Arab Board Urology Final Written key terms

A nuclear grading system for renal cell carcinoma based on nucleolar prominence, nuclear size and pleomorphism, ranging from grade 1 to 4, with higher grades predicting worse prognosis and more aggressive behaviour.

Histologic variants of kidney cancer distinguished by cell type and architecture, chiefly clear cell, papillary (types 1 and 2), chromophobe, collecting duct and unclassified, each with differing genetics, behaviour and treatment response.

The presence of spindle-shaped, high-grade malignant cells within a renal cell carcinoma, indicating aggressive biology, high metastatic potential and poor survival independent of the underlying histologic subtype.

The internationally standardised system describing cancer extent by primary tumour size and invasion (T), regional lymph node involvement (N) and distant metastasis (M), guiding prognosis and treatment selection across urologic malignancies.

Instillation of live attenuated bacillus Calmette-Guerin into the bladder to provoke local immune-mediated destruction of urothelial carcinoma in situ and high-risk non-muscle-invasive tumours, reducing recurrence and progression.

Urothelial carcinoma invading the detrusor muscle (stage T2 or higher), requiring radical cystectomy with urinary diversion or, in selected cases, trimodal bladder-sparing chemoradiotherapy rather than simple transurethral resection alone.

A flat, high-grade, non-papillary urothelial malignancy confined to the mucosa that is often multifocal, easily missed on cystoscopy and carries a high risk of progression to muscle invasion.

A serine protease produced by prostatic epithelium that liquefies seminal coagulum; serum levels rise with benign enlargement, prostatitis and prostate cancer, making it useful for screening and monitoring but not diagnostic on its own.

A grading system for prostate adenocarcinoma that sums the two most prevalent architectural patterns (each scored 1 to 5), now often reported as Grade Group, correlating strongly with prognosis and treatment choice.

A management strategy for low-risk prostate cancer involving regular PSA testing, repeat biopsy and imaging with deferred curative treatment only if disease progresses, avoiding overtreatment of indolent tumours.

Surgical removal of the retroperitoneal lymphatic tissue draining the testes, used for staging and treatment of non-seminomatous germ cell tumours, with nerve-sparing techniques to preserve ejaculatory function.

Serum proteins used in diagnosis and monitoring of testicular tumours: alpha-fetoprotein (raised in non-seminomatous elements), beta-hCG (raised in choriocarcinoma and some seminomas) and lactate dehydrogenase as a non-specific marker.

Classification of germ cell tumours by extent of disease, using tumour markers, scrotal and retroperitoneal imaging and CT, distinguishing stage I (testis only) from nodal and visceral metastatic disease.

Radical removal of inguinal and femoral lymph nodes for staging and control of penile squamous cell carcinoma, with high wound complication rates, often reserved for patients with palpable or high-risk nodal disease.

The commonest penile malignancy, arising usually from the glans or prepuce, strongly linked to human papillomavirus and chronic inflammation, and treated by organ-sparing surgery or penectomy with nodal staging.

Inability to retract the foreskin over the glans, which may be physiological in boys or pathological from scarring (balanitis xerotica obliterans) and is a recognised risk factor for penile cancer.

A catecholamine-secreting tumour of adrenal medullary chromaffin cells causing paroxysmal hypertension, headache, sweating and palpitations; preoperative alpha-blockade is essential to prevent intraoperative hypertensive crisis.

An adrenal mass discovered incidentally on imaging performed for unrelated reasons; evaluation requires assessment of hormonal hypersecretion and imaging characteristics to distinguish benign adenoma from malignancy.

Autonomous aldosterone overproduction, usually from a unilateral adenoma or bilateral hyperplasia, causing hypertension with hypokalaemia and suppressed renin; treated by adrenalectomy or mineralocorticoid antagonists.

A measure of radiographic density on CT used to characterise urinary calculi; higher values indicate harder stones less likely to fragment with shock wave lithotripsy, helping select treatment modality.

Non-invasive fragmentation of urinary stones by focused acoustic shock waves generated outside the body, suitable for renal stones under about 2 cm and proximal ureteric stones of favourable density.

Removal of renal stones through a nephrostomy tract created percutaneously into the collecting system, first-line for large or complex stones and lower pole calculi unsuitable for lithotripsy.

A hollow tube placed cystoscopically into the ureter during retrograde intrarenal surgery to facilitate repeated passage of a flexible ureteroscope, improve irrigation flow and reduce intrarenal pressure.

Flexible ureteroscopic access to the kidney via the natural urinary tract for laser fragmentation and extraction of stones, typically used for stones up to 2 cm or when lithotripsy has failed.

A tubular device, usually double-J shaped, placed in the ureter to maintain drainage and relieve obstruction from stones, stricture or surgery, though it may cause irritation, infection and encrustation.

Analysis of serum and 24-hour urine for calcium, oxalate, citrate, uric acid and cystine to identify reversible causes of recurrent stone formation, guiding dietary and pharmacologic prevention.

Excessive urinary calcium excretion, commonly above 250 mg/day in women or 300 mg/day in men, a frequent cause of calcium stones addressed with hydration, dietary sodium restriction and thiazide diuretics.

An inherited defect of renal tubular cystine reabsorption causing recurrent cystine stones that are poorly visible on plain radiography and resistant to lithotripsy, managed with high fluid intake and alkalinisation.

Persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance, commonly vascular, neuropathic, hormonal or psychogenic, and often a marker of cardiovascular disease.

A drug class (sildenafil, tadalafil and others) that blocks breakdown of cyclic GMP in cavernosal smooth muscle, enhancing nitric oxide-mediated erection; contraindicated with nitrates because of severe hypotension.

A prolonged erection lasting more than four hours without sexual stimulation; low-flow (ischaemic) cases are surgical emergencies requiring aspiration or shunt procedures, while high-flow cases are usually painless and arterial.

Inadequate testicular androgen production, diagnosed by low morning serum testosterone with symptoms such as reduced libido and fatigue, classified as primary (testicular) or secondary (pituitary-hypothalamic).

Complete absence of spermatozoa in ejaculate, divided into obstructive and non-obstructive causes; evaluation includes hormonal testing, genetic studies and testicular biopsy or sperm retrieval for assisted reproduction.

Dilatation of the pampiniform plexus, usually left-sided, associated with impaired testicular function and male subfertility; surgical ligation may improve semen parameters in selected men.

A symptom syndrome of urinary urgency, usually with frequency and nocturia, with or without urgency incontinence, arising from detrusor overactivity or sensory dysfunction and treated by behavioural therapy, drugs or neuromodulation.

A urodynamic observation of involuntary detrusor contractions during bladder filling, which may be idiopathic or neurogenic and underlies many cases of urgency and urge incontinence.

A set of tests measuring bladder and urethral function during filling and voiding, including cystometry and pressure-flow analysis, used to characterise incontinence, obstruction and neurogenic bladder dysfunction.

Retrograde flow of urine from the bladder into the ureter, graded I to V on contrast studies, predisposing to pyelonephritis and renal scarring, especially in children with urinary tract infection.

A congenital obstructing membrane in the posterior urethra of boys causing bilateral hydronephrosis, bladder wall thickening and renal damage; treated by endoscopic valve ablation, with lifelong surveillance for bladder dysfunction.

A congenital anomaly in which the urethral meatus opens on the ventral penis, often with a ventral curvature and deficient prepuce; repair is usually performed in infancy, and circumcision should be avoided before assessment.

Failure of one or both testes to descend into the scrotum, associated with impaired spermatogenesis and increased malignancy risk, treated by orchidopexy usually within the first year of life.

Narrowing of the ureter from ischaemia, instrumentation, stone impaction or malignancy, causing obstruction and renal impairment; managed by stenting, endoureterotomy or surgical reconstruction.

Fibrotic narrowing of the urethra from trauma, infection, instrumentation or idiopathic causes, producing obstructive voiding; short bulbar strictures may be treated endoscopically, while longer or recurrent ones require urethroplasty.

A strip of oral mucosa harvested from the cheek or lip and used to augment or replace urethral tissue in urethroplasty, favoured for its robust vascularity and resistance to stricture recurrence.

A rapidly progressive necrotising fasciitis of the perineum and genitalia, usually polymicrobial and often in diabetic or immunosuppressed patients, requiring urgent surgical debridement and broad-spectrum antibiotics.

Inflammation of the epididymis from ascending bacterial infection or sexually transmitted organisms, causing scrotal pain and swelling; must be distinguished from testicular torsion, which is a surgical emergency.

Secondary tuberculosis of the urinary tract, typically causing sterile pyuria, ureteric strictures and a contracted bladder, treated with prolonged multidrug antituberculous chemotherapy and sometimes reconstructive surgery.

Twisting of the spermatic cord causing testicular ischaemia, presenting with acute severe scrotal pain; salvage depends on prompt surgical exploration and bilateral orchidopexy, with viability falling after six hours.

Acute severe flank pain from obstruction of the urinary tract by a stone, often with nausea and haematuria; management includes analgesia, imaging to confirm obstruction and urgent decompression if infected.

A technique of instilling fluid into the bladder through a three-way catheter to prevent clot retention after bladder surgery or bleeding, monitored to maintain clear drainage and avoid overdistension.

Immune-mediated injury of a transplanted kidney, classified as hyperacute, acute (cellular or antibody-mediated) or chronic, monitored by creatinine trends, drug levels and biopsy, and treated by immunosuppression adjustment.

An immunosuppressant class (tacrolimus, ciclosporin) blocking T-cell activation and preventing transplant rejection, but requiring therapeutic drug monitoring because of nephrotoxicity and drug interactions.

A focal area of bladder wall inflammation with glomerulations or ulceration seen in interstitial cystitis, associated with severe frequency, urgency and pelvic pain and often refractory to standard therapy.

A chronic scarring inflammatory skin condition affecting the glans and prepuce (lichen sclerosus), causing phimosis and meatal stenosis and associated with urethral stricture and penile cancer.