Genitourinary Pathology

What Is Genitourinary Pathology?

Genitourinary pathology is a medical sub-specialty of surgical pathology. It may also be referred to as urologic pathology. It focuses on the tissue-based diagnosis of the male reproductive system and the male and female urinary systems, including genitourinary cancers, inflammatory conditions, and degenerative diseases.

A genitourinary pathologist is a type of doctor with highly specialized training who analyzes tissues and focuses on diagnosing diseases of the genitourinary system, including those that affect the:

• Adrenal glands
• Bladder
• Kidneys
• Penis
• Prostate
• Testis
• Urethra
• Vas deferens

They examine samples that come from biopsies and tissues that have been surgically removed. Techniques used to look at the samples include histopathology, cytology, immunohistochemistry, and molecular pathology to diagnose various conditions.

Genitourinary pathology is a subspecialty for doctors certified in pathology. Genitourinary pathologists don’t directly treat patients. They work closely with other doctors, like urologists and urologic surgeons, to help diagnose conditions from sexually transmitted infections to cancers.

What Do Genitourinary Pathologists Do?

Genitourinary pathologists use different types of microscopes and other specialized tools to examine tissue samples, including those from surgically removed tissue, urine, and skin.

They have extensive schooling and training to identify cancers, infectious diseases, immune system disorders, and more.

A genitourinary pathologist can also provide individualized information about any cancer that is found to help the physician understand how best to treat the cancer.

What’s The Difference Between a Urologist and a Genitourinary Pathologist?

A urologist is a doctor you’ll see for preventive care, diagnosis, and treatment of conditions of the male reproductive system and the male and female urinary systems. You might see a urologist for kidney and urinary infections, pelvic organ prolapse, urinary incontinence, bladder pain, testosterone replacement therapy, erectile dysfunction, kidney stones, prostate issues, and more.

They’re specially trained to examine and diagnose disorders of the male and female urinary system and the male reproductive system. They may also care for patients with reproductive cancers.

When a diagnosis can’t be made with a visual exam and medical history, or when more information is needed, a tissue sample can be sent to a genitourinary pathologist for study under a microscope.

Genitourinary pathologists are experts in diagnosing and providing detailed information about cancers, immunological conditions that affect the urinary or male reproductive system, infectious diseases, lesions, rashes, and more from tissue samples.

What Types of Tissues Do Genitourinary Pathologists Study?

Genitourinary pathology studies the changes that occur in the male or female urinary system and male reproductive system due to disease. Some conditions that a genitourinary pathologist may study include tissue samples taken from:

• Cysts
• Fluids/discharge
• Fungal infections
• Lesions
• Organs of the urinary and male reproductive system
• Polyps
• Rashes
• Tumors
• Ulcers
• Urinary calculi (stones)
• Urine

A genitourinary pathologist is an expert in conditions like:

• Adenosis
• Amyloidosis
• Cancers of the adrenal glands, kidneys, bladder, penis, prostate, and testicles
• Cystitis
• Leukemia
• Prostatitis
• Renal tuberculosis
• Sexually transmitted diseases
• And much, much more.

Techniques to Identify Genitourinary Conditions

After a tissue sample is obtained and processed, a genitourinary pathologist uses specialized techniques, tools, and processes to investigate its condition.

Genitourinary pathologists are experts in other testing techniques that may provide more information if needed. Some tools and methods they use include:

Stains – Chemicals or stains can be applied to tissue samples to highlight signs of disease or cell abnormalities. Different stains are used to identify causes, foreign substances, and other markers that identify characteristics of the specimen.

Direct immunofluorescence – A special type of staining that helps identify autoimmune diseases.

Frozen section – A sample can be frozen and examined at once if a diagnosis is needed quickly, like during surgery.

Immunohistochemistry – This technique uses the body’s own antibodies to help identify the interaction between the antibodies and antigens triggering the immune system.

Electron microscopy – A special type of microscope that uses a beam of electrons instead of light, which allows pathologists to examine cell structures not otherwise visible.

Flow cytometry – A technique of analyzing the identity and quantity of a type of cell or particle. Samples are suspended in fluid and passed through different light sources, lenses, and filters to generate wavelength data. Flow cytometry can measure characteristics like cell size, total DNA, and more.

What Do Results Look Like?

The results of a genitourinary pathological examination are documented in a biopsy or pathology report, which includes information like:

• A diagnosis
• A description of the tissue sample
• A microscopic description of the disease process discovered
• Clinical data that helped support the diagnosis
• Additional information to help determine treatment
• If cancer is found, it may also include information to help form a treatment plan
• Comments from the pathologist

The report is sent to the treating doctor, who will discuss the results with the patient.