EAU Entrance Exam key terms

A five-tier prostate cancer grading system that replaces the raw Gleason sum, grouping scores by their architectural pattern combinations so that group 1 (Gleason 3+3) carries the best prognosis and group 5 (9-10) the worst.

The International Society of Urological Pathology consensus version of prostate cancer grading, assigning biopsy or prostatectomy specimens to groups 1 through 5 based on dominant and secondary Gleason patterns, used to guide treatment decisions.

Serum prostate-specific antigen divided by prostate volume, expressed in ng/mL per mL. Higher values suggest that elevated PSA reflects tumour rather than benign enlargement and support biopsy decisions in men with borderline PSA.

Prostate imaging combining T2-weighted, diffusion-weighted and dynamic contrast-enhanced sequences, scored with PI-RADS to stratify the likelihood of clinically significant cancer and to target biopsies.

A standardized reporting scale from 1 to 5 for prostate MRI that expresses the probability that a lesion is a clinically significant cancer, where scores of 4 and 5 generally prompt targeted biopsy.

Prostate sampling in which pre-biopsy MRI images are registered with live transrectal ultrasound so that cores are directed into suspicious lesions, improving detection of significant cancer compared with systematic sampling alone.

A prostatectomy pathology category describing cancer that has spread beyond the prostate capsule (extraprostatic extension) or into the bladder neck, but not into the seminal vesicles, indicating locally advanced disease.

A rise in serum PSA after curative-intent local treatment for prostate cancer, typically defined as PSA above 0.2 ng/mL after prostatectomy or a rise above nadir after radiotherapy, prompting consideration of salvage therapy.

A nuclear grading system for renal cell carcinoma based on nucleolar prominence and nuclear size, ranging from grade 1 to 4, with higher grades associated with poorer survival; largely superseded by WHO/ISUP grading.

The most common kidney cancer subtype, arising from proximal tubule cells and characterized by lipid-rich clear cytoplasm, loss of chromosome 3p and VHL gene inactivation, and responsiveness to angiogenesis-targeted drugs.

Surgical removal of a kidney tumour with preservation of the remaining renal parenchyma, preferred for T1 masses when technically feasible to reduce the risk of chronic kidney disease and cardiovascular morbidity.

A standardized anatomical scoring system (for example the RENAL or PADUA score) that quantifies tumour size, location and endophytic extent to predict the technical difficulty and risk of partial nephrectomy.

Instillation of attenuated Mycobacterium bovis into the bladder after transurethral resection to prevent recurrence and progression of high-risk non-muscle-invasive urothelial carcinoma, acting through local immune stimulation.

A flat, high-grade urothelial neoplasm confined to the mucosa that is not visible as a papillary tumour, carries a high risk of progression to muscle invasion, and is usually treated with intravesical BCG.

Surgical removal of the urinary bladder, most often with urinary diversion, performed for muscle-invasive bladder cancer, BCG-unresponsive high-risk disease, or intractable bladder dysfunction.

A urinary diversion in which a segment of ileum is used to carry urine from the ureters to an abdominal stoma, requiring an external collecting appliance and leaving the patient incontinent of urine.

A continent urinary reservoir constructed from detubularized bowel and anastomosed to the urethra after cystectomy, allowing voiding per urethra, though patients may need to strain or self-catheterize.

The most common solid malignancy in young men, divided into seminoma and non-seminoma, characterized by elevated AFP, hCG or LDH, and highly curable with orchiectomy and platinum-based chemotherapy.

Removal of a testis and spermatic cord through an inguinal incision with early clamping of the cord, serving as both the diagnostic and first therapeutic step for suspected testicular cancer.

Surgical clearance of the retroperitoneal lymph nodes, used for staging or treatment of non-seminomatous germ cell tumours, with nerve-sparing techniques aimed at preserving ejaculatory function.

The persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance, commonly reflecting vascular, neurogenic, hormonal or psychogenic causes and often a marker of cardiovascular disease.

An oral drug class that blocks breakdown of cyclic GMP in cavernosal smooth muscle, amplifying nitric oxide signalling and improving erection, while being contraindicated with nitrates because of severe hypotension risk.

Delivery of vasoactive agents such as alprostadil directly into the corpus cavernosum to produce erection, used as second-line therapy for erectile dysfunction and as a treatment for priapism in some settings.

A prolonged erection lasting more than four hours without sexual stimulation; the low-flow ischaemic type is a urological emergency requiring aspiration and vasoactive injection or shunt surgery to prevent cavernosal fibrosis.

Backward flow of semen into the bladder at orgasm due to failure of bladder neck closure, seen after transurethral prostate surgery, retroperitoneal lymph node dissection or in diabetic neuropathy, causing dry ejaculate and infertility.

Microscopic reconnection of the divided ends of the vas deferens to restore sperm passage after vasectomy, with success depending on the interval since vasectomy and the quality of fluid found at the testicular side.

Abnormal dilatation of the pampiniform venous plexus, usually left-sided, palpable as a bag of worms and associated with impaired semen quality and testicular atrophy; treatable by ligation or embolization.

Twisting of the spermatic cord that compromises blood flow to the testis, presenting with acute scrotal pain and a high-riding testis; surgical exploration and bilateral fixation are required urgently to avoid infarction.

A rapidly progressive necrotizing fasciitis of the perineum and genitalia, usually arising from a urogenital or anorectal source in diabetic patients, requiring urgent broad-spectrum antibiotics and aggressive surgical debridement.

Inflammation of the epididymis causing scrotal pain and swelling, most often due to sexually transmitted organisms in young men or urinary pathogens in older men, treated with antibiotics and scrotal support.

Acute infection of the prostate presenting with fever, perineal pain and voiding symptoms, sometimes with urinary retention; treated with antibiotics, and prostatic massage is avoided because of bacteraemia risk.

Persistent pain in the pelvic region in men, often without proven infection, classified among prostatitis syndromes; management is multimodal and includes alpha-blockers, physiotherapy and neuromodulatory drugs.

A calculus within the ureter, typically formed in the kidney and impacted at narrow points, causing colicky flank pain, haematuria and possible obstruction; managed by observation, medical expulsive therapy or ureteroscopy.

Low-dose computed tomography of the kidneys, ureters and bladder without intravenous contrast, the reference standard for diagnosing urinary stones because it shows stone size, location and obstruction.

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

Endoscopic passage of a rigid or flexible instrument through the urethra and bladder into the ureter to visualize and treat stones or urothelial lesions, usually with laser lithotripsy and stent placement.

Non-malignant proliferation of prostatic glandular and stromal tissue around the urethra causing lower urinary tract symptoms, often assessed with the IPSS and treated with alpha-blockers, 5-alpha-reductase inhibitors or surgery.

Endoscopic removal of obstructing prostatic tissue through the urethra using an electrical loop, the standard surgical treatment for benign prostatic obstruction, carrying risks of bleeding, retrograde ejaculation and hyponatraemia.

A set of pressure-flow measurements during bladder filling and voiding that assesses detrusor function, compliance and outlet obstruction, used when symptoms or non-invasive tests do not explain lower urinary tract dysfunction.

A symptom syndrome of urgency, usually with frequency and nocturia, with or without urge incontinence, in the absence of infection; treated with bladder training, antimuscarinics or beta-3 agonists.

Involuntary leakage of urine on effort, coughing or sneezing due to urethral sphincter weakness, common after childbirth; managed with pelvic floor training, mid-urethral sling or bulking agents.

Retrograde flow of urine from the bladder into the ureter due to an incompetent ureterovesical junction, graded I to V, predisposing children to pyelonephritis and renal scarring.

A congenital obstructing membrane in the posterior urethra of boys causing bilateral hydronephrosis, thick-walled bladder and possible renal failure; treated by endoscopic valve ablation after bladder drainage.

Dilatation of the renal pelvis and calyces due to obstruction or reflux, detected on ultrasound; severity and renal function determine whether drainage, reconstruction or observation is needed.

Failure of one or both testes to descend into the scrotum, increasing the risk of malignancy and infertility; surgical orchidopexy is recommended within the first year or two of life.

A congenital anomaly in which the urethral meatus opens on the ventral penis, often with chordee and a hooded prepuce; repaired surgically, and circumcision should be avoided before repair.

Immune-mediated injury to a transplanted kidney, classified as hyperacute, acute or chronic, presenting with rising creatinine and managed by immunosuppression adjustment or biopsy-guided therapy.

A surgically created connection between an artery and a vein, usually in the forearm, that provides high-flow vascular access for haemodialysis; complications include thrombosis, stenosis and aneurysm formation.

Failure of a transplanted kidney to function immediately after surgery, requiring dialysis in the first week; often due to ischaemia-reperfusion injury and associated with longer-term graft impairment.

Narrowing of the urethra due to scarring, causing obstructed voiding and recurrent infection; managed by dilation, internal urethrotomy or substitution urethroplasty depending on length and location.

Open surgical reconstruction of a narrowed urethra, using anastomotic repair for short bulbar strictures or graft/flap augmentation for longer ones, offering the most durable cure.