monitoring of testosterone deficiency with attention to symptoms, biochemical confirmation, fertility, and safety. Open Testosterone Guideline

AUA Erectile Dysfunction Guideline Clinical strategy for ED diagnosis, cardiovascular implications, treatment options, and shared decision-making. Open ED Guideline

AUA Adult Neurogenic Lower Urinary Tract Dysfunction Risk stratification, surveillance, bladder management, upper-tract protection, and treatment options. Open NLUTD Guideline

AUA Stone Guideline Resource Center Medical and surgical guidance for kidney and ureteral stone evaluation and management. Open Stone Guidelines

Supporting GlobalRPh clinical resources

Nephrology, infectious disease, endocrinology, oncology, geriatrics, neurology, and medication support

Kidney / infection crossover

Endocrine / aging / neurologic crossover

Oncology / medication support

Rationale for retaining established urology questionnaires and calculators

Several GlobalRPh urology instruments remain useful for standardized symptom measurement, longitudinal comparison, or physiologic calculation. We retain those tools while modernizing diagnostic language, current guideline links, medication safety, organ-function considerations, procedural pathways, and clear distinctions between screening, symptom scoring, and diagnosis.

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Clinical use: Our urology questionnaires, calculators, medication tables, and clinical articles are intended to support, not replace, comprehensive history and examination, current urologic guidelines, current product labeling, appropriate laboratory and imaging evaluation, malignancy and infection risk assessment, specialist consultation when indicated, and independent professional judgment.

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Alphabetical Listing of individual drugs

a b c d e f g h i j k l m
n o p q r s t u v w x y z

Common LAB Values Renal Dosing