Which of the following symptoms requires immediate urologic evaluation?

Severe urinary retention is a significant symptom that indicates a potential urologic emergency. This condition can result in serious complications, including bladder damage, kidney injury, or severe infection if not addressed promptly. When a patient experiences severe urinary retention, they may be unable to urinate despite a full bladder, leading to distress and pain. Immediate evaluation by a urologist is necessary to determine the underlying cause of the retention and to initiate appropriate management, which may include catheterization or other interventions.

In contrast, while mild dysuria can be bothersome and may warrant evaluation, it often does not require immediate attention unless accompanied by severe symptoms. Intermittent hematuria, while concerning, can sometimes be managed with outpatient follow-up depending on the patient's overall condition and risk factors. Seasonal allergies, while uncomfortable, fall outside the realm of urologic issues and do not necessitate evaluation by a urologist. Therefore, severe urinary retention stands out as the symptom that requires urgent intervention to prevent serious complications.