Urogenital Tract: the ISUD Classification System

Classification of Urological Diseases

ISUD developed a Classification System of Urological Diseases reflecting today's everyday Urology practice. The classification rationale is simple: firstly, according to the organ affected; secondly, according to the symptom or disease;  thirdly, according to the intervention (diagnostic or therapeutic).  Lastly, the intervention is individualized among differente diagnostic and therapeutic options. The ISUD Classification System is useful for codifying the website material  and using terms as "key-words" when searching.

  1. Classification of Organs
  2. Classification of Symptoms
  3. Classification of Diseases
  4. Classification of Renal Diseases
  5. Classification of Ureteral Diseases
  6. Classification of Bladder Diseases
  7. Classification of Urethral Diseases
  8. Classification of Prostate Diseases
  9. Classification of Testicular Diseases
  10. Classification of Penile Diseases
  11. Classification of Pelvic Floor Diseases
  12. Classification of other Diseases
  13. Classification of Interventions - Non invasive
  14. Classification of Interventions- Diagnositc
  15. Classification of Interventions - Therapeutic
  16. Classification of Interventions - Surgical

The philosophy of the ISUD Classification System is illustrated schematically below:

Classification of Organs

Code Organ
Table 1: Organ Classification
Ο1 Kidney
Ο2 Ureter
Ο3 Bladder
Ο4 Urethra
Ο5 Prostate
Ο6 Testes
Ο7 Penis
Ο8 Pelvic Floor
Ο9 Others

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Classficiation of Symptoms

Code Symptoms
Table 2: Symptom Classification
Σ1 Colic
Σ2 Bladder Pain
Σ3 Prostatodynia
Σ4 Orchidynia 
Σ5 Urinary Frequency
Σ6 Urinary Urgency
Σ7 Νocturia
Σ8 Dysuria
Σ9 Urinary Retention
Σ10 Enuresis
Σ11 Urinary Incontinence
Σ12 Hematuria
Σ13 Pyuria
Σ14 Polyuria
Σ15 Anuria
Σ16 Hemospermia

Επιστροφή στον Πίνακα Περιεχομένων

Classification of Diseases

Code Diseases
Table 3: Disease Classification
ΠΝΕ Renal Diseases
ΠΟΡ Ureteral Diseases
ΠΟΚ Bladder Diseases
ΠΟΘ Urethral Diseases
ΠΠΑ Prostatic Diseases
ΠΟΧ Testicular Diseases
ΠΕΣ Penile Diseases
ΠΕΔ Pelvic Floor Diseases
ΠΛΟ Other Diseases

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The numbers added to codification correspond to the most common diseases of the specific organ. Numerical order starts from Congenital and Anatomical Diseases, then follow Functional Diseases and in the end come Tumors. In large chapters of Urology Oncology, there is further subclassification.

For example, prostate cancer is subclassified in localized, metastatic, hormone-refractory. Also, Prostate Cancer falls in a special category related to Bone Disease induced either by cancer itself or its therapy (bone metastases and osteoporosis, respectively). 


Classification of Renal Diseases

Code Diseases
Table 4: Renal Disease Classification
ΠΝΕ1 Cysts
ΠΝΕ2 Ureteropelvic Junction Stenosis
ΠΝΕ3 Hydronephrosis
ΠΝΕ4 Pyelonephritis
ΠΝΕ5 Injuries
ΠΝΕ6 Lithiasis
ΠΝΕ7 Benign Tumors
ΠΝΕ8 Cancer
ΠΝΕ9 Other

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Classification of Ureteral Diseases

Code Diseases
Table 5: Ureter Disease Classification
ΠΟΡ1 Μegaureter
ΠΟΡ2 VesicoUreteral Reflux (VUR)
ΠΟΡ3 Ureteral Stricture
ΠΟΡ4 Injuries
ΠΟΡ5 LIthiasis
ΠΟΡ6 Cancer
ΠΟΡ7 Retroperitoneal Fibrosis
ΠΟΡ8 Other

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Classification of Bladder Diseases

Code Diseases
Table 6: Bladder Disesase Classification
ΠΟΚ1 VesicoUreteral Reflux (VUR)
ΠΟΚ2 Injury
ΠΟΚ3 Cystitis
ΠΟΚ4 Painful Bladder Syndrome
ΠΟΚ5 Lithiasis
ΠΟΚ6 Overactive Bladder
ΠΟΚ7 Nocturnal Enuresis
ΠΟΚ8 Neurogenic Bladder
ΠΟΚ9 Non invasive Cancer
ΠΟΚ10 Invasive Cancer
ΠΟΚ11 Ohter Diseases

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Classificaiton of Urethral Diseases

Code Diseases
Table 7: Classification of Urethral Diseases
ΠΟΘ1 Ypospadias and other Congenital Diseases
ΠΟΘ2 Urethral Injury/ Stricture
ΠΟΘ3 Sphincter Incompetence
ΠΟΘ4 Urethritis
ΠΟΘ5 Cancer
ΠΟΘ6 Other

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Classification of Prostatic Diseases

Code Diseases
Table 8: Prostatic Disease Classification
ΠΠΑ1 Prostatitis
ΠΠΑ2 Chronic Pelvic Pain
ΠΠΑ3 Prostatic Hyperplasia/ Hypertrophy
ΠΠΑ4 Localized Prostate Cancer
ΠΠΑ5 Metastatic Prostate Cancer
ΠΠΑ6 Refractory Prostate Cancer
ΠΠΑ7 Prostate Cancer - Osteoporosis/ Bone Metastasis
ΠΠΑ8 Other

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Classification of Testicular Diseases

Code Diseases
TAble 9: Testicular Disease Classification
ΠΟΧ1 Cryptorchidism
ΠΟΧ2 Hydrocele
ΠΟΧ3 Torsion
ΠΟΧ4 Injury
ΠΟΧ5 Testicular Epididymitis
ΠΟΧ6 Varicocele
ΠΟΧ7 Infertility
ΠΟΧ8 Azoospermia
ΠΟΧ9 Other
ΠΟΧ10 Atrophy/ Hypogonadism
ΠΟΧ11 Testicular Cancer
ΠΟΧ12 Other

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Classification of Penile Diseases

Code Diseases
Table 10: Penile Disease Classification
ΠΕΣ1 Phimosis/ Paraphimosis
ΠΕΣ2 Balanoposthitis
ΠΕΣ3 Fournier Gangrene
ΠΕΣ4 Injury/ Fracture
ΠΕΣ5 Penile Curvature/ Peyronie's Disease
ΠΕΣ6 Erectile Dysfunction
ΠΕΣ7 Ejaculation Disorders
ΠΕΣ8 Penile Cancer
ΠΕΣ9 Other

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Classification of Pelvic Floor Diseases

Code Diseases
Table 11: Classification of Pelvic Floor Diseases
ΠΕΔ1 Cystocele
ΠΕΔ2 Rectocele
ΠΕΔ3 Uterine Prolapse
ΠΕΔ4 Stress Incontinence
ΠΕΔ5 Chronic Pelvic Pain Syndrome
ΠΕΔ6 Other

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Classification of Other Diseases

Code Diseases
Table 12:  Other Disease Classification
ΠΛΟ1 Skin Diseases
ΠΛΟ4 Perioperative and cancer pain

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Classification of Procedures - Non invasive

Code Interventions Type Category
Table 13:  Classification of Non-invasive Interventions 
ΕΤ Epidemiology - Lifestyle    
ΠΠ Pathophysiology - Prevention    
ΔΙ Nutrition    
ΦΘ Physiotherapy    
ΨΥ Health Psychology`    

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Classification of Interventions - Diagnostic

Code Interventions Type Category
Table 14:  Classification of Diagnostic Interventions
ΔΕ1 Diagnostic - Laboratory 1. Blood tests  
ΔΕ2 Diagnostic - Laboratory 2. Biochemical tests  
ΔΕ3 Diagnostic - Laboratory 3. Urine Test

a. general urine test
b. urine culture

c. antibiogram

ΔΕ4 Diagnostic - Laboratory 4. Cell Test  
ΔΕ5 Diagnostic - Laboratory 5. Molecular Markers  
ΔΕ6 Diagnostic - Laboratory 6. Sperm Tests

α. semen analysis (spermiogram)

b. semen culture - antibiogram

c. chlamydia test

d. functional tests

ΔΕ7 Diagnostic - Laboratory 7. Genetic Control

α. karyotype

b. microdeficits

c. DNA fragmentation

d. cystic fibrosis

ΔΑΥ Diagnostic - Imaging UltraSound screening
  1. renal
  2. bladder
  3. urethra
  4. prostate
  5. penis
  6. scrotum
  7. scrotal Triplex 
  8. penile Triplex
  9. Elastography
  10. Pelvic Floor
ΔΑΟ Diagnostic - Laboratory Intravenous Urography  
ΔΑΚΟ Diagnostic - Imaging Cystography - Urethrography
  1. ascending
  2. descending
ΔΑΞ Diagnostic - Imaging CTscan
  1. upper abdomen
  2. lower abdomen - pelvis
  3. retroperitoneal space
  4. chest
ΔΑΜ Diagnostic - Imaging MRI
  1. upper abdomen
  2. lower abdomen - pelvis
  3. retroperitoneal space
  4. bones
ΔΑΠ Diagnostic - Imaging Nuclear Tests
  1. Static Renal Scintigraphy
  2. Dynamic Renal Scintigraphy
  3. Bladder Scintigraphy
  4. Bone Scintigraphy
ΔΚΕ Diagnostic - Clinical Clinical Examination
  1. physical examination
  2. neurological examination
  3. digital examination
ΔΚΟ Diagnostic - Clinical Urodynamic Test
  1. Uroflowmetry
  2. Cystomanometry
  3. Profilometry
  4. Evoked Potentials
  5. Video-Urodynamics
ΔΚΣ Diagnostic - Clinical Endoscopies
  1. Urethroscopy
  2. Ureteroscopy
  3. Nephroscopy
ΔΚΒ Diagnostic - Clinical Biopsies
  1. renal
  2. bladder
  3. prstate
  4. testes
  5. penile

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Classification of Interventions - Therapeutic

Code Interventions Type Category
Table 15: Classification of Therapeutic Interventions
ΘΑΠ Therapy - Monitoring/ Follow-up    
ΘΦΚ Therapy - Pharmacotherapy - Antibiotics kinolones
  1. ciprofloxacin
  2. norfloxacin
  3. levovloxacin
  4. prulifoxacin
ΘΦΑΜ Therapy - Pharmacotherapy - Antibiotics aminoglycosides
  1. amikacin
  2. netilmicin
ΘΦΚΕ Therapy - Pharmacotherapy - Antibiotics cephalosporins  
ΘΦΧΗ Therapy - Pharmacotherapy - Antibiotics chemoprophylaxis
  1. trimethoprim
  2. nitrofurantoin
ΘΦΜΣ Therapy - Pharmacotherapy - Antiinflammatory drugs non-steroids & cyclooxygenase inhibitors
  1. diclofenac
  2. ketoprofen
  3. parecoxib
  4. selecoxib
ΘΦΑΛ Therapy - Pharmacotherapy analgesics
  1. paracetamol
  2. tramadol
  3. pethidine
  4. morphin
ΘΦΤΑ Therapy - Pharmacotherapy local anesthetics
  1. xylocaine
  2. lidocaine
ΘΦΚΙ Therapy - Pharmacotherapy kinase inhibitors axitinib
ΘΦΑΚ Therapy - Pharmacotherapy cytokines interferon
ΘΦΤΟ Therapy - Pharmacotherapy mTOR inhibitors everolimus
ΘΦVG Therapy - Pharmacotherapy VEGF inhibitors
  1. sorefanib
  2. sunitinib
ΘΦΑΓ Therapy - Pharmacotherapy LH-RH agonists
  1. leuprolide
  2. goserelin
  3. triptorelin
ΘΦΑΝ Therapy - Pharmacotherapy  LH-RH antagonists degarelix
ΘΦΑΑ Therapy - Pharmacotherapy antiandrogens flutamide  bicalutamide
ΘΦΝΛ Therapy - Pharmacotherapy neuroleptics gapapentin pregabalin
ΘΦΧ Therapy - Pharmacotherapy anticholinergics
  1. oxybutin
  2. solifenacin
  3. tolterodin
  4. fesoterodine
  5. darifenacin
  6. trospio
  7. propiverine
ΘΦΤΑ Therapy - Pharmacotherapy tricyclic antidepressants amitriptyline
ΘΦΑΟ Therapy - Pharmacotherapy antidiuretic hormones desmopressin
ΘΦΤ Therapy - Pharmacotherapy toxins botulinum toxin
ΘΦΒΑ Therapy - Pharmacotherapy β-adrenergic agonists mirabegron
ΘΦΑΠ Therapy - Pharmacotherapy α-adrenergic blockers
  1. tamsulosin
  2. alfuzosin
  3. silodosin
ΘΦΑΝΑΓ Therapy - Pharmacotherapy 5α-reductase inhibitors
  1. finasteride
  2. dudasteride
ΘΦΦΧ Therapy - Pharmacotherapy natural extracts
  1. pygeum africanum
  2. serenoa repens
ΘΦΦΔ Therapy - Pharmacotherapy phosphodiesterase type5 inhibitors
  1. sildenafil
  2. tadalafil
  3. vardenafil
  4. avanafil
ΘΦΠΡ Therapy - Pharmacotherapy prostagladines alprostadil
ΘΦΕΣ Therapy - Pharmacotherapy SSRIs
  1. dapoxetine
  2. duloxetine
ΘΦΤΕ Therapy - Pharmacotherapy testosterone
  1. gel
  2. spray
  3. injections
ΘΦΔΦ Therapy - Pharmacotherapy biphosphonates zolendronic acid
ΘΕΞΟ Therapy - Pharmacotherapy monoclonal antibodies denosumab
ΘΦΔΦ Therapy - Pharmacotherapy immune therapy BCG
ΘΦKY Therapy - Pharmacotherapy cytostatics  abiraterone
ΘΦΔΑ Therapy - Pharmacotherapy dermatological isokonazole
ΘΣ Therapy - Devices
  1. biofeedback
  2. neurostimulators
  3. shock waves
  4. vacuum
ΘΕΞΛ Therapy - Extractorporeal LIthotripsy  
ΘΕΞΟ Therapy - Hormones
  1. testosterone
  2. FSH
  3. LH
  4. clomiphene
  5. tamoxifen
  6. testolactone
  7. anastrozole
  8. bromocryptin
ΘΕΞΓ Therapy - Extracorporeal Fertilization  
ΘΚ Therapy–Catheters
  1. urethral
  2. intermittent
  3. ureteral
ΘΣΤ Therapy – Stomia
  1. Nephrostomy
  2. Ureterostomy
  3. Cystostomy
  4. Ileostomy
ΑΚ Radiotherapy
  1. Brachytherapy
  2. external
ΧΗ Chemotherapy
  1. regional
  2. systemic

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Classification of Interventions - Surgical

Code Interventions Type Category
Table 16: Classification of Surgical Interventions
ΧΑ Surgery - Open
  1. circumcision
  2. transcystic prostatectomy
  3. radical prostatectomy
  4. nephrectomy
  5. nephro-ureterectomy
  6. Nephrolithotomy
  7. UPJ plastic surgery
  8. ureter reimplantation
  9. total cystectomy
  10. bladder augmentation
  11. urinary diversion
  12. cystolithotomy
  13. orcheopexy
  14. anastomosis of spermatic ducts
  15. internal spermatic vein ligation
  16. orchectomy/ lymphnode dissection
  17. penile curvatures
  18. scrotal gangrene
  19. penectomy
ΧΕ Surgery - Endoscopic
  1. nephrolithotripsy
  2. renal cyst
  3. UPJ Obstruction
  4. ureterolithotripsy
  5. renal/ureter tumor
  6. transurethral resection of bladder tumor (TURBT)
  7. transurethral prostatectomy
  8. thransurethral  incision/resection of bladder neck
  9. internal urethrotomy
ΧL Surgery – Laser
  1. skin lesions
  2. prostatectomy
ΧΛ Surgery - Laparoscopic
  1. renal cystν
  2. UPJ obstruction
  3. nephrectomy
  4. cystectomy
  5. radical prostatectomy
  6. other
ΧΡ Surgery - Robotic
  1. renal cystνεφρού
  2. UPJ Obstruction
  3. nephrectomy
  4. cystectomy
  5. radical prostatectomy
  6. other
ΧΠ Surgery - Prosthetic
  1. tape
  2. mesh
  3. sphincter
  4. penile prosthesis
  5. testicular inlays
ΧΠ Surgery - Minimally Invasive
  1. intracystic therapy
  2. neurostimulators
  3. radiofrequency
  4. cryotherapy
  5. infusion of dilating materials (ureteral - urethral)

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