Over the past 25 years, diagnostic categories in genitourinary pathology have changed dramatically. Prostate cancer reporting incorporated numerous new variant categories, recognized the importance of intraductal carcinoma, and introduced the concept of Grade Groups. Pathologic diagnosis of bladder cancer not only added new variant categories, but also modified the grading of non-invasive urothelial neoplasms and refined staging definitions. Kidney cancer classification expanded from a handful of diagnostic categories to a broad array of additional cancer types defined by unique immunohistochemical and molecular findings. Segregation of penile carcinoma by human papillomavirus status more accurately reflected pathogenesis and helped improve prediction of cancer behavior. Testicular pathology research advanced understanding of germ cell tumor subtypes and their impact on patient outcomes. Finally, adrenal gland pathology has evolved to incorporate a broader recognition of morphological variation and risk factors associated with tumor progression. Taken together, changes in pathology over the past quarter century have revolutionized our approach to genitourinary cancers. This review seeks to highlight some of the many significant changes in genitourinary pathology that have occurred during the past 25 years and emphasize impacts on clinical outcomes or therapy, as relevant.

在过去的 25 年中，泌尿生殖病理学的诊断类别发生了巨大变化。前列腺癌报告纳入了许多新的变异类别，认识到导管内癌的重要性，并引入了分级组的概念。膀胱癌的病理诊断不仅增加了新的变异类别，而且修改了非侵袭性尿路上皮肿瘤的分级和细化的分期定义。肾癌分类从少数诊断类别扩展到由独特的免疫组织化学和分子发现定义的广泛的其他癌症类型。通过人乳头瘤病毒状态对阴茎癌的分离更准确地反映了发病机制并有助于改善对癌症行为的预测。睾丸病理学研究加深了对生殖细胞肿瘤亚型及其对患者预后影响的理解。最后，肾上腺病理学已经发展到包括对与肿瘤进展相关的形态变异和风险因素的更广泛认识。总而言之，过去四分之一世纪的病理学变化彻底改变了我们治疗泌尿生殖系统癌症的方法。本综述旨在强调过去 25 年中发生的泌尿生殖系统病理学的许多重大变化，并强调对临床结果或治疗的影响（视情况而定）。过去四分之一世纪的病理学变化彻底改变了我们治疗泌尿生殖系统癌症的方法。本综述旨在强调过去 25 年中发生的泌尿生殖系统病理学的许多重大变化，并强调对临床结果或治疗的影响（视情况而定）。过去四分之一世纪的病理学变化彻底改变了我们治疗泌尿生殖系统癌症的方法。本综述旨在强调过去 25 年中发生的泌尿生殖系统病理学的许多重大变化，并强调对临床结果或治疗的影响（视情况而定）。