FEBU flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

PSA density threshold

PSA divided by prostate volume; a value above 0.15 ng/mL per mL increases suspicion of prostate cancer and is used to decide on biopsy, especially in men with borderline PSA.

ISUP grade group 3

Corresponds to Gleason score 4+3=7, an intermediate-to-unfavourable pattern with predominant grade 4, associated with higher recurrence risk than 3+4 and influencing treatment choice.

D'Amico high-risk prostate cancer

Any of PSA above 20 ng/mL, Gleason 8-10 (ISUP 4-5), or clinical stage T2c or higher. Treatment usually combines radiotherapy with androgen deprivation or radical prostatectomy with extended lymphadenectomy.

BCG-unresponsive NMIBC

Non-muscle-invasive bladder cancer persisting or recurring after adequate BCG, including CIS at three months or recurrence at six months; radical cystectomy is the recommended standard of care.

Renal mass partial nephrectomy

Preferred treatment for T1 renal tumours when technically feasible, preserving renal function and reducing cardiovascular risk; radical nephrectomy is reserved for tumours not amenable to nephron-sparing surgery.

Seminoma stage I management

After radical inguinal orchidectomy, options are surveillance, single-agent carboplatin or para-aortic radiotherapy; surveillance avoids overtreatment but requires reliable follow-up with imaging and tumour markers.

Uric acid stone dissolution

Uric acid stones are radiolucent and dissolve with urinary alkalinisation to pH 6.5-7.0 using potassium citrate or sodium bicarbonate, plus high fluid intake; avoid over-alkalinisation to prevent calcium phosphate stones.

Struvite stone management

Infection-related stones from urease-producing organisms require complete stone clearance, usually by percutaneous nephrolithotomy, plus treatment of infection and, where appropriate, urease inhibition to prevent recurrence.

Fournier's gangrene

Necrotising fasciitis of the perineum and genitalia; a surgical emergency requiring immediate broad-spectrum antibiotics, urgent debridement and often repeated debridements, with high mortality if treatment is delayed.

Testicular torsion

Acute scrotal pain with high-riding testis and absent cremasteric reflex; diagnosis is clinical and management is immediate scrotal exploration with bilateral orchidopexy, without waiting for imaging.

Ischaemic priapism

Painful erection lasting more than four hours with low cavernosal blood flow; managed by corporal aspiration and irrigation, then intracavernosal phenylephrine, and shunt surgery if refractory.

Obstructed infected kidney

Infection in an obstructed collecting system is a urological emergency; immediate decompression by percutaneous nephrostomy or ureteric stent plus antibiotics is required, with definitive stone treatment deferred.

Post-TURBT single instillation

Immediate intravesical chemotherapy, typically mitomycin C, after TURBT reduces recurrence in low-risk non-muscle-invasive bladder cancer; it is avoided if perforation or extensive resection is suspected.

Upper tract urothelial carcinoma

Standard treatment for high-risk disease is radical nephroureterectomy with bladder cuff excision; kidney-sparing surgery is reserved for selected low-risk tumours, and adjuvant chemotherapy is considered for high-risk disease.

EAU risk groups NMIBC

Non-muscle-invasive bladder cancer is stratified into low, intermediate and high risk using grade, stage, tumour number, size and recurrence; high-risk disease receives BCG and low-risk receives single instillation.

Clavien-Dindo classification

Grades surgical complications by treatment required: I no intervention, II pharmacological, III intervention, IV organ failure or ICU, V death; used to standardise reporting in urological surgery.

Stress urinary incontinence

Involuntary leakage on effort or exertion, sneezing or coughing, due to urethral sphincter deficiency or hypermobility; urodynamics show leakage without detrusor contraction.

Detrusor overactivity

Involuntary detrusor contractions during the filling phase of cystometry, producing urgency and urgency incontinence; managed by bladder training, antimuscarinics or beta-3 agonists, and botulinum toxin in refractory cases.

Bladder outlet obstruction urodynamics

Pressure-flow study shows high detrusor pressure with low urinary flow rate; it distinguishes obstruction from detrusor underactivity and guides surgery such as TURP.

Orchidopexy timing

Surgery for undescended testis is recommended between 6 and 18 months of age to reduce risk of impaired spermatogenesis and testicular malignancy, and to allow surveillance.

Vesicoureteric reflux grading

Graded I to V on micturating cystourethrography: I ureter only, II up to renal pelvis without dilatation, III mild dilatation, IV moderate dilatation with blunting, V gross dilatation with tortuosity.

Posterior urethral valve

Congenital obstruction in male infants presenting with bilateral hydronephrosis, thick-walled bladder and poor stream; confirmed by micturating cystourethrogram and treated by endoscopic valve ablation.

WHO 2021 semen limits

Lower reference limits include volume 1.4 mL, concentration 16 million/mL, total motility 42%, progressive motility 30% and normal morphology 4%; used to define oligozoospermia and asthenozoospermia.

Varicocele repair indication

Considered for palpable varicocele with abnormal semen parameters, documented infertility and otherwise unexplained male factor; options are microsurgical subinguinal ligation or embolisation.

Penile cancer lymph nodes

Inguinal lymph node staging is prognostic; dynamic sentinel node biopsy is used for intermediate-risk disease, and inguinal lymphadenectomy for node-positive disease, with neoadjuvant chemotherapy in bulky disease.

Renal colic analgesia

First-line analgesia is an NSAID such as diclofenac or ketorolac; opioids are used when NSAIDs are contraindicated, and medical expulsive therapy may be considered for distal ureteric stones.

BPH medical therapy

Alpha-blockers improve symptoms within days; 5-alpha reductase inhibitors, such as finasteride, reduce prostate volume and progression risk over months and are best for prostates above 40 mL.

TURP syndrome

Dilutional hyponatraemia and hypervolaemia from absorption of hypotonic irrigant during monopolar TURP; presents with confusion, nausea, hypertension and visual disturbance, and is treated by stopping surgery and correcting sodium.

TNM bladder cancer

Ta is non-invasive papillary, T1 invades lamina propria, T2 muscle, T3 perivesical fat, T4 adjacent organs; N and M stages determine whether radical cystectomy or systemic therapy is appropriate.

Adrenal incidentaloma workup

Assess hormonal activity with overnight dexamethasone suppression, plasma metanephrines and aldosterone-renin ratio; imaging characteristics and size above 4 cm influence surgical removal.

Urethral stricture management

Short bulbar strictures may be treated by dilation or internal urethrotomy, but recurrence is common; excision and anastomotic urethroplasty offers the best long-term success for recurrent bulbar strictures.

Neobladder versus ileal conduit

Orthotopic neobladder requires adequate renal and hepatic function, motivated patient and negative urethral margins; ileal conduit is simpler with fewer metabolic complications but needs a stoma.