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Laboratory Studies

Laboratory testing in functional urology and urogynecology is anchored on a small set of high-yield clusters: urine studies (the workhorse), renal function and post-diversion metabolic surveillance, hormonal assessment (testosterone, gonadotropins, PSA), and a focused set of preoperative labs. Interpretation is fundamentally context-dependent — thresholds that define a UTI in a healthy outpatient woman are meaningless in a neobladder; PSA reference ranges built from cisgender unmedicated men do not apply in patients on 5-ARI or in trans women on estrogen; routine preop labs are low-yield in healthy ASA 1-2 patients undergoing minor reconstructive procedures. The pages below collect the validated thresholds, AUA / IDSA / KDIGO / NCCN guideline-anchored recommendations, and the framework for interpreting these tests in the reconstructive-urology and urogynecology populations where standard cutoffs do not apply.

  • Urine StudiesSpecimen collection, dipstick and microscopic urinalysis, urine culture thresholds by collection method, urine cytology in bladder-cancer surveillance, the Meares-Stamey localization test, 24-hour urine for stone disease, EQUC and next-generation sequencing, and interpretation in urinary diversions, augmented bladders, and CIC patients.
  • Renal Function & Metabolic SurveillanceSerum creatinine and eGFR per KDIGO 2024, BMP/CMP for the three classic post-diversion derangements (hyperchloremic acidosis, hypokalemia, hyponatremia), vitamin B12 surveillance after ileal/ileocecal segments, bone-density panel, and the AUA/SUFU annual surveillance schedule for bowel-based reconstructions.
  • Hormonal AssessmentTotal testosterone (AUA <300 ng/dL deficiency threshold), reflex LH/FSH/prolactin/estradiol, hematocrit on TRT, and PSA — including the reconstruction-specific interpretation caveats: 5-ARI halves the measured value; gender-affirming estrogen suppresses PSA to a median of 0.02 ng/mL.
  • Preoperative LabsWhat to order vs. skip — anchored on AAFP / ACP de-implementation guidance. CBC, coagulation, glucose/HbA1c, BMP, and type-and-screen by procedural risk and patient comorbidity. Routine preop labs in healthy ASA 1-2 patients are low-yield and not recommended.