Urology OSCE Stations

Urology OSCE Stations

You are seeing Mrs. Singh, a 72 year old female, in your outpatient clinic today. She tells you that she has discomfort during urination and has difficulty controlling her urine. Take a focused history of his complaint.


  • Clarifies symptom of dysuria
  • Onset of dysuria
  • Urinary frequency
  • Change in urine color (cloudiness, darkening)
  • Presence of hematuria (none)
  • Nocturia
  • Urgency
  • Overflow Incontinence
  • Incomplete voiding
  • Flank/back pain
  • Abdominal discomfort/fullness/pain
  • Nausea and vomiting
  • Fever
  • Gastrointestinal symptoms such as pain, diarrhea, blood in stool
  • Pregnancy history
  • Current medications (particularly anti-cholinergic medication, estrogen creams)
  • Past history of urinary tract infections
  • Past history of urinary incontinence and treatments
  • Exposure to pool/lake/ocean water
  • Recent antibiotic use
  • Effect on daily life

You are seeing Mr. Ali, a 72 year old male, in your outpatient clinic today for ‘bloody urine.’ Take a focused history of his complaint.


  • Onset and duration of hematuria
  • Progression or worsening of hematuria
  • Clarifies color of urine (bright red blood)
  • Urinary frequency
  • Pain on urination
  • Urgency
  • Nocturia
  • Incomplete voiding
  • Hesitancy
  • Penile tip pain
  • Flank Pain
  • Abdominal discomfort/fullness
  • Systemic Symptoms – weight loss, fever, night sweats
  • Personal history of bleeding diathesis
  • Personal history of renal stones
  • Past history of renal disease
  • Current medications
  • Surgical history
  • Smoking history (quantity in pack-years)
  • Occupational history – especially exposure to exogenous toxins
  • Concerns as to what is causing the hematuria
  • Past history of urinary tract infections
  • Family history of urogenital cancers

You are seeing Bill Byrd, a 40 year old man in your outpatient clinic because he recently noticed a testicular mass. Perform a full genital examination.

Physical Examination


  • Inspects scrotum for asymmetry and skin lesions
  • Palpates testicles bilaterally
  • Comments on masses: size, location, consistency, tenderness, irregular shape
  • Palpates epididymis for tenderness, enlargement


  • Inspects penis for erythema, swelling, deformity
  • Palpates along penile shaft for irregularity
  • Examines foreskin for signs of infection
  • Exposes glans for inspection, and replaces the foreskin after completing the examination
  • Examines meatus for discharge


  • Palpates inguinal region bilaterally for presence of hernias
  • Assesses for hernias with patient standing up
  • Asks patient to bear down during palpation of scrotum

Digital Rectal Examination

  • States that a digital rectal examination would be performed as part of the genitourinary examination

You are seeing Ms. Hamilton, a 64 year old man, for left sided back pain. She says it began three days ago and isn’t getting any better. Take a focused history of her complaint and perform a physical examination.


  • Onset and duration of pain
  • Progression of pain
  • Location of pain (unilateral)
  • Frequency of pain (intermittent)
  • Quality of pain (sharp)
  • Radiation (to abdomen and groin)
  • Flank pain (yes)
  • Changes in amount of urine
  • Dysuria
  • Urgency
  • Hematura (some darkening)
  • Post-void dribbling
  • Fever (recently)
  • Nausea/vomiting
  • Diarrhea (none)
  • Diaphoresis
  • Current Medications
  • Diet history (focusing on calcium and oxalate intake)
  • Personal history of renal stones
  • Personal history of urinary tract infections
  • Family history of renal stones
  • Past medical history

Physical Examination


  • Comments on general appearance of patient (uncomfortable, diaphoretic)
  • Measures heart rate (elevated) and states that temperature should also be measured

Renal Examination

  • Palpates location of back in which pain is located
  • Assesses for CVA percussion tenderness
  • Attempts to palpates for kidneys with patient supine
  • Auscultates for renal bruits bilaterally

Abdominal Examination

  • Inspects abdomen for masses, scars
  • Auscultates in all four quadrants of the abdomen
  • Palpates all quadrants for tenderness, commenting on absence/presence of guarding
  • Assesses for rebound tenderness in the left and right lower quadrants
  • States that they would perform a digital rectal examination as part of the abdominal examination

Special Maneuvers

  • Examines for signs of appendicitis: McBurney’s point tenderness, Rovsing’s sign, Psoas sign