Introduction

Learning objectives

Structure a complete urological history starting from the chief complaint.
Know the urological, general, and sexual history relevant to the diagnosis.
Understand the importance of assessing the impact of symptoms on quality of life.

🩺 Practice with a virtual patient · INFIN Virtual Patient

Practice taking a history in a simulated, AI-powered consultation: talk with Carlos, a 68-year-old patient with urinary symptoms, by typing or speaking. You can then request the physical exam and tests, propose a diagnosis and a treatment, and get an evaluation at the end. It is a complementary practice tool, free to use.

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Video

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Summary

The medical history remains one of the most important tools for guiding the urological diagnosis.

Reason for consultation

First we need to identify what led the patient to seek care:

pain;
difficulty urinating;
hematuria;
infection;
incontinence;
genital abnormalities;
sexual dysfunction;
infertility;
incidental finding on a test.

Characteristics of the symptoms

We need to determine:

when they started;
intensity;
course;
triggering factors;
associated symptoms;
previous treatments.

Urological history

Ask especially about:

stone disease;
urinary tract infections;
hematuria;
urinary retention;
urological surgeries;
previous catheterizations;
prostate disease;
tumors;
trauma.

General history

The following are important:

diabetes;
hypertension;
kidney disease;
neurological diseases;
smoking;
anticoagulation;
medications;
previous surgeries.

Sexual history

When appropriate, we should ask in a natural and respectful way about:

erectile function;
ejaculation;
libido;
fertility;
sexually transmitted infections.

Clinical pearl

A good urological history is not just asking "how do you urinate?". You have to understand symptoms, history, medications, and impact on quality of life.

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PDF

⬇ Download lesson summary

Downloadable PDF pending upload.

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Practical algorithm

What is wrong with the patient? → history.
What symptoms does the patient have? → characterize them correctly.
What do I find? → focused physical exam.
What is my diagnostic hypothesis?
Which test do I really need to answer it?
Is there any situation that requires referral or urgent treatment?

To remember

Urologic semiology is not about ordering many tests, but about formulating the clinical question correctly and choosing the test that can answer it.

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Clinical case

Content pending upload Progressive clinical case focused on decision-making.

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Self-assessment

Questions pending upload 5–10 multiple-choice questions on this lesson.

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References

Links pending upload References to PubMed, DOI, scientific society guidelines and journals.

How to take a urological history