5 Common Types of Urology Exams to Know

So you've taken the first step and made an appointment to visit a urologist — chances are, you are now wondering just what types of urology exams might you be subjected to and why.

Top 5 Commonly Performed Urology Exams

It all depends on how you are feeling at the time of your appointment and the symptoms you are experiencing, but listed below are five of the most frequent exams and procedures performed at most urologist offices:

Physical Exam

Perhaps you think you may have a urinary tract infection or you are a man experiencing erectile dysfunction, either way a urologist will start with a series of questions and paperwork. These questions will lead to an in-office physical examination of the kidneys, ureters and bladder if you are having urinary tract issues or an examination of the penis and testis if you are having erectile dysfunction or other symptoms affecting the penis or testicles.

Other physical examinations include the Digital rectal exam (DRE) which is an exam of the prostate gland.

By inserting a lubricated, gloved finger into the rectum, the urologist can feel the prostate to measure its size or detect any abnormal nodules or firmness. Any abnormalities may will lead the urologist to order further tests (an ultrasound or biopsy).

Blood Tests

Urologists find several blood tests to be useful in determining the health of the urinary system, male erectile dysfunction or infertility. These tests include:

PSA Test

Prostate specific antigen (PSA) is helps to detect prostate cancer or can indicate inflammation of the prostate. PSA is a substance released from the prostate tissue and is measured by a simple blood test. 

Creatinine and BUN Tests

A creatinine blood test and a blood urea nitrogen (BUN) test help to assess kidney function. A high level of creatinine in the blood may mean that the kidneys are not in proper working order. A creatinine to BUN ratio can be found by using the two tests together. 

Testosterone Test

Checking the levels of testosterone in the blood is important when evaluating male erectile dysfunction. To evaluate infertility, several different blood tests are used.

Urine Tests


To help diagnose the cause of your symptoms, your urologist may choose to order many different types of urine analysis tests. 

There are many tests performed on urine that help the urologist diagnose disease or monitor treatment. Some commonly performed tests include:


urinalysis is a diagnostic test of your urine. This test is done in your urologist's office and requires you to urinate into a sterile cup.

The sample is sent to a laboratory for analysis and the results provide a lot of information about your kidneys, can even indicate disease in other organs as well. If you have complaints of frequent or painful urination, blood in your urine, back or abdominal pain, a urinalysis may pinpoint where your complaints are coming from.

A visual exam of the urine shows color, clarity or murkiness, and density. The laboratory part of the exam detects bacteria, white blood cells, red blood cells, epithelial cells, casts, glucose, ketones, protein, bilirubin, crystals and chemical markers suggestive of infection known as leukesterase and nitrites. Normally, the urine should be clear of these elements.

Bacteria, white blood cells, leukesterase and nitrites are suggestive of a urinary tract infection. Depending on what is found, certain diagnoses may be likely—although not necessarily definitive. For example, a high glucose level (or sugar) may be of concern and your doctor may order more definitive tests to see if you have diabetes. High protein levels, bilirubin, and red blood cells may be an early indication of kidney disease.

Urine Cultures and Sensitivity Studies

When a urinary tract infection is suspected, your urologist will order a urine culture test. This test is performed in a laboratory and cultures are incubated for several hours. Any bacterial growth is examined by a lab technician to determine the type of bacteria causing the infection. Subsequent sensitivity studies are then performed on the culture growth to see which antibiotics will most likely kill the bacteria to clear up the infection.

24-hour Urine Tests

For this type of test, you will have to collects all urine that you expel in a 24 hour time period. This will help to detect many disease processes as a lab will analyze the urine (which you have to collect in a large bottle) for abnormal levels of the many substances filtered from the bloodstream by your kidneys.

Ultrasound, X-Rays and other Imaging

When a problem is not readily visible to the doctor's naked eye, you may be sent for tests that use ultrasound, x-rays and other imaging technology to get a better look.

An imaging tool that is often used right in the urology office is an ultrasound machine, which is most often used to examine the kidneys, the bladder, the prostate and the testicles. An ultrasound machine may helps to detect and diagnose many conditions such as:

  • tumors
  • cysts
  • stones
  • kidney enlargement
  • abnormal movement of the bladder and urethra

To diagnose conditions of the urinary tract, different x-rays may be ordered by your urologist. These x-rays include:

  • A Kidney, Ureter, and Bladder (KUB) x-ray. This test is exactly as the name suggests and is often performed to assess for causes of abdominal pain, or to assess the organs and structures of the urinary system.
  • Intravenous pyelogram x-ray (IVP). This type of x-ray requires a contrast (dye) injected into the bloodstream to help define the structures of the urinary tract to better see stones, tumors or other conditions and abnormalities.
  • Voiding Cystourethrogram x-ray (VCUG). This test is done while the bladder fills and empties to examine the bladder and urethra using radiopaque liquid (that can be seen on x-ray). 

When a test that is more sensitive than x-ray diagnostics is required, then a CT scan may be ordered. A CT stands for "computerized tomography" that uses helps diagnose urologic disorders such as stones, tumors and cysts. Other types of imaging include a cystoscopy which requires a local anesthetic to numb the urethra before a small telescope-like instrument is inserted into the bladder. The bladder is then filled with water while the urethra, the prostate in men and the inside of the bladder is examined. This type of imaging can observe bladder tumors and other abnormalities of the bladder wall.

Semen Analysis

In cases of male infertility, a semen analysis is done as a first step. For this test, you will provide a sample to your urologists office. The sample is then sent to a lab where a laboratory technician will examine it for the presence of sperm and the motility and quality of the sperm. 

This test is also conducted after a vasectomy to determine if the sperm has successfully been eliminated from the ejaculate after the procedure.


Kreder KJ, Williams RD. Urologic laboratory examination. In: Tanagho EA, McAninch JW. Eds. Smith’s General Urology. 17th edition. 2008. New York:McGraw Hill

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