The American Urological Association (AUA) is a professional association in the United States for urology professionals. It has its headquarters at the William P. Didusch Center for Urologic History in Maryland.AUA works with many international organizations, representing urologists from across the world. These groups offer full or half day sessions, covering a variety of topics, during the annual meeting..
PURPOSE:The recommendations discussed on the early detection of prostate cancer provide a framework to facilitate clinical decision-making in the implementation of prostate cancer screening and follow-up. MATERIALS AND METHODS:The Early Detection of Prostate Cancer Guideline was reviewed in 2025 and updated through the AUA amendment process. This process involved reviewing and integrating newly published literature into the previously established Guideline. The methodologist updated the original Guideline search strategy to systematically search Ovid MEDLINE and Embase for new evidence published between November 2022 and December 2024. RESULTS:The Early Detection of Prostate Cancer Amendment Panel updated evidence- and consensus-based Guideline statements to provide guidance on prostate cancer screening, imaging and biomarker use, initial and repeat biopsies, and biopsy technique. CONCLUSIONS:This update provides several new insights, including revised strength of evidence based on recently published literature on the use of MRI in biopsy-naïve patients and biopsy techniques, updates on available biomarkers, and revised recommendations for atypical small acinar proliferation (ASAP). This Guideline will require future review and updates, as early detection and diagnostic strategies in this space continue to evolve.
PURPOSE:Following completion of the 2025 Update Literature Review (ULR), the American Urological Association (AUA) incorporated new evidence generated since the 2022 publication of this Guideline via the AUA Amendment process. The resulting 2026 Guideline Amendment addresses updated recommendations to provide a clinical framework for the evaluation and management of clinically localized prostate cancer. MATERIALS AND METHODS:In 2025, this Guideline was reviewed via the AUA ULR process, which identified 29 studies for full-text review that were published between July 1, 2021 and December 5, 2024. An additional 8 studies were identified reviewing artificial intelligence (AI) as it relates to disease management. Relevant studies were incorporated into the Guideline evidence base, and Guideline statements were updated as appropriate. RESULTS:The Panel developed evidence- and consensus-based statements based on an updated review to provide guidance on evaluation and management of clinically localized prostate cancer. These updates are detailed herein. CONCLUSIONS:This Amendment provides several new insights, including revised guidance on imaging, updated information on shared decision-making (SDM), and new direction regarding radiation treatment and disease management. This Guideline will require further review as the diagnostic and treatment options in this space continue to evolve.
PURPOSE:Following completion of the 2025 Update Literature Review (ULR), the American Urological Association (AUA) incorporated new evidence generated since the 2023 publication of this Guideline via the AUA Amendment process. The summary presented herein represents Part II of the two-part series dedicated to addressing updated recommendations to provide a clinical framework for the evaluation and management of metastatic castration-resistant prostate cancer (mCRPC). MATERIALS AND METHODS:The AUA/SUO Advanced Prostate Cancer Guideline was reviewed via the AUA ULR process, which identified 38 studies for full-text review that were published between March 16, 2022, and August 26, 2025. Relevant studies were incorporated into the Guideline evidence base, and Guideline statements were updated as appropriate. RESULTS:The Panel developed evidence- and consensus-based statements based on an updated review to provide guidance on evaluation and management of advanced prostate cancer. These updates are detailed herein. CONCLUSIONS:Part II of this Amendment provides new guidance on treatment of mCRPC and discusses future directions for the evaluation and management of advanced prostate cancer overall. Additional guidance regarding non-metastatic castration-resistant prostate cancer (nmCRPC) was deemed current following review. This Guideline will require further review as the diagnostic and treatment options in this space continue to evolve.
PURPOSE:Benign prostatic hyperplasia (BPH) refers to the proliferation of glandular and stromal components within the transition zone of the prostate. Non-neurogenic lower urinary tract symptoms (LUTS) can be due to bladder, prostate, urethral, or other pathology. Bothersome LUTS is the main reason patients seek treatment and generally drives management decisions. As such, shared decision-making plays a critical role in the initiation and escalation of treatment. This Guideline covers the evaluation and treatment of LUTS/BPH. The summary presented herein represents Part I of the three-part series dedicated to Management of LUTS/BPH. Please refer to Parts II and III and the full version of the Guideline for additional information on this topic. MATERIALS AND METHODS:The systematic review that informs this Guideline was based on searches in Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews through January 2025. Update searches were conducted on December 15, 2025. Literature searches were limited to studies of medical therapies published since 2009 and surgical studies published since 2014. The searches were supplemented by reviewing electronic database reference lists of relevant articles. Criteria for inclusion and exclusion of studies were based on the Key Questions and the populations, interventions, comparators, outcomes, timing, types of studies and settings (PICOTS) of interest developed by the Panel. RESULTS:The recommendations herein address initial presentation, evaluation, and initial management of patients with LUTS/BPH. Where possible, evidence levels were assigned along with relevant supporting text to assist clinicians when encountering men with LUTS/BPH. Standard evaluation is established with appropriate tests and shared decision-making. CONCLUSIONS:The presentation, evaluation, and initial management of patients presenting with LUTS/BPH is straightforward. In addition to patient history and physical examination, the recommendations herein include the appropriate use of tests and patient counseling.
OBJECTIVE:To evaluate longitudinal trends in the Urology In-Service Examination (ISE) from 2016 to 2023 and identify changes in performance patterns over time. METHODS:Retrospective cohort analysis of aggregate ISE scores provided by the American Urological Association. Mean percent-correct scores across postgraduate years (PGY1-5) and subtopics were analyzed from 2016 to 2023. 2020 was used as a temporal marker for the onset of the COVID-19 pandemic in sub-analyses. Two-sample t tests determined statistical significance (α ≤ 0.05). RESULTS:A total of 680 scores were analyzed. Mean scores increased with PGY level (43%-46% in PGY1 to 68%-71% in PGY5) but declined over time. Linear trend analysis showed a statistically significant decline for PGY2-5, with the steepest and strongest correlation seen in PGY3-5. Subtopic declines were most notable in calculous disease (64.2% to 56.1%, P = .01) and physiology/immunology/adrenal (70.2% to 56.5%, P <.001), both affecting all PGY levels. Additional decreases were noted in pediatrics (PGY2-4), congenital anomalies/embryology/anatomy (PGY1-2, 4), and imaging (PGY3-4). In contrast, PGY1 scores in fluid & electrolytes/transplant/hypertension/vascular/nephrology improved modestly (50.5% vs 56.0%, P = .05). Performance on 217 repeated questions was stable (69.3% vs 69.7%). CONCLUSION:Mean ISE performance declined from 2016 to 2023 across all PGY levels, with the greatest decreases observed in general urology subtopics. Scores after 2020 were lower across most PGY levels and content domains, while performance on repeated questions remained stable. These trends may reflect increased examination difficulty, expanded content, changes in question composition, evolving study strategies, and variability in clinical exposure rather than diminished knowledge.
