Exam Content

Level 2 Lifelong Learning

The Life Long Learning Exam for Urology Consists of:

Core Urology (45 Questions)

  • all applicants (including FPMS) with the exception of the Pediatric Urology Subspecialty applicants, will take the core exam - the core is included in Pediatric Urology exam

The applicant will also choose one of the following subsections:

Please note > 30% of all questions for the General Urology LLL exam (Not FPMS and Pediatric Urology) will come from the last 5 years SASP & pertinent AUA guidelines for the section of the exam they choose).


Topics that will be covered on the various modular exams including the core are listed below:

Core Urology

  1. Office Based Urology - 33% of exam
    1. Urinary Tract Infection: Cystitis, Prostatitis, Pyelonephritis
      1. Guidelines
      2. Dx, (Chemical Analysis), Rx
    2. Dx and Rx of sexually transmitted disease
    3. Microscopic hematuria -Guidelines
    4. Proteinuria – Dx and Evaluation
    5. LUTS -Guidelines
    6. When and how to use PSA screening
    7. Antibiotic prophylaxis - Guidelines
    8. DVT Prophylaxis
  2. Postoperative Complications & Trauma - 37% of exam
    1. Ureteroscopy complications
    2. ESWL complications
    3. TRUS prostate biopsy complications
    4. Traumatic Renal, bladder and urethral injuries;
      1. Dx and Triage
    5. Vesicovaginal- ureterovaginal fistula
      1. Dx and Triage
    6. Penile fracture: Dx and Triage
    7. Nerve injuries
      1. Positional nerve injuries
      2. Nerve injuries following surgery
        1. obturator, illioinguinal, femoral, etc
      3. Metabolic urgencies and emergencies
        1. Hyponatremia
        2. Myoglobinuria (positional)
        3. Postop Addisonian crisis, etc
  3. Imaging, radiation and patient safety - 30% of exam
    1. methods to reduce exposure of physician to radiation
    2. How to alter ultrasound techniques for better visibility
    3. Patient safety- outpatient concerns
      1. Sterilization of scopes etc.
      2. Dx and treatment of autonomic dysreflexia
    4. Opioid abuse

Oncology & Urinary Diversion

  1. Upper tract disease - 35% of exam
    1. Adrenal Pathology (Dx - Treatment)
      1. Benign
      2. Malignant
      3. Concepts on Chemotherapy
    2. Renal Tumors
      1. Benign
      2. Malignant
      3. Concepts on Chemo-Immunotherapy
      4. Ablative Rx of renal tumors
      5. Observation protocols for renal tumors
    3. Upper Tract Urothelial disease
  2. Lower Tract disease - 45%
    1. Bladder Tumors
      1. Benign
      2. Malignant
        1. Concepts on Chemotherapy
      3. intravesical therapy
    2. Prostate Cancer
      1. PSA monitoring
      2. Malignant
      3. Dx and Rx
        1. Observation protocols
        2. Androgen resistant prostate cancer
      4. Concepts on Chemo-Immuno therapy
    3. Penile Cancer
      1. Dx, Rx
      2. When to pursue lymphadenectomy
      3. Rudimentary concepts on Chemotherapy
    4. Testicular Cancer
      1. Dx, management
      2. Rudimentary Concepts on Chemotherapy
  3. Urinary diversions – 20% of exam
    1. Patient selection
    2. Postoperative complications (fistulas and strictures)
      1. Dx and Management
    3. Metabolic complications including vitamin deficiencies

Calculus Disease, Laparoscopy, Robotics & Upper Tract Obstruction

  1. Upper Tract Obstruction - 20% of exam
    1. UPJ obstruction
      1. Dx and management
    2. Retroperitoneal Fibrosis
      1. Dx, management- surgical and medical
    3. Ureteral strictures and fistulas post endoscopy
      1. Dx and management
    4. Complications of long term indwelling ureteral stents
  2. Renal and Ureteral Calculi - 55% of exam
    1. Dx- including metabolic evaluation
    2. Rx
      1. All forms, SWL, PCN, ureteroscopy, etc
      2. Medical therapy for underlying metabolic abnormalities
    3. Recommended follow-up following stone extraction
  3. Complications of PCN, ECSWL, Laparoscopy and Robotics - 25% of exam
    1. Ureteral stricture post ureteroscopy Dx and Rx
    2. Ureteral perforation: Dx and Rx
    3. PCN complications
      1. Bleed
      2. Bowel perforation
      3. Urinoma
    4. ECSWL- complications
    5. Robotic complications
      1. Diminished blood flow
      2. Reduced urine output
      3. Air embolism
      4. Complications of trocar placement

Erectile Dysfunction, Andrology and Infertility

  1. Impotence-Andrology-Androgen Deficiency - 50% of exam
    1. Androgen deficiency
      1. Dx, when to treat
    2. ED
      1. Dx
      2. Medical therapy
      3. Concepts on Chemo-Immunotherapy
      4. Use and contraindications of medical therapy
        1. use in cardiac patients
      5. injectable therapy, use and contraindications
    3. ED- Surgical treatment- IPP
      1. who to consider- contraindications for usage
      2. complications of placement and management
      3. long term complications
    4. Peyronnie’s disease
      1. Diagnosis
      2. Medical therapy
      3. Surgical therapy
        1. Complications of surgical therapy
    5. Priapism
      1. Etiologies
        1. High flow vs low flow
        2. sickle cell Rx
        3. Medical causes both drugs and malignancy as etiology
      2. Treatment
  2. Infertility - 50% of exam
    1. Diagnosis and Rx
      1. Obstructive causes
        1. Dx and Treatment
        2. Findings and significance of findings at time of vaso-vasostomy
        3. Association of Cystic fibrosis with vassal anomalies and significance
      2. Endocrinologic causes
        1. Dx and Treatment

Office Based Urology

  1. BPH - urethral obstruction - LUTS (male and female) - 25% of exam
    1. BPH
      1. Dx
      2. Medical treatment BPH
      3. Surgical Treatment BPH
    2. Urethral strictures-stenosis
      1. Pelvic Fracture Urethral Injuries
        1. Dx
        2. Treatment
      2. Urethral stricture (Anterior)
        1. Dx
        2. Treatment
    3. LUTS - male and female
      1. Dx (UDS when is it necessary?)
      2. Behavioral management
      3. Pharmacological management
      4. Options for refractory UUI/OAB (OnabotulinumtoxinA, neuromodulation)
    4. Stress Incontinence
      1. Behavioral and functional treatment
      2. Surgical treatment (bulking agents, slings)
  2. Sexual dysfunction – ED - 20% of exam
    1. Androgen deficiency
      1. Dx
      2. Medical therapy
    2. Erectile Dysfunction
      1. Use and contraindications of medical therapy
        1. use in cardiac patients
      2. Injectable therapy, use and contraindications
      3. Rx priapism
  3. Neoplasia - 30% of exam
    1. Low grade bladder tumor
      1. Dx, management ,Rx, including intravesicular therapy
    2. Prostate Cancer (Dx- observation protocols, antiandrogen therapy)
      1. Bx, MRI, observation protocols, antiandrogen therapy
  4. Renal and Ureteral Calculi (does not include metabolic evaluation) - 25% of exam
    1. Dx - Stones
    2. Rx
      1. All forms, SWL, PCN, ureteroscopy, etc
      2. Medical therapy for underlying metabolic abnormalities, e.g. uric acid calculi
    3. Recommended follow-up following stone extraction
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