FEBU Part 1 key terms

Persistent inability to attain or maintain a penile erection sufficient for satisfactory sexual performance, often vascular, neuropathic, hormonal or psychogenic in origin, and considered a marker of cardiovascular risk.

Clinical syndrome in ageing men combining consistently low serum testosterone with symptoms such as reduced libido, fatigue and erectile difficulty; diagnosis requires morning total testosterone confirmed on repeat testing.

Abnormal dilatation of the pampiniform plexus veins, usually left-sided, palpable as a bag of worms that empties when the patient lies flat; associated with impaired semen parameters and male subfertility.

Acquired fibrosis of the tunica albuginea producing a palpable penile plaque, curvature, shortening and painful erections; a stable phase after about twelve months may warrant surgical correction.

Glycoprotein produced by prostatic epithelium that leaks into serum; used for screening, monitoring and risk stratification, but also raised in benign hyperplasia, prostatitis and after instrumentation as well as cancer.

Five-tier prostate cancer grading system derived from Gleason architectural patterns, where group 1 equals Gleason 3+3 and group 5 equals Gleason 9-10, giving better prognostic separation than the Gleason score alone.

Prostate cancer progressing despite castrate serum testosterone below 50 ng/dL, shown by rising PSA, radiological progression or clinical deterioration; treated with next-generation hormonal agents, chemotherapy, radium-223 or PARP inhibitors.

Live attenuated Mycobacterium bovis instilled into the bladder to provoke a local immune response, the standard adjuvant treatment for high-risk non-muscle-invasive urothelial carcinoma; contraindicated in immunosuppression and gross haematuria.

Surgical removal of the kidney, renal pelvis and entire ureter with a cuff of bladder, the standard treatment for high-risk upper tract urothelial carcinoma; performed open, laparoscopically or robot-assisted.

Removal of a renal tumour with preservation of the remaining parenchyma, preferred for T1 renal masses; carries risks of bleeding, urinary fistula and positive surgical margins.

Numerical measure of radiodensity on CT, where water is zero and bone is high; stone density in Hounsfield units, together with skin-to-stone distance, helps predict shockwave lithotripsy success.

Flexible ureteroscopic stone treatment using a holmium laser within the kidney, usually after placing a ureteral access sheath; suited to stones under two centimetres or after failed lithotripsy.

Minimally invasive creation of a nephrostomy tract to remove large or complex renal stones, first-line for stones above two centimetres; complications include bleeding, colonic injury and sepsis.

Hollow tube placed over a guidewire into the ureter that facilitates repeated passage of a flexible ureteroscope, lowers intrarenal pressure and improves stone fragment clearance during retrograde surgery.

Subepithelial calcium phosphate deposits at the renal papilla that erode the urothelium and act as attachment sites for calcium oxalate stones, a key mechanism in idiopathic stone formation.

Excessive urinary oxalate excretion, either inherited from hepatic enzyme defects or secondary to enteric disease and diet, causing calcium oxalate stones and nephrocalcinosis.

Urodynamic observation of involuntary detrusor contractions during filling cystometry, producing urgency and frequency; it may be idiopathic or neurogenic and underlies overactive bladder syndrome.

Involuntary contraction of the external urethral sphincter during detrusor contraction in suprasacral spinal cord injury, causing high bladder pressures, incomplete emptying and risk of upper tract damage.

Volume of urine left in the bladder immediately after voiding, measured by ultrasound or catheter; a raised value suggests incomplete emptying from obstruction or an underactive detrusor.

Implanted electrode stimulating sacral nerve roots S3 to modulate bladder and bowel function, used for refractory urgency incontinence, non-obstructive retention and faecal incontinence.

Retrograde flow of urine from bladder to ureter due to a short or incompetent ureterovesical junction, graded I to V; linked to febrile urinary tract infection and renal scarring in children.

Congenital obstructing membranous folds in the posterior urethra of boys causing bilateral hydronephrosis, a thick-walled bladder and possible renal failure; treated by primary endoscopic valve ablation.

Failure of one or both testes to descend into the scrotum, associated with impaired spermatogenesis and malignancy risk; orchidopexy is recommended within the first twelve to eighteen months of life.

Congenital ventral urethral meatus with a hooded prepuce and possible chordee; repair is usually performed at six to eighteen months and neonatal circumcision should be avoided.

Fibrotic narrowing of the urethra from trauma, instrumentation or inflammation causing reduced flow, straining and recurrent infection; short bulbar strictures may be treated endoscopically, longer ones by urethroplasty.

Autologous graft harvested from the inner cheek used in substitution urethroplasty for long or recurrent strictures, valued for its thin, hairless and well-vascularised epithelial surface.

Necrotising fasciitis of the perineum and genitalia, usually polymicrobial and arising from a urogenital or perineal source; requires immediate broad-spectrum antibiotics and repeated surgical debridement.

Category III prostatitis defined by pelvic pain and lower urinary tract symptoms without demonstrable bacterial infection; managed with alpha-blockers, trials of antibiotics, physiotherapy and multimodal analgesia.

Presence of significant bacteria in urine without urinary symptoms; treated only in pregnancy and before urological procedures involving mucosal trauma, since routine antibiotics do not improve other outcomes.

Need for dialysis within the first week after kidney transplantation, reflecting ischaemia-reperfusion injury; associated with longer hospital stay and increased risk of acute rejection and graft loss.

Drug class including tacrolimus and ciclosporin that blocks T-cell activation through calcineurin inhibition; a mainstay of transplant immunosuppression, but nephrotoxic and requiring therapeutic drug monitoring.

Percentage of a reference donor panel against which a recipient's serum antibodies react, indicating the degree of HLA sensitisation and guiding crossmatch requirements and organ allocation.

Kidney retrieval after withdrawal of life-sustaining treatment and confirmed circulatory arrest, expanding the donor pool but carrying a higher risk of delayed graft function than donation after brain death.

Twisting of the spermatic cord that compromises testicular blood flow, presenting with acute scrotal pain and a high-riding testis; surgical exploration within six hours is required to preserve the testis.

Painful erection lasting over four hours caused by sluggish cavernosal blood flow with hypoxia and acidosis; a compartment syndrome requiring aspiration, irrigation and shunt surgery to prevent fibrosis and impotence.

Sudden inability to void despite a palpable, painful bladder, often from benign prostatic obstruction, clot, stone or neurological causes; managed by immediate urethral or suprapubic catheterisation.

Volume of plasma filtered by the kidneys per unit time, estimated from creatinine or cystatin C; the key measure of renal function used for staging chronic kidney disease and dosing drugs.

Multilayered transitional epithelium lining the urinary tract, with umbrella cells and a glycosaminoglycan layer that maintain a permeability barrier against urine and its solutes.

Hormonal cascade in which renin release triggers angiotensin II formation, causing vasoconstriction and aldosterone-driven sodium retention; targeted by ACE inhibitors and ARBs in renal and cardiovascular disease.

Functional unit of the kidney comprising glomerulus, proximal tubule, loop of Henle, distal tubule and collecting duct, where filtration, reabsorption and secretion produce urine.