Pharmacology
A searchable reference to the systemic and topical pharmacotherapy encountered in functional urology, reconstructive urology, and urogynecology — organized by clinical indication rather than chemical class. Type a drug name, agent, or use case in the search box to find the relevant class page.
For intraoperative materials (ICG, hemostatic matrices, fibrin sealants) see the materials-focused Intraoperative Adjuncts section. For implanted devices see Biomaterials.
62 of 62 drug classes
| Drug Class | Category | Key Agents | Clinical Use / Note |
|---|---|---|---|
| Antimuscarinics / Anticholinergics | Storage & OAB | Oxybutynin, tolterodine, solifenacin, darifenacin, fesoterodine, trospium | OAB medication option; discuss cognitive risk and agent-specific precautions |
| β3-Adrenergic Agonists | Storage & OAB | Mirabegron (Myrbetriq), vibegron (Gemtesa) | OAB; vibegron FDA-approved for men on BPH therapy |
| Desmopressin | Storage & OAB | DDAVP, NOCDURNA | Nocturnal polyuria; formulation-specific dosing and hyponatremia monitoring |
| Alpha Blockers | Voiding & Outlet | Tamsulosin, silodosin, alfuzosin, doxazosin, terazosin | BPH/LUTS first-line; MET for distal stones; IFIS risk |
| 5α-Reductase Inhibitors | Voiding & Outlet | Finasteride (Proscar), dutasteride (Avodart) | BPH with demonstrable enlargement; PSA interpretation and progression prevention |
| Alpha Agonists | Voiding & Outlet | Midodrine, pseudoephedrine, phenylephrine | Selected off-label uses; intracavernosal phenylephrine for acute ischemic priapism |
| Cholinergic Agonists | Voiding & Outlet | Bethanechol | Underactive bladder / detrusor underactivity; largely legacy |
| Skeletal Muscle Relaxants | Voiding & Outlet | Cyclobenzaprine, baclofen, tizanidine, methocarbamol | Pelvic-floor hypertonicity; baclofen for detrusor-sphincter dyssynergia |
| Dantrolene | Voiding & Outlet | Dantrium | Refractory dyssynergia; hepatotoxicity limits use; historical |
| Oral IC/BPS Agents | Bladder Pain & IC/BPS | Pentosan polysulfate (Elmiron), amitriptyline, hydroxyzine, cimetidine | IC/BPS options; PPS retinal risk requires baseline and periodic evaluation |
| Intravesical Agents | Bladder Pain & IC/BPS | DMSO, heparin, lidocaine, bupivacaine, rescue cocktail (lido + heparin + bicarb) | IC/BPS flare therapy; GAG replenishment; rescue cocktail |
| Gabapentinoids | Neuropathic & Pelvic Pain | Gabapentin, pregabalin | Selected neuropathic pain; routine nonspecific pelvic-pain benefit unproven |
| Tricyclic Antidepressants | Neuropathic & Pelvic Pain | Amitriptyline, nortriptyline, imipramine | IC/BPS, CP/CPPS, neuropathic pain; amitriptyline workhorse |
| SNRIs | Neuropathic & Pelvic Pain | Duloxetine, venlafaxine, milnacipran | Neuropathic pelvic pain; duloxetine SUI-approved in Europe |
| NSAIDs & Analgesics | Neuropathic & Pelvic Pain | Ibuprofen, naproxen, celecoxib, acetaminophen, ketorolac | Acute pelvic pain, post-op analgesia; ERAS narcotic-sparing |
| Topical Compounded Agents | Neuropathic & Pelvic Pain | Compounded amitriptyline, baclofen, gabapentin, ketamine, lidocaine | Off-label vulvar pain formulations; limited evidence and possible systemic absorption |
| Local Anesthetics | Neuropathic & Pelvic Pain | Lidocaine, bupivacaine, ropivacaine, mepivacaine | Pudendal blocks; intravesical; IPP and urethroplasty penile block |
| Antispasmodics | Neuropathic & Pelvic Pain | Diazepam (vaginal suppository), cyclobenzaprine, baclofen | Pelvic-floor hypertonicity adjuncts; limited evidence, sedation and withdrawal risks |
| Botulinum Toxin | Neuromodulation Adjuncts | OnabotulinumtoxinA (Botox) | Intradetrusor for OAB/NDO; external sphincter for DSD |
| Perioperative Antibiotic Prophylaxis | Infection & Prophylaxis | Cefazolin, vancomycin, gentamicin, ceftriaxone, piperacillin-tazobactam, fluconazole | Procedure, culture and device-specific prophylaxis; stewardship and observational evidence |
| UTI Treatment Antibiotics | Infection & Prophylaxis | Nitrofurantoin, TMP-SMX, fosfomycin, fluoroquinolones, β-lactams, aminoglycosides | Uncomplicated vs complicated UTI; antibiogram-driven selection |
| UTI Suppressive & Prophylactic Therapy | Infection & Prophylaxis | Nitrofurantoin, trimethoprim/TMP-SMX, cephalexin; selected postcoital regimens | Selected recurrent UTI prevention; reassess duration, cultures and adverse effects |
| Non-Antibiotic UTI Prevention | Infection & Prophylaxis | Methenamine, D-mannose, vaginal estrogen, cranberry, probiotics | Methenamine, vaginal estrogen and cranberry options; D-mannose not proven effective |
| Antifungals | Infection & Prophylaxis | Fluconazole, amphotericin B, echinocandins | Candiduria and selected prophylaxis; observational IPP evidence, not a universal protocol |
| Prosthetic Infection & Biofilm Protocols | Infection & Prophylaxis | IPP dipping solutions (vanc-gent, Irrisept by device), salvage washout regimens | Device-specific compatibility, manufacturer instructions and salvage evidence |
| PDE-5 Inhibitors | Sexual Medicine & Andrology | Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), avanafil (Stendra) | ED first-line; tadalafil 5 mg also BPH-approved; nitrate contraindication |
| Intracavernosal Injection Agents | Sexual Medicine & Andrology | Alprostadil (Caverject/Edex), bimix, trimix, quadmix | ED injection options; supervised titration, compounding and priapism precautions |
| Intraurethral Alprostadil | Sexual Medicine & Andrology | MUSE (Medicated Urethral System for Erection) | Needle-free ED option; less effective than ICI |
| Testosterone Replacement | Sexual Medicine & Andrology | Cypionate/enanthate IM, transdermal (AndroGel/Testim), pellets (Testopel), SC auto-injector (Xyosted), nasal (Natesto), oral (Jatenzo) | Hypogonadism; monitor T, CBC, PSA; not first-line for ED alone |
| Androgen Adjuncts | Sexual Medicine & Andrology | hCG, clomiphene, enclomiphene (unapproved in US), anastrozole | Selected fertility-preserving alternatives; agent-specific off-label status and monitoring |
| Peyronie's Disease Agents | Sexual Medicine & Andrology | Collagenase clostridium histolyticum (Xiaflex), interferon α-2b, verapamil | CCH only FDA-approved; IMPRESS ~8° net curvature reduction |
| Priapism Management | Sexual Medicine & Andrology | Intracavernosal phenylephrine, etilefrine, pseudoephedrine, daily low-dose PDE5i (SCD prevention) | Acute ischemic priapism emergency therapy; recurrent-priapism prevention remains uncertain |
| Vaginal & Topical Estrogen | Hormonal Therapies | Estradiol cream/ring (Estring)/tablet (Vagifem), conjugated equine estrogen cream (Premarin) | GSM; rUTI prevention (AUA-endorsed); minimal systemic absorption |
| Vaginal DHEA | Hormonal Therapies | Prasterone (Intrarosa) 6.5 mg | Postmenopausal dyspareunia; estrogen metabolite and breast-cancer label precautions |
| Vaginal Moisturizers & Lubricants | Hormonal Therapies | Hyaluronic acid, polycarbophil, polyacrylic acid, water/silicone lubricants | Nonhormonal first-line GSM therapy; default for breast-cancer survivors |
| Ospemifene | Hormonal Therapies | Osphena 60 mg daily | SERM for GSM dyspareunia; oral alternative to vaginal therapy |
| Preoperative Hormonal Priming | Hormonal Therapies | Vaginal estrogen for selected GSM symptoms around surgery | May improve GSM symptoms; not established prevention of prolapse-repair failure |
| Gender-Affirming Hormone Therapy | Hormonal Therapies | Estradiol, testosterone, progesterone, spironolactone, GnRH agonists | WPATH SOC8; individualized perioperative hormone and thrombosis assessment |
| High-Potency Topical Corticosteroids | Dermatologic & Topical Urethral | Clobetasol 0.05%, betamethasone, mometasone | Lichen sclerosus first-line; urethral use has separate off-label evidence |
| Topical Calcineurin Inhibitors | Dermatologic & Topical Urethral | Tacrolimus 0.1% (Protopic), pimecrolimus (Elidel) | Selected off-label LS / vulvar dermatosis alternatives; limited comparative evidence |
| Intralesional Corticosteroids | Dermatologic & Topical Urethral | Triamcinolone acetonide | Hunner lesions, refractory LS, keloid, dilation-resistant stricture |
| Antimitotics & Antifibrotics | Dermatologic & Topical Urethral | Mitomycin C, triamcinolone | Selected off-label scar/stenosis adjuncts; serious local injury risks and uncertain protocols |
| Drug-Coated Balloon Therapy | Dermatologic & Topical Urethral | Optilume (paclitaxel-coated balloon) | Selected male anterior urethral stricture; device label and ROBUST follow-up |
| Platelet-Rich Plasma | Dermatologic & Topical Urethral | Autologous PRP injection | Investigational urologic uses; no established routine ED or Peyronie indication |
| Visualization Agents | Intraoperative Adjuncts | ICG, methylene blue, indigo carmine, sodium fluorescein, pudexacianinium (ASP-5354) | Perfusion, ureter ID, lymphatic mapping; ICG needs NIR |
| Hemostatic Agents | Intraoperative Adjuncts | Surgicel, Arista AH, Gelfoam/Surgiflo, FloSeal, topical thrombin (Evithrom/Recothrom) | Diffuse oozing; passive vs active; FloSeal for renal bed |
| Tissue Sealants | Intraoperative Adjuncts | Fibrin sealants (Tisseel/Evicel/Artiss), TachoSil, cyanoacrylates (Dermabond), PEG (CoSeal) | Anastomotic reinforcement; PICS for Peyronie's; skin closure |
| Hydrodissection | Intraoperative Adjuncts | Saline ± epinephrine, vasopressin, ornipressin, lidocaine + epinephrine | Vaginal-wall plane development + hemostasis (prolapse surgery, vaginal hysterectomy, colpocleisis) |
| Tranexamic Acid | Intraoperative Adjuncts | TXA — IV, oral, topical, irrigation | Antifibrinolytic; benefit and risks depend on procedure and route |
| Liposomal Bupivacaine | Intraoperative Adjuncts | Exparel (bupivacaine liposome injectable suspension) | Formulation-specific infiltration/nerve blocks; benefit over plain bupivacaine inconsistent |
| VTE Prophylaxis | Perioperative & ERAS | Enoxaparin, unfractionated heparin, rivaroxaban, apixaban, SCDs | Postoperative thromboprophylaxis; procedure, patient and bleeding risk assessment |
| Anticoagulation Reversal | Perioperative & ERAS | Idarucizumab, 4-factor PCC, vitamin K, protamine; andexanet US withdrawal | Emergent reversal for bleeding or urgent surgery; agent-specific |
| Bowel Preparation | Perioperative & ERAS | PEG (MoviPrep, GoLYTELY), sodium phosphate, oral antibiotics (neomycin + erythromycin/metronidazole) | Selective preparation; routine mechanical prep not recommended before cystectomy |
| Post-op Bowel & Ileus Management | Perioperative & ERAS | Alvimopan, osmotic/stimulant laxatives; neostigmine for selected ACPO | Postoperative bowel dysfunction; distinguish ileus, constipation and obstruction |
| Corticosteroids | Perioperative & ERAS | Dexamethasone, methylprednisolone, prednisone, hydrocortisone | PONV and indication-specific use; avoid routine chronic systemic IC/BPS treatment |
| Urinary Acidifiers | Urinary Diversion-Specific | Sodium bicarbonate (for acidosis), ammonium chloride, ascorbic acid | Acid-base management in ileal conduit / orthotopic neobladder |
| Vitamin B12 Supplementation | Urinary Diversion-Specific | Cyanocobalamin IM or oral, methylcobalamin | Post-ileal-resection deficiency; annual monitoring after diversion |
| Mucus Management | Urinary Diversion-Specific | Saline irrigation; selected mucolytic adjuncts with limited evidence | Conduit / pouch mucus; prevents catheter obstruction |
| Parasympathomimetics | Legacy & Low-Evidence | Bethanechol, neostigmine, pyridostigmine | Underactive bladder; evidence weak; largely legacy |
| Imipramine | Legacy & Low-Evidence | Tofranil | Historical SUI and childhood enuresis; largely superseded |
| Phenazopyridine | Legacy & Low-Evidence | Pyridium, AZO | Symptomatic analgesic; 2-day max; G6PD hemolysis risk |
| Phytotherapy | Legacy & Low-Evidence | Saw palmetto (Serenoa repens), beta-sitosterol, pumpkin seed, Pygeum africanum | Saw palmetto offers little/no meaningful benefit; products are not interchangeable |