Evaluating a New Urology Patient

Chief Complaint and Symptom Assessment

The American Urological Association recommends using validated symptom questionnaires such as the International Prostate Symptom Score (IPSS) or AUA Symptom Score to quantify lower urinary tract symptoms (LUTS) and assess symptom severity and bother 3, 4, 5
Patients should be asked to describe their primary urological problem in their own words, and inquired about specific urinary symptoms, including storage symptoms (frequency, urgency, nocturia, and urgency incontinence) and voiding symptoms (hesitancy, intermittency, weak stream, straining to void, and sensation of incomplete emptying) 1, 2, 3, 4, 6

The patient's medical history should be inquired, including previous urological conditions, procedures, or surgeries, and relevant medical conditions that may affect urinary function, such as cardiovascular disease, neurological conditions, and endocrine disorders 3, 7
Current medications, particularly those known to affect urinary function, should be reviewed 1, 2

For patients with LUTS, determine if symptoms are predominantly storage or voiding, and ask about impact on quality of life using the Disease Specific Quality of Life Question 3, 4, 5, 7
For patients with nocturia, ask about number of nighttime voids, fluid intake patterns, and consider using a frequency-volume chart to document patterns 3, 6, 7

Ask about family history of urological cancers, occupational exposures to chemicals or dyes, and smoking history with specific pack-years (>30 pack-years is high risk for urothelial cancer) 8
For patients with hematuria, assess risk factors using the AUA/SUFU Microhematuria Risk Stratification System 8

Failing to quantify symptom severity using validated tools, such as the IPSS or AUA Symptom Score, can lead to inadequate treatment decisions 3, 4
Not asking about impact on quality of life, which is crucial for treatment decisions, can result in suboptimal patient outcomes 1, 4