Flowcharts
Every urology cancer as a single connected pathway. Follow the constellation of phases from first suspicion to the final line of treatment.
Acute Epididymitis
The EAU 2026 acute epididymitis pathway — exclude testicular torsion first, stratify the likely organism (a sexually transmitted infection versus Enterobacterales), work up with mid-stream and first-voided urine culture plus NAAT and scrotal ultrasound, treat empirically to cover C. trachomatis and Enterobacterales (adding single-dose ceftriaxone when gonorrhoea is likely), manage supportive care and complications, and take the STI test of cure fourteen days after the antibiotic course ends, with partner tracing. Switch between the visual Pathway map and the phase-by-phase Explorer.
Bacterial Prostatitis
The EAU 2026 bacterial prostatitis pathway (NIDDK/NIH Types I & II) — the acute-versus-chronic split drives diagnostic workup, empirical-then-culture-directed antibiotics with prostate-penetration-driven durations, management of acute retention and prostatic abscess, and the chronic fluoroquinolone-first regimen with pathogen-directed alternatives. Switch between the visual Pathway map and the phase-by-phase Explorer.
Bladder Cancer
The complete EAU 2026 bladder cancer pathway — from haematuria work-up through NMIBC risk groups, MIBC management, BCG failure, adjuvant therapy and metastatic lines of treatment. Switch between the visual Pathway map and a step-by-step Guided tool.
Bladder Stones
The EAU 2026 bladder stone pathway — a distinct entity from upper-tract stones. Classify the stone as primary/endemic, secondary or migratory (bladder outlet obstruction is behind 45–79% of adult cases), diagnose it with ultrasound first-line then cystoscopy or CT, then diagnose the CAUSE, treat the stone endoscopically (transurethral → percutaneous → open, with a separate children's lane), and close by eliminating the cause so it does not recur. Switch between the visual Pathway map and the phase-by-phase Explorer.
Bladder Trauma
The EAU 2026 bladder trauma pathway — cystography-driven diagnosis, then the extraperitoneal-versus-intraperitoneal split drives conservative versus operative management, with healing cystography after a complex repair. Switch between the visual Pathway map and the phase-by-phase Explorer.
Chronic Pelvic Pain
The EAU 2026 chronic-pelvic-pain pathway — a history- and examination-led algorithm whose two sequential gates first separate confirmable chronic secondary (disease-associated) pelvic pain from chronic primary pelvic pain syndrome (CPPPS), then route the CPPPS arm by organ system, before a UPOINT-phenotype-directed, bio-psychosocial management ladder across the bladder, prostate, scrotal, urethral, anorectal, pudendal, gynaecological and pelvic-floor pain syndromes. New for 2026: ketamine uropathy, on the secondary arm. Switch between the visual Pathway map and the phase-by-phase Explorer.
Erectile Dysfunction
The EAU 2026 erectile dysfunction pathway — a basic work-up of medical and psychosexual history with a validated questionnaire, focused examination and laboratory tests including early-morning total testosterone, Princeton IV cardiovascular risk stratification, select-case advanced testing, then the treatment ladder from first-line PDE5 inhibitors through intracavernosal injection and the less-invasive alternatives to a penile prosthesis, with follow-up and post-prostatectomy rehabilitation. Switch between the visual Pathway map and the phase-by-phase Explorer.
Female Bladder Outlet Obstruction
The EAU 2026 female bladder-outlet-obstruction pathway — BOO is a urodynamic diagnosis that must be classified anatomical versus functional, and that single branch dictates everything downstream: cystourethroscopy and videourodynamics with cause-directed surgery on one side; pelvic-floor relaxation training, outlet-relaxing drugs and neuromodulation on the other, with bladder drainage and lifelong surveillance underneath both. Switch between the visual Pathway map and the phase-by-phase Explorer.
Female Stress Urinary Incontinence
The EAU 2026 non-neurogenic female stress-urinary-incontinence pathway — SUI is diagnosed clinically with a standardised cough stress test and classified uncomplicated vs complicated, then managed conservatively first (supervised pelvic-floor muscle training for ≥ 3 months and weight loss), with non-surgical drug options, a co-equal surgical menu for uncomplicated SUI (mid-urethral sling, colposuspension, autologous fascial sling, urethral bulking), a separate complicated/recurrent lane in experienced centres that the Phase 1 classification routes into, and post-treatment follow-up. Switch between the visual Pathway map and the phase-by-phase Explorer.
Fournier's Gangrene
The EAU 2026 Fournier's gangrene pathway. Recognise necrotising fasciitis of the perineum and external genitalia and know its risk factors, start broad-spectrum antibiotics on presentation (Strong), take the patient for repeated surgical debridement within 24 hours (Strong) with urinary — and, for para-rectal disease, bowel — diversion, then reconstruct by defect size. Sepsis resuscitation runs alongside and is carried over from EAU 2025 §3.9, which EAU 2026 has placed under review for the 2027 edition. Switch between the visual Pathway map and the phase-by-phase Explorer.
Genital Trauma
The EAU 2026 genital trauma pathway — penile fracture and testicular trauma (plus penetrating injury). New this edition: a treatment algorithm (Figure 4.4.3) that opens on the ABCDE trauma protocol, an explicit superficial-versus-significant branch for penetrating penile injury, and early psychological counselling in follow-up. Clinical and ultrasound diagnosis (exclude a urethral injury in penile fracture), surgical repair of the tunica albuginea, exploration of testicular rupture, then wound / erectile / fertility follow-up. Switch between the visual Pathway map and the phase-by-phase Explorer.
Male Hypogonadism
The EAU 2026 male hypogonadism pathway — symptom-triggered diagnosis on a confirmed low morning fasting total testosterone, LH and FSH to separate primary from secondary hypogonadism, the pivotal fertility fork that decides between testosterone therapy and gonadotropins, testosterone preparations and their contraindications, and haematocrit, PSA and cardiovascular safety monitoring. Switch between the visual Pathway map and the phase-by-phase Explorer.
Male Infertility
The EAU 2026 male infertility pathway — assess the couple simultaneously with history, examination, at least two semen analyses and hormones, classify the semen defect and split azoospermia into obstructive versus non-obstructive, target the genetic and imaging work-up to that split, treat the reversible and surgically correctable causes, and retrieve sperm for ICSI when spontaneous conception is not achievable. Switch between the visual Pathway map and the phase-by-phase Explorer.
Male Urinary Incontinence
The EAU 2026 male urinary incontinence pathway — leakage, not obstruction. Classify as stress, urgency or mixed and quantify severity with a validated score, a bladder diary and a pad weight test (all Strong), offer conservative care for every type, then split into two lanes: the sphincter-deficiency lane where severity picks a sling or an artificial urinary sphincter, and the urgency lane climbing antimuscarinic or β3 agonist to onabotulinumtoxinA or sacral neuromodulation and on to augmentation or diversion. Switch between the visual Pathway map and the phase-by-phase Explorer.
Mixed Urinary Incontinence
The EAU 2026 non-neurogenic mixed-urinary-incontinence pathway — MUI is coexisting stress and urgency incontinence, characterised where possible as stress- or urgency-predominant, then managed by tackling the most bothersome component first: bladder training and pelvic-floor muscle training for all women, component-directed drug therapy (antimuscarinic or beta-3 agonist for urgency-predominant, duloxetine for stress-predominant), with surgery a warned last resort that is less successful than for stress incontinence alone. Switch between the visual Pathway map and the phase-by-phase Explorer.
Neuro-urology (NLUTD)
The EAU 2026 neuro-urology pathway for neurogenic lower urinary tract dysfunction (NLUTD) — from recognising the neurological cause, through video-urodynamic assessment and lesion-based classification, to an escalating, upper-tract-protective bladder-management ladder (catheterisation settled by shared decision-making, antimuscarinics or beta-3 agonists → botulinum toxin A injected into the detrusor → neuromodulation, augmentation and diversion), plus neurogenic UTI, autonomic dysreflexia, sexual and fertility care, and life-long surveillance. The through-line is “as effective as needed, as non-invasive as possible.” Switch between the visual Pathway map and the phase-by-phase Explorer.
Non-neurogenic Male LUTS
The EAU 2026 non-neurogenic male LUTS / benign prostatic obstruction pathway — assess and phenotype bothersome male LUTS, then match watchful waiting, phenotype-driven drug therapy (with a nocturia branch) or size-stratified surgery, with follow-up tuned to the chosen modality. A separate lane, new in 2026, covers young men with primary bladder neck obstruction or dysfunctional voiding, where the obstruction is functional rather than prostatic. Standard options lead; select-case techniques are subordinated. Switch between the visual Pathway map and the phase-by-phase Explorer.
Overactive Bladder
The EAU 2026 non-neurogenic female overactive-bladder pathway — OAB is a symptom diagnosis, managed up a fixed ladder: assessment and wet/dry classification, conservative and behavioural therapy (including PTNS), pharmacotherapy (antimuscarinic then beta-3 agonist), refractory minimally-invasive third-line (intravesical onabotulinumtoxinA, sacral neuromodulation), last-resort surgery, and early follow-up. Switch between the visual Pathway map and the phase-by-phase Explorer.
Pelvic Organ Prolapse & LUTS
The EAU 2026 pathway for lower urinary tract symptoms in women with pelvic organ prolapse — staged on POP-Q, but turning on one dominant decision: what to do about stress incontinence (symptomatic, occult, or absent) in a woman who needs prolapse surgery. Built around the POP reduction test and the combined-versus-alone-versus-staged fork, which behaves differently by surgical route. Switch between the visual Pathway map and the phase-by-phase Explorer.
Penile Cancer
The EAU 2026 (EAU-ASCO) penile cancer pathway — from clinical suspicion, expert-centre referral and biopsy through TNM staging, stage-directed primary-tumour treatment, risk-based cN0 and cN1–cN3 lymph node management, and metastatic disease. Switch between the visual Pathway map and the phase-by-phase Explorer.
Penile Curvature (Peyronie's Disease)
The EAU 2026 penile curvature pathway — separating congenital penile curvature, which goes straight to plication surgery, from Peyronie's disease, where the active-versus-stable gate governs everything: conservative and intralesional treatment while the disease is active, and surgery only once it is stable and the deformity is costing him intercourse, choosing between tunical shortening, tunical lengthening with grafting, and a penile prosthesis according to penile length, curvature severity, complex deformity and erectile function. Switch between the visual Pathway map and the phase-by-phase Explorer.
Peri-procedural Antibiotic Prophylaxis
The EAU 2026 peri-procedural antibiotic prophylaxis pathway — a decision map, not a temporal spine. Cross-cutting general principles (screen and treat bacteriuria, non-antibiotic asepsis, agent choice) gate every procedure, then the procedure type routes to a give-or-don't-give call and, where indicated, an agent strategy: lower-tract and transurethral resection, stone surgery, prostate biopsy, or the procedures with no formal recommendation. EAU 2026 brings two substantive changes: shockwave lithotripsy leaves the blanket do-not row for a recommendation that turns on the urine, and transperineal biopsy gains a Weak recommendation to omit prophylaxis altogether in patients without risk factors. Switch between the visual Pathway map and the phase-by-phase Explorer.
Premature Ejaculation
The EAU 2026 premature ejaculation pathway — a history-based, multi-dimensional diagnosis (self-estimated IELT, perceived control, distress) with classification into lifelong, acquired, variable and subjective PE, treating any underlying ED, prostatitis or other cause first, then approved on-demand pharmacotherapy (dapoxetine, lidocaine/prilocaine spray), off-label escalation to daily SSRIs, clomipramine or on-demand tramadol, and the refractory options. Switch between the visual Pathway map and the phase-by-phase Explorer.
Priapism
The EAU 2026 priapism pathway — the decisive first step separates ischaemic (low-flow) priapism, a urological emergency accounting for over 95% of episodes, from non-ischaemic (high-flow) priapism and stuttering priapism, using penile blood gas analysis and colour duplex ultrasound. From there the pathway runs the ischaemic ladder of aspiration, intracavernous phenylephrine, shunt surgery and early prosthesis, the non-ischaemic conservative-then-embolisation route, and prevention of stuttering episodes. Switch between the visual Pathway map and the phase-by-phase Explorer.
Prostate Cancer
The complete EAU 2026 prostate cancer pathway — from PSA testing and MRI/biopsy through risk stratification, curative treatment (active surveillance, surgery, radiotherapy), adjuvant therapy and recurrence, metastatic hormone-sensitive disease and castration-resistant treatment lines. Switch between the visual Pathway map and the phase-by-phase Explorer.
Renal Cell Carcinoma
The EAU 2026 renal cell carcinoma pathway — from clinical suspicion or incidental finding through diagnosis, cT staging and chest imaging, localized treatment (partial/radical nephrectomy, ablation, active surveillance, adjuvant pembrolizumab), follow-up and recurrence, to metastatic care: oligo/metastasis-directed therapy, IMDC risk stratification, and histology-directed systemic therapy for clear-cell and non-clear-cell disease. Switch between the visual Pathway map and the phase-by-phase Explorer.
Renal Trauma
The EAU 2026 renal trauma pathway — mechanism and haemodynamic stability drive imaging and AAST grading, a non-operative-first approach delivered as a stepwise package of care (selective angioembolisation for active bleeding, escalating when a step stops working), with operative management reserved for instability and expanding haematoma, then complication management and follow-up of major injury. Switch between the visual Pathway map and the phase-by-phase Explorer.
Testicular Cancer
The EAU 2026 testicular (germ-cell) cancer pathway — from clinical suspicion through ultrasound, tumor markers and inguinal orchiectomy to histology (seminoma vs non-seminoma), CT/IGCCCG staging, and stage- and histology-directed treatment: Stage I/II seminoma (surveillance, carboplatin, radiotherapy, RPLND) and non-seminoma (surveillance, adjuvant PEB, primary RPLND, chemotherapy), advanced/metastatic disease by IGCCCG prognosis, post-chemotherapy restaging and residual-mass management, and relapse. Switch between the visual Pathway map and the phase-by-phase Explorer.
Underactive Bladder
The EAU 2026 underactive bladder pathway — a failure of emptying, not a failure of storage. Underactive bladder is the symptom complex, detrusor underactivity the urodynamic diagnosis, and invasive pressure-flow study the only widely accepted way to make it. Management is deliberately pragmatic, and new Figure 7 finally maps it: the man who declines treatment goes to active surveillance, and the man who wants it is banded by post-void residual — behavioural measures and an alpha-blocker trial at 150–300 mL, intermittent catheterisation above 300 mL or where the upper tracts are at risk. Alpha-blockers before more-invasive techniques, never parasympathomimetics, then a fork on the prostate. Switch between the visual Pathway map and the phase-by-phase Explorer.
Upper Tract Urothelial Carcinoma
The EAU 2026 upper tract urothelial carcinoma (UTUC) pathway — from clinical suspicion through CT-urography, ureteroscopy and urine cytology to diagnosis (with germline/Lynch testing), CT staging and risk stratification, and risk-directed treatment: kidney-sparing surgery for low-risk disease, radical nephroureterectomy with bladder-cuff (± lymphadenectomy, adjuvant chemo/IO) for high-risk and cN+, metastatic systemic therapy (EVP / platinum chemo ± IO / avelumab maintenance / later lines), and risk-based follow-up. Switch between the visual Pathway map and the phase-by-phase Explorer.
Ureteral Trauma
The EAU 2026 ureteral trauma pathway — mostly iatrogenic: prevention and intra-operative vigilance, immediate repair when recognised during surgery, temporary diversion (nephrostomy / JJ stent) when diagnosed late, and location- and length-directed reconstruction of the resulting strictures. Switch between the visual Pathway map and the phase-by-phase Explorer.
Urethral Strictures
The EAU 2026 urethral-stricture pathway — from diagnosis (RUG ± VCUG, MRI ancillary) through the master anterior-vs-posterior branch that drives everything: select-case endoluminal management (DVIU, dilatation) versus definitive urethroplasty (EPA vs graft, graft > flap), posterior/PFUI reconstruction, and the female and transgender pathways, then peri-operative care and follow-up. Switch between the visual Pathway map and the phase-by-phase Explorer.
Urethral Trauma
The EAU 2026 urethral trauma pathway — anterior vs posterior (pelvic-fracture) injury, male vs female: catheter / endoscopic management acutely, with suprapubic diversion and deferred urethroplasty for complete posterior disruption in men and early repair for female PFUI. Switch between the visual Pathway map and the phase-by-phase Explorer.
Urethritis
The EAU 2026 urethritis pathway — confirm urethral inflammation with point-of-care diagnostics, classify gonococcal (GU) versus non-gonococcal (NGU) urethritis on the Gram stain, test with NAAT before treating, give empirical then pathogen-directed antibiotics, and manage sexual partners with a test of cure and a route for persistent or recurrent NGU. New in 2026: whether to treat empirically now or defer for the NAAT no longer turns on the GU/NGU split but on the clinical picture — objective findings, distress, exposure and follow-up availability. Switch between the visual Pathway map and the phase-by-phase Explorer.
Urinary Fistula
The EAU 2026 urinary fistula pathway — built as an anatomical decision map rather than an evidence chart, because the evidence here is "generally low level and largely composed of case series." Aetiology sorts obstetric from iatrogenic, radiation and rare causes; direct visual inspection confirms and localises; the WHO simple-versus-complex split sets the prognosis; a conservative window precedes any repair; the anatomical type then dictates the route; and continuous drainage runs to a duration set by complexity. Switch between the visual Pathway map and the phase-by-phase Explorer.
Urinary Tract Infections
The urinary tract infection continuum — asymptomatic bacteriuria → uncomplicated cystitis → recurrent cystitis → pyelonephritis → complicated UTI / CAUTI → urosepsis — each with its diagnosis, empirical-versus-culture-directed therapy, named first-line agents and a strong antimicrobial-stewardship spine (fluoroquinolones deliberately restricted). Phases 1–5 follow EAU 2026; phase 6 follows EAU 2025 §3.9, which EAU 2026 has placed under review for the 2027 edition. Switch between the visual Pathway map and the phase-by-phase Explorer.
Urolithiasis
The EAU 2026 urolithiasis pathway — from acute renal colic and imaging (ultrasound → confirmatory NCCT) and the septic-obstruction emergency, through size- and location-driven ureteral and renal intervention (SWL / URS / RIRS / PCNL), special populations and peri-procedural care, to metabolic evaluation and recurrence prevention. Switch between the visual Pathway map and the phase-by-phase Explorer.