The Urological Age and Longevity Score: a step towards a targeted measure of biological aging

Aging affects all organ systems, yet no standard method exists to quantify urological age. Renal function, prostate health, sexual function, fertility, and bladder control are central to men's health span, but their relationship with mental health and chronological aging remains poorly defined. The aim of this study was to develop the Urological Age and Longevity (UAL) framework, a consensus-driven composite index that quantifies urological biological age in men and explores its potential for guiding personalized strategies for healthy aging.

The UAL model was constructed through a three-phase process combining literature evidence and expert consensus. First, a multidisciplinary group systematically reviewed aging and urology indices to identify relevant longevity domains. Second, the preliminary framework underwent content validation using qualitative and quantitative feedback from an expert panel. Third, each parameter was organized into consensus-defined risk tiers to create a personalized UAL score.

Ten domains central to urological aging, including functional measures, biochemical markers, hormonal profile, sexual functions, systemic correlates, mental health, environmental exposures, lifestyle habits, surgical history, and family history, were identified and validated. Each parameter was assigned consensus-defined tiers, generating a structured 0 to 20 scoring system that estimates urological biological age and supports individualized risk profiling.

The UAL framework is the first organ-specific biological age model in urology. It enables assessment of genitourinary aging using routine clinical and lifestyle data, offering opportunities for targeted, modifiable interventions. Prospective validation studies are now warranted to confirm its predictive and clinical utility.