honeypot link
skip to main content
Professional
Consumer
Professional edition active
ENGLISH
MSD Manual
Professional Version
MEDICAL TOPICS
RESOURCES
COMMENTARY
PROCEDURES
QUIZZES
ABOUT US
MEDICAL TOPICS
RESOURCES
COMMENTARY
PROCEDURES
QUIZZES
Professional
/
Genitourinary Disorders
/
Genitourinary Disorders
Expand all
Collapse all
Approach to the Genitourinary Patient
Evaluation of the Renal Patient
History
Physical Examination
Chest examination
Abdominal examination
Skin examination
Neurologic examination
Testing
Urinalysis
Microscopic urine analysis
Other urine tests
Blood tests
Evaluating Kidney Function
GFR
Creatinine clearance
Estimating creatinine clearance
Evaluation references
Evaluation of the Urologic Patient
History
Physical Examination
Costovertebral angle
Abdomen
Rectum
Groin and genitals
Testing
Symptoms of Genitourinary Disorders
Dysuria
Pathophysiology
Etiology
Evaluation
History
Physical examination
Red flags
Interpretation of findings
Testing
Treatment
Treatment reference
Key Points
Hematospermia
Pathophysiology
Etiology
Evaluation
History
Physical examination
Red flags
Interpretation of findings
Testing
Treatment
Key Points
Isolated Hematuria
Pathophysiology
Etiology
Evaluation
History
Physical examination
Red flags
Interpretation of findings
Testing
Evaluation reference
Treatment
Key Points
Painless Scrotal Mass
Etiology
Evaluation
History
Physical examination
Red flags
Interpretation of findings
Testing
Treatment
Key Points
Polyuria
Pathophysiology
Etiology
Evaluation
History
Physical examination
Red flags
Interpretation of findings
Testing
Treatment
Key Points
Priapism
Pathophysiology
Ischemic priapism
Nonischemic priapism
Etiology
Evaluation
History
Physical examination
Red flags
Interpretation of findings
Testing
Treatment
Ischemic priapism
Stuttering priapism
Nonischemic priapism
Refractory priapism
Key Points
Proteinuria
Pathophysiology
Consequences
Etiology
Evaluation
History and physical examination
Testing
Evaluation reference
Treatment
Scrotal Pain
Etiology
Evaluation
History
Physical examination
Red flags
Interpretation of findings
Testing
Treatment
Geriatrics Essentials
Key Points
Urinary Frequency
Pathophysiology
Etiology
Evaluation
History
Physical examination
Red flags
Interpretation of findings
Testing
Treatment
Geriatrics Essentials
Key Points
Genitourinary Tests and Procedures
Bladder Catheterization
Catheters
Urethral catheterization
Urethral catheterization reference
Suprapubic catheterization
Biopsy of the Kidneys, Bladder, and Prostate
Renal biopsy
Bladder biopsy
Prostate biopsy
Cystoscopy
Genitourinary Imaging Tests
Plain X-Rays Without Contrast
X-Rays With Use of Contrast
IV urography (IVU)
Percutaneous antegrade urography
Retrograde urography
Cystourethrography
Angiography
Ultrasonography
Computed Tomography
Magnetic Resonance Imaging
Radionuclide Scanning
Urethral Dilation
Acute Kidney Injury
Acute Kidney Injury (AKI)
Etiology
Symptoms and Signs
Changes in urine output
Diagnosis
Determination of cause
Imaging
Staging of AKI
Diagnosis references
Treatment
Emergency treatment
General measures
Prognosis
Prognosis reference
Prevention
Key Points
COVID-19 and Acute Kidney Injury (AKI)
General references
Rhabdomyolysis
Pathophysiology
Etiology
Symptoms and Signs
Symptoms and signs reference
Diagnosis
Treatment
Key Points
Benign Prostate Disease
Benign Prostatic Hyperplasia (BPH)
Pathophysiology
Symptoms and Signs
Lower urinary tract symptoms
Urinary retention
Symptom scores
Digital rectal examination
Diagnosis
Prostate-specific antigen (PSA) levels
Other testing
Diagnosis reference
Treatment
Urinary retention
Drug therapy
Surgery
Other procedures
Treatment references
Key Points
Prostate Abscess
Symptoms and Signs
Diagnosis
Treatment
Prostatitis
Etiology
Classification
Symptoms and Signs
Diagnosis
Treatment
Acute bacterial prostatitis
Chronic bacterial prostatitis
Chronic prostatitis/chronic pelvic pain syndrome
Asymptomatic inflammatory prostatitis
Key Points
Chronic Kidney Disease
Chronic Kidney Disease
General reference
Etiology
Pathophysiology
Creatinine and urea
Sodium and water
Potassium
Calcium and phosphate
pH and bicarbonate
Anemia
Symptoms and Signs
Diagnosis
Stages of chronic kidney disease
Treatment
Nutrition
Mineral and bone disorders
Fluid and electrolytes
Anemia and coagulation disorders
Heart failure
Medications
Dialysis
Transplantation
Treatment references
Prognosis
Key Points
Cystic Kidney Disease
Overview of Cystic Kidney Disease
Acquired Renal Cysts
Solitary renal cysts
Multiple renal cysts
Autosomal Dominant Polycystic Kidney Disease (ADPKD)
Etiology
Pathophysiology
Symptoms and Signs
Diagnosis
Treatment
Treatment references
Prognosis
Prognosis references
Key Points
Congenital Renal Cystic Dysplasia
Medullary Sponge Kidney
Diagnosis
Treatment
Nephronophthisis and Autosomal Dominant Tubulointerstitial Kidney Disease (ADTKD)
Nephronophthisis
Diagnosis
Treatment
Autosomal dominant tubulointerstitial kidney disease (ADTKD)
Treatment reference
Key Points
Genitourinary Cancers
Bladder Cancer
General reference
Symptoms and Signs
Diagnosis
Diagnosis reference
Treatment
Superficial cancers
Invasive cancers
Metastatic and recurrent cancers
Treatment reference
Prognosis
Key Points
Penile Cancer
General reference
Symptoms and Signs
Diagnosis
Treatment
Prevention
Key Points
Prostate Cancer
General references
Symptoms and Signs
Diagnosis
Screening
Grading and staging
Diagnosis references
Treatment
Active surveillance
Local therapies
Systemic therapies
Treatment references
Prognosis
Prevention
Key Points
Renal Cell Carcinoma
General reference
Symptoms and Signs
Diagnosis
Staging
Diagnosis reference
Treatment
Curative treatments
Palliative treatments
Treatment references
Prognosis
Prognosis reference
Key Points
Renal Metastases
Renal Pelvic and Ureteral Cancers
Symptoms and Signs
Diagnosis
Treatment
Prognosis
Key Points
Testicular Cancer
General reference
Symptoms and Signs
Diagnosis
Treatment
Radiation therapy
Lymph node dissection
Chemotherapy
Surveillance
Recurrences
Prognosis
Key Points
Urethral Cancer
Symptoms and Signs
Diagnosis
Treatment
Prognosis
Glomerular Disorders
Overview of Glomerular Disorders
Diagnosis
Overview of Nephritic Syndrome
Acute glomerulonephritis
Chronic glomerulonephritis
Alport Syndrome
Symptoms and Signs
Diagnosis
Treatment
Treatment reference
Key Points
Immunoglobulin A Nephropathy
Symptoms and Signs
Diagnosis
Treatment
Angiotensin inhibition in IgA nephropathy
Sodium-glucose cotransporter 2 inhibitors
Corticosteroids and immunosuppressants in IgA nephropathy
Other treatments
Treatment references
Prognosis
Key Points
Postinfectious Glomerulonephritis (PIGN)
Etiology
Symptoms and Signs
Diagnosis
Treatment
Prognosis
Key Points
Rapidly Progressive Glomerulonephritis (RPGN)
Antiglomerular basement membrane antibody disease
Immune complex RPGN
Pauci-immune RPGN
Double-antibody disease
Idiopathic RPGN
Symptoms and Signs
Diagnosis
Treatment
Treatment references
Prognosis
Key Points
Thin Basement Membrane Disease
Symptoms and Signs
Diagnosis
Treatment
Overview of Nephrotic Syndrome
Etiology
Pathophysiology
Complications of nephrotic syndrome
Symptoms and Signs
Diagnosis
Urine testing
Adjunctive testing in nephrotic syndrome
Testing for secondary causes of nephrotic syndrome
Treatment
Treatment of disorder causing nephrotic syndrome
Proteinuria treatment
Edema treatment
Dyslipidemia treatment
Hypercoagulability treatment
Management of infection risk
Nephrectomy for nephrotic syndrome
Prognosis
Key Points
Congenital Nephrotic Syndromes
Diffuse mesangial sclerosis
Finnish-type nephrotic syndrome
Other congenital nephrotic syndromes
Diabetic Nephropathy
Pathophysiology
Symptoms and Signs
Diagnosis
Urinary protein
Screening
Treatment
Blood glucose control
Blood pressure control
Dyslipidemia
Other treatments
Kidney transplantation
Treatment references
Prognosis
Key Points
More Information
Focal Segmental Glomerulosclerosis
Symptoms and Signs
Diagnosis
Treatment
Immunosuppressive therapy
Prognosis
Key Points
HIV-Associated Nephropathy
Diagnosis
Treatment
Membranous Nephropathy
Etiology
Symptoms and Signs
Diagnosis
Diagnosis of cause
Diagnosis reference
Treatment
Immunosuppressive therapy
Treatment references
Prognosis
Key Points
Minimal Change Disease
Symptoms and Signs
Diagnosis
Treatment
Corticosteroids
Other immunosuppressive therapies
Treatment references
Prognosis
Prognosis reference
Key Points
Fibrillary and Immunotactoid Glomerulopathies
Diagnosis
Treatment
Prognosis
Lupus Nephritis
Pathophysiology
Antiphospholipid syndrome nephropathy
Symptoms and Signs
Diagnosis
Treatment
Immunosuppression
Other treatments
Treatment references
Prognosis
Key Points
Membranoproliferative Glomerulonephritis
Immunoglobulin/immune complex–mediated MPGN
Complement-mediated MPGN
Membranoproliferative pattern MPGN without immunoglobulin or complement deposition
Symptoms and Signs
Diagnosis
Treatment
Prognosis
More Information
Key Points
How To Do Genitourinary Procedures
How To Do Paraphimosis Reduction Without Dorsal Slit
Indications
Contraindications
Complications
Equipment
Additional Considerations
Positioning
Step-by-Step Description of Procedure
Aftercare
Warnings and Common Errors
Tips and Tricks
Reference
How To Do Urethral Catheterization in a Female
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Aftercare
Warnings and Common Errors
Tips and Tricks
How To Do Urethral Catheterization in a Male
Indications
Contraindications
Complications
Equipment
Additional Considerations
Relevant Anatomy
Positioning
Step-by-Step Description of Procedure
Aftercare
Warnings and Common Errors
Tips and Tricks
How To Remove a Zipper From a Penis
Indications
Contraindications
Complications
Equipment
Additional Considerations
Positioning
Step-by-Step Description of Procedure
Aftercare
Warnings and Common Errors
Tips and Tricks
Male Reproductive Endocrinology and Related Disorders
Male Reproductive Endocrinology
Physiology
Sexual Differentiation, Adrenarche, and Puberty
Effects of Aging
Gynecomastia
Pathophysiology
Etiology
Evaluation
History
Physical examination
Red flags
Interpretation of findings
Testing
Treatment
Key Points
Male Hypogonadism
Etiology
Symptoms and Signs
Diagnosis
Diagnosis of primary and secondary hypogonadism
Evaluation of secondary hypogonadism
Treatment
Testosterone replacement therapy (TRT)
Treatment of infertility due to hypogonadism
Key Points
Male Sexual Function and Dysfunction
Overview of Male Sexual Function and Dysfunction
Libido
Erection
Emission, Ejaculation, and Orgasm
Ejaculatory dysfunction
References
Erectile Dysfunction
Reference
Etiology
Etiology reference
Diagnosis
Testing
Treatment
Medications for erectile dysfunction
Mechanical devices and procedures
Surgery for erectile dysfunction
Treatment references
Key Points
Obstructive Uropathy
Obstructive Uropathy
Etiology
Pathophysiology
Obstructive nephropathy
Symptoms and Signs
Diagnosis
Evaluation of suspected urethral obstruction
Evaluation of ureteral or more proximal obstruction
Evaluation of hydronephrosis without apparent obstruction
Diagnosis reference
Treatment
Treatment reference
Prognosis
Key Points
Penile and Scrotal Disorders
Balanitis, Posthitis, and Balanoposthitis
Symptoms and Signs
Diagnosis
Treatment
Treatment reference
Cutaneous Penile Lesions
Balanitis xerotica obliterans
Carcinoma in situ
Penile lichen planus
Pearly penile papules
Contact dermatitis of the penis
Epididymitis
Etiology
Bacterial epididymitis
Nonbacterial epididymitis
Symptoms and Signs
Diagnosis
Treatment
Treatment reference
Key Points
Orchitis
Symptoms and Signs
Diagnosis
Treatment
Peyronie Disease
General reference
Treatment
Phimosis and Paraphimosis
Phimosis
Paraphimosis
Testicular Torsion
Symptoms and Signs
Symptoms and signs reference
Diagnosis
Treatment
Key Points
More Information
Urethral Stricture
General reference
Symptoms and Signs
Diagnosis
Treatment
Renal Replacement Therapy
Overview of Renal Replacement Therapy
Continuous Hemofiltration and Hemodialysis
General reference
Hemodialysis
Settings for hemodialysis
Vascular access for dialysis
Vascular access complications
General references
Complications of Hemodialysis
Complications reference
Prognosis
Prognosis reference
Peritoneal Dialysis
Access
General reference
Complications of Peritoneal Dialysis
Peritonitis
Catheter tunnel exit-site infection
Complications references
Prognosis
Prognosis reference
Medical Aspects of Long-Term Renal Replacement Therapy
Diet
Anemia of renal failure
Coronary artery disease
Hyperphosphatemia
Hypocalcemia and secondary hyperparathyroidism
Aluminum toxicity
Bone disease
Vitamin deficiencies
Calciphylaxis
Constipation
References
Renal Transport Abnormalities
Introduction to Renal Transport Abnormalities
Fanconi Syndrome
Etiology
Hereditary Fanconi syndrome
Acquired Fanconi syndrome
Pathophysiology
Symptoms and Signs
Diagnosis
Treatment
Treatment references
Key Points
Liddle Syndrome
Diagnosis
Treatment
More Information
Arginine
Vasopressin
Resistance
General reference
Etiology
Inherited AVP-R
Acquired AVP-R
Symptoms and Signs
Diagnosis
Water deprivation test
Treatment
Prognosis
Key Points
Pseudohypoaldosteronism Type I
Autosomal recessive pseudohypoaldosteronism type I
Autosomal dominant pseudohypoaldosteronism type 1
Diagnosis
Treatment
Renal Glucosuria
Symptoms and Signs
Diagnosis
Treatment
Renal Tubular Acidosis
Type 1 (distal) RTA
Type 2 (proximal) RTA
Type 4 (generalized) RTA
Symptoms and Signs
Symptoms and signs reference
Diagnosis
Treatment
Type 1 RTA
Type 2 RTA
Type 4 RTA
Key Points
Renovascular Disorders
Hypertensive Arteriolar Nephrosclerosis
Symptoms and Signs
Diagnosis
Treatment
Treatment reference
Prognosis
Key Points
Renal Artery Stenosis and Occlusion
Etiology
Acute renal artery occlusion
Chronic progressive renal artery stenosis
Symptoms and Signs
Diagnosis
Treatment
Acute renal artery occlusion
Chronic progressive renal artery stenosis
Renovascular hypertension
Treatment reference
Key Points
Renal Atheroembolism
Symptoms and Signs
Diagnosis
Treatment
Prognosis
Key Points
Renal Cortical Necrosis
Etiology
Symptoms and Signs
Diagnosis
Treatment
Prognosis
Key Points
Renal Vein Thrombosis
Etiology
Symptoms and Signs
Diagnosis
Treatment
Prognosis
Key Points
Tubulointerstitial Diseases
Overview of Tubulointerstitial Diseases
Pathophysiology
Acute Tubular Necrosis (ATN)
Etiology
Etiology references
Symptoms and Signs
Diagnosis
Treatment
Prognosis
Prognosis reference
Prevention
Key Points
Analgesic Nephropathy
References
Symptoms and Signs
Diagnosis
Diagnosis reference
Treatment
Contrast Nephropathy
Risk factors for contrast nephropathy
Diagnosis
Treatment
Prevention
Key Points
Heavy Metal Nephropathy
Lead nephropathy
Cadmium nephropathy
Other heavy metal nephropathies
Metabolic Nephropathies
Acute urate nephropathy
Chronic urate nephropathy
Hyperoxaluria
Hypercalcemia
Chronic hypokalemia
Myeloma-Related Kidney Disease
Tubulointerstitial disease
Glomerulopathies
Symptoms and Signs
Diagnosis
Treatment
Treatment reference
Prognosis
Key Points
Tubulointerstitial Nephritis
Etiology
Acute tubulointerstitial nephritis
Chronic tubulointerstitial nephritis
General references
Symptoms and Signs
Acute tubulointerstitial nephritis
Chronic tubulointerstitial nephritis
Diagnosis
Acute tubulointerstitial nephritis
Chronic tubulointerstitial nephritis
Treatment
Prognosis
Acute tubulointerstitial nephritis
Chronic tubulointerstitial nephritis
Key Points
Vesicoureteral Reflux and Reflux Nephropathy
Reference
Symptoms and Signs
Diagnosis
Prenatal diagnosis
Postnatal diagnosis
Diagnosis references
Treatment
Key Points
Urinary Calculi
Urinary Calculi
Etiology
Pathophysiology
Symptoms and Signs
Diagnosis
Urinalysis
Imaging tests
Identifying the cause
Diagnosis references
Treatment
Analgesia
Expulsive therapy
Calculus removal
Calculus dissolution
Prevention
General reference
Key Points
Urinary Tract Infections (UTIs)
Introduction to Urinary Tract Infections (UTIs)
Bacterial Urinary Tract Infections
References
Pathophysiology
Risk factors
Pathophysiology reference
Etiology
Classification
Urethritis
Cystitis
Acute urethral syndrome
Asymptomatic bacteriuria
Acute pyelonephritis
Classification reference
Symptoms and Signs
Diagnosis
Urine collection
Urine testing
Infection localization
Other testing
Diagnosis reference
Treatment
Urethritis
Cystitis
Acute urethral syndrome
Asymptomatic bacteriuria
Acute pyelonephritis
Treatment references
Prevention
Prevention references
Key Points
Catheter-Associated Urinary Tract Infections
References
Symptoms and Signs
Diagnosis
Treatment
Prevention
Prevention reference
Key Points
Chronic Pyelonephritis
Symptoms and Signs
Diagnosis
Treatment
Prognosis
Key Points
Fungal Urinary Tract Infections
Symptoms and Signs
Diagnosis
Treatment
Key Points
Voiding Disorders
Overview of Voiding
Interstitial Cystitis
Symptoms and Signs
Diagnosis
Treatment
Lifestyle modification
Choice of treatment
Drug therapies
Surgical and other procedures
Key Points
Neurogenic Bladder
Symptoms and Signs
Diagnosis
Treatment
Catheterization
Medications and other therapies
Surgery
Key Points
Urinary Incontinence in Adults
Types
Etiology
Transient incontinence
Established incontinence
Evaluation
History
Physical examination
Testing
Treatment
General measures
Bladder training
Kegel exercises
Drugs
Urge incontinence
Stress incontinence
Overflow incontinence
Refractory incontinence
Treatment references
Key Points
Urinary Retention
Diagnosis
Treatment
Key Points