100+ Free TiSBU Urologia Practice Questions

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Key Facts: TiSBU Urologia Exam

100 Items

Multiple-choice questions on the theoretical exam stage

Edital TiSBU — SBU / AMB

4–5 Hours

Theoretical examination duration per testing session

Edital TiSBU — SBU / AMB

R$ 2.220,00

Registration Fee for SBU/AMB Affiliated Members (R$ 4.400 for Non-Members)

Edital Oficial SBU / AMB

60%

Minimum Passing Grade Benchmark (6.0 / 10.0 Scale)

Regulamento CSTE / SBU

RQE Urologia

Specialist Registration Credential Conferred with CFM

Conselho Federal de Medicina (CFM) / AMB

Annual / Pró-TiSBU

Official Examination Frequency Conducted by CSTE / SBU

Sociedade Brasileira de Urologia (SBU)

The TiSBU (Título de Especialista em Urologia) is the premier Brazilian urology board certification examination administered annually by SBU and AMB. It rigorously evaluates candidates through theoretical, theoretical-practical, and clinical-surgical assessments covering oncological guidelines, endourological procedures, urodynamics, reconstructive surgery, and emergency management.

Sample TiSBU Urologia Practice Questions

Try these sample questions to test your TiSBU Urologia exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 54-year-old man presents for a routine urological evaluation. His serum prostate-specific antigen (PSA) is 5.8 ng/mL, and digital rectal examination (DRE / toque retal) reveals a benign, smooth, non-nodular prostate. Transrectal ultrasound (TRUS) calculates a total prostate volume of 32 mL. When assessing the patient's risk of harboring clinically significant prostate cancer to determine the need for multiparametric MRI or prostate biopsy, what is the widely accepted cutoff for Prostate-Specific Antigen Density (PSAD)?

A.PSAD > 0.05 ng/mL/cm³

B.PSAD > 0.15 ng/mL/cm³

C.PSAD > 0.35 ng/mL/cm³

D.PSAD > 0.50 ng/mL/cm³

Explanation: Prostate-Specific Antigen Density (PSAD) is calculated by dividing total serum PSA by prostate volume (in mL/cm³). A PSAD threshold >0.15 ng/mL/cm³ significantly increases the suspicion of clinically significant prostate cancer (ISUP Grade Group ≥2) and serves as an established trigger for pre-biopsy multiparametric MRI (mpMRI) or targeted prostate biopsy according to SBU, EAU, and AUA guidelines.

2According to the Prostate Imaging–Reporting and Data System version 2.1 (PI-RADS v2.1) guidelines for multiparametric magnetic resonance imaging (mpMRI) of the prostate, which imaging sequences serve as the primary determining sequence (dominant sequence) for evaluating lesions located in the Peripheral Zone (PZ) and Transition Zone (TZ), respectively?

A.Diffusion-Weighted Imaging (DWI/ADC) for the Peripheral Zone, and T2-Weighted Imaging (T2W) for the Transition Zone.

B.T2-Weighted Imaging (T2W) for the Peripheral Zone, and Dynamic Contrast-Enhanced (DCE) imaging for the Transition Zone.

C.Dynamic Contrast-Enhanced (DCE) imaging for the Peripheral Zone, and Diffusion-Weighted Imaging (DWI/ADC) for the Transition Zone.

D.T1-Weighted Imaging (T1W) for the Peripheral Zone, and MR Spectroscopy for the Transition Zone.

Explanation: In PI-RADS v2.1, the dominant (primary) sequence for scoring lesions in the Peripheral Zone (PZ) is Diffusion-Weighted Imaging (DWI) paired with its Apparent Diffusion Coefficient (ADC) map (with DCE serving as a tie-breaker for PI-RADS 3). Conversely, the dominant sequence for scoring lesions in the Transition Zone (TZ) is T2-Weighted Imaging (T2W) (with DWI serving as a modifier for PI-RADS 3).

3A 62-year-old man undergoes transperineal targeted prostate biopsy for a PI-RADS 4 lesion. Histopathology reveals adenocarcinoma with predominantly well-formed glands (Gleason pattern 3, 60%) alongside poorly formed/fused cribriform glands (Gleason pattern 4, 40%). According to the 2014/2019 International Society of Urological Pathology (ISUP) consensus, what is the corresponding ISUP Grade Group, and what is the clinical significance of the cribriform architectural pattern?

A.ISUP Grade Group 1; cribriform pattern indicates indolent behavior suitable for unmonitored observation.

B.ISUP Grade Group 2; presence of cribriform pattern independently predicts adverse pathology, higher recurrence rates, and is considered an unfavorable feature for active surveillance.

C.ISUP Grade Group 3; cribriform pattern mandates immediate systemic chemotherapy prior to any local therapy.

D.ISUP Grade Group 4; cribriform pattern is classified as Gleason pattern 5 and confers a uniformly poor survival.

Explanation: Gleason score 3+4=7 corresponds directly to ISUP Grade Group 2 (whereas 4+3=7 is ISUP Grade Group 3). The cribriform architectural pattern of Gleason pattern 4 is recognized by SBU, EAU, and ISUP as an independent adverse prognostic factor associated with increased biochemical recurrence, distant metastases, and lower cancer-specific survival, generally arguing against active surveillance.

4According to the D'Amico and European Association of Urology (EAU) risk stratification systems for localized prostate cancer, which of the following combinations of clinical parameters defines the Low-Risk category?

A.PSA < 10 ng/mL, ISUP Grade Group 1 (Gleason score ≤ 6), and clinical stage cT1c to cT2a.

B.PSA 10–20 ng/mL, ISUP Grade Group 2 (Gleason 3+4=7), and clinical stage cT2b.

C.PSA < 15 ng/mL, ISUP Grade Group 2 (Gleason 3+4=7), and clinical stage cT2c.

D.PSA < 20 ng/mL, ISUP Grade Group 3 (Gleason 4+3=7), and clinical stage cT3a.

Explanation: Low-Risk localized prostate cancer is strictly defined by the combination of PSA <10 ng/mL, ISUP Grade Group 1 (Gleason score ≤6), AND clinical stage cT1c–cT2a (organ-confined involving ≤half of one lobe on DRE). All three criteria must be fulfilled simultaneously to qualify as low risk.

5A 58-year-old asymptomatic man with a life expectancy >15 years is diagnosed with localized prostate cancer following an elevated PSA of 4.6 ng/mL. A 12-core systematic biopsy reveals ISUP Grade Group 1 (Gleason 3+3=6) adenocarcinoma in 1 core (involving 15% of the core). Pre-biopsy mpMRI showed a 7 mm PI-RADS 3 lesion in the left peripheral zone, and DRE is normal (cT1c). According to major consensus guidelines (such as PRIAS and SBU guidelines), what is the most appropriate initial management strategy?

A.Immediate radical prostatectomy with bilateral extended pelvic lymphadenectomy.

B.Active surveillance with serial PSA monitoring, periodic clinical/mpMRI evaluation, and confirmatory/surveillance biopsies.

C.External beam radiation therapy with 24 months of androgen deprivation therapy (ADT).

D.Immediate bilateral subcapsular orchiectomy.

Explanation: Active Surveillance (AS) is the preferred management strategy for men with low-risk prostate cancer (cT1c-cT2a, PSA <10 ng/mL, ISUP Grade Group 1, low tumor volume on biopsy). AS preserves quality of life and erectile/urinary function while monitoring disease with regular PSA tests, mpMRI, and repeat biopsies to detect grade reclassification or progression within the window of curability.

6During robot-assisted radical prostatectomy (RARP) for localized prostate cancer, a surgeon plans a nerve-sparing dissection to preserve erectile function. What anatomical fascial plane corresponds to an intrafascial dissection relative to the prostatic capsule and the prostatic fascia (periprostatic fascia)?

A.Dissection carried out strictly between the true prostatic capsule and the prostatic fascia, leaving the entire neurovascular bundle and periprostatic tissue intact on the posterolateral aspect.

B.Dissection carried out outside the Denonvilliers fascia, excising the perirectal fat and rectum wall.

C.Dissection carried out widely lateral to the levator ani fascia, removing all neurovascular tissue with a wide surgical margin.

D.Dissection entering the prostatic parenchyma directly through the transitional zone adenoma.

Explanation: An intrafascial nerve-sparing radical prostatectomy is performed by developing the plane directly between the prostatic capsule and the inner surface of the prostatic fascia (periprostatic fascia). This leaves all periprostatic connective tissue and the neurovascular bundle intact, maximizing functional erectile recovery in carefully selected low-risk/favorable intermediate-risk patients with no evidence of capsular abutment.

7According to international (EAU) and Brazilian (SBU) guidelines, which anatomical lymph node stations must be resected to constitute an anatomically complete Extended Pelvic Lymph Node Dissection (ePLND) during radical prostatectomy, and what is the validated nomogram probability threshold (e.g., Briganti 2019) that triggers this procedure?

A.Obturator fossa nodes only; triggered when nomogram risk of nodal metastasis exceeds 15%.

B.External iliac, internal iliac (hypogastric), and obturator fossa nodes (with or without presacral/common iliac nodes); triggered when nomogram risk of nodal metastasis exceeds 7%.

C.Inguinal and femoral canal lymph nodes; triggered when nomogram risk of nodal metastasis exceeds 20%.

D.Retroperitoneal para-aortic and interaortocaval nodes; triggered when nomogram risk of nodal metastasis exceeds 1%.

Explanation: An extended pelvic lymph node dissection (ePLND) includes the external iliac nodes (around the external iliac vein and artery up to the common iliac bifurcation), the obturator fossa nodes (above and below the obturator nerve), and the internal iliac (hypogastric) nodes. The Briganti 2019 nomogram recommends ePLND when the pre-operative risk of nodal involvement exceeds 7%, yielding accurate staging and potential therapeutic benefit.

8A 69-year-old man is diagnosed with high-risk localized prostate cancer (PSA 28 ng/mL, ISUP Grade Group 4 / Gleason 4+4=8, cT2c, negative conventional bone scan and CT). He elects definitive radiation therapy. According to randomized clinical trials and SBU/EAU guidelines, what is the standard recommended duration of concurrent and adjuvant Androgen Deprivation Therapy (ADT) in combination with External Beam Radiotherapy (EBRT)?

A.No ADT is required when high-dose image-guided EBRT is delivered.

B.Short-term ADT for 4 to 6 months.

C.Long-term ADT for 24 to 36 months.

D.Continuous lifelong ADT until disease progression.

Explanation: For high-risk and locally advanced localized prostate cancer treated with definitive radiotherapy, multiple phase III randomized trials (EORTC 22961, RTOG 9202) have established that combining EBRT with long-term ADT (24 to 36 months of LHRH agonists/antagonists) significantly improves biochemical recurrence-free, metastasis-free, and overall survival compared to short-term ADT or radiotherapy alone.

9What is the consensus definition of Biochemical Recurrence (BCR) following Radical Prostatectomy versus following definitive External Beam Radiotherapy (Phoenix criteria), respectively?

A.Post-RP: Two consecutive rising PSA values ≥ 0.2 ng/mL; Post-EBRT: An absolute PSA rise of ≥ 2.0 ng/mL above the post-treatment nadir.

B.Post-RP: Any detectable PSA > 0.01 ng/mL; Post-EBRT: PSA rising above 4.0 ng/mL at any single visit.

C.Post-RP: An increase of PSA > 1.0 ng/mL above nadir; Post-EBRT: Serum PSA > 10.0 ng/mL.

D.Post-RP: PSA doubling time < 3 months; Post-EBRT: Inability to achieve PSA < 0.1 ng/mL within 6 months.

Explanation: Biochemical recurrence (BCR) following radical prostatectomy is defined by the AUA, EAU, and SBU as a confirmed serum PSA rise ≥0.2 ng/mL. Following definitive radiation therapy, the ASTRO/RTOG Phoenix consensus defines BCR as an increase in serum PSA by ≥2.0 ng/mL above the post-radiation nadir (nadir + 2.0 ng/mL), regardless of whether the patient received concurrent ADT.

10A 64-year-old man who underwent radical prostatectomy 18 months ago (pT3aN0R1, ISUP Grade Group 3) presents with a confirmed rising PSA from undetectable to 0.28 ng/mL. Restaging 68Ga-PSMA PET/CT shows no evidence of distant metastasis or regional lymphadenopathy. When planning salvage radiotherapy (sRT) to the prostatic fossa, what does high-level clinical trial evidence (e.g., SPPORT, GETUG-AFU 16) demonstrate regarding timing and the addition of androgen deprivation therapy?

A.Early salvage radiotherapy should be administered while PSA is < 0.5 ng/mL (ideally < 0.2–0.3 ng/mL), and adding short-term ADT (4–6 months) significantly improves progression-free and metastasis-free survival.

B.Radiotherapy should be delayed until the PSA reaches > 2.0 ng/mL to maximize targeting accuracy on conventional imaging, without ADT.

C.Salvage radiotherapy has no oncological benefit compared to immediate continuous lifelong ADT monotherapy.

D.The prostatic bed should never be irradiated in patients with positive surgical margins (R1).

Explanation: Early salvage radiotherapy (sRT) offers the highest cure rates when initiated at the lowest detectable rising PSA levels (PSA <0.5 ng/mL, ideally <0.2 ng/mL). Large phase III trials (SPPORT, GETUG-AFU 16, RTOG 9601) demonstrated that combining sRT with short-term ADT (4 to 6 months) substantially improves biochemical recurrence-free survival and reduces distant metastasis compared to sRT alone.

About the TiSBU Urologia Exam

The Título de Especialista em Urologia (TiSBU) is the official board certification for urologists in Brazil, awarded by the Sociedade Brasileira de Urologia (SBU) in partnership with the Associação Médica Brasileira (AMB) and registered with the Conselho Federal de Medicina (CFM). Organised by the Comissão de Seleção e Título de Especialista (CSTE), the examination evaluates comprehensive knowledge across urological oncology, lithiasis and endourology, benign prostatic hyperplasia, neurourology and female urology, andrology, male infertility, pediatric urology, and urological trauma. Attaining the TiSBU title is the definitive requirement for Brazilian physicians to obtain their official Registro de Qualificação de Especialista (RQE) in Urology.

Assessment

Annual national board certification administered by the Comissão de Seleção e Título de Especialista (CSTE) of the Sociedade Brasileira de Urologia (SBU) with the AMB. Prova Teórica: multiple-choice questions covering all domains of clinical and surgical urology. Prova Teórico-Prática: clinical case vignettes, imaging (CT, MRI, ultrasound, urodynamic tracings), and surgical technique scenarios. Prova Prática / Análise Curricular: evaluation of surgical skills, training curriculum, and academic output.

Time Limit

4 to 5 hours for the theoretical examination session (with separate dedicated scheduling for theoretical-practical and practical assessments)

Passing Score

Minimum composite passing score of 60% (6.0 on a 10.0 scale) in the theoretical and theoretical-practical stages, as established in the annual SBU/AMB notice (Edital)

Exam Fee

R$ 880,00 (taxa de inscrição do Exame Seriado Pró-TiSBU Nível R3, Edital nº 001/2026); a taxa de confecção do título cobrada pela AMB é informada à parte (R$ 930,00 vigentes) (Sociedade Brasileira de Urologia (SBU) — Associação Médica Brasileira (AMB))

TiSBU Urologia Exam Content Outline

20%

Uro-Oncologia: Próstata

Prostate cancer screening, PSA kinetics, mpMRI PI-RADS v2.1 scoring, ISUP Grade Groups, risk stratification, active surveillance criteria, radical prostatectomy nerve-sparing planes, extended lymphadenectomy, radiotherapy + ADT, biochemical recurrence, and advanced systemic therapies for mHSPC (triplet regimens) and mCRPC (PARP inhibitors, 177Lu-PSMA-617).

25%

Uro-Oncologia: Rim, Bexiga, Testículo e Pênis

Bosniak 2019 cystic renal mass classification, partial vs radical nephrectomy, advanced RCC systemic immunotherapy combinations; NMIBC risk groups, TURBT quality metrics, intravesical BCG therapy; MIBC neoadjuvant chemotherapy, radical cystectomy, and urinary diversions (Ileal conduit vs Neobladder); Testicular germ cell tumors (markers, orchiectomy, RPLND, BEP); Penile cancer staging and lymphadenectomy.

15%

Litíase Urinária e Endourologia

24-hour urine metabolic evaluation (hypercalciuria, hyperoxaluria, hypocitraturia, cystinuria, dRTA), stone composition, medical expulsive therapy, shock wave lithotripsy (SWL), semirigid and flexible ureteroscopy (fURS/RIRS with Holmium/Thulium fiber laser), percutaneous nephrolithotomy (PCNL) access and tract dilation, and infected hydronephrosis emergency decompression.

15%

Hiperplasia Prostática, Neurourologia e Urologia Feminina

Benign Prostatic Hyperplasia (BPH) medical therapy (alpha-blockers, 5-ARIs, PDE5i) and surgical techniques (TURP, HoLEP, robotic simple prostatectomy); Urodynamics (filling cystometry, detrusor overactivity, BOOI, BCI); Neurogenic bladder (DSD, autonomic dysreflexia, CIC, botulinum toxin); Female stress incontinence (midurethral slings, AUS); and Pelvic organ prolapse (POP-Q).

10%

Andrologia, Infertilidade e Medicina Sexual

Erectile dysfunction pathophysiology and therapies (PDE5i, intracavernosal injections, 3-piece inflatable penile prosthesis); Peyronie disease acute vs chronic management; Ischemic vs non-ischemic priapism emergency protocols; WHO 2021 semen analysis criteria; Varicocele microsurgical repair; Obstructive vs non-obstructive azoospermia (micro-TESE); and Hypogonadism TRT.

Urologia Pediátrica

Cryptorchidism timing and surgical management; Hypospadias principles and repair (TIP/Snodgrass); Vesicoureteral reflux (VUR) grading and treatment (Deflux vs reimplantation); UPJ obstruction evaluation (MAG3 scintigraphy, Anderson-Hynes pyeloplasty); Posterior urethral valves (PUV) ablation; and Pediatric tumors (Wilms tumor vs neuroblastoma).

Emergências, Trauma e Cirurgia Reconstrutora

AAST Renal trauma staging (I–V) and management; Bladder trauma (extraperitoneal vs intraperitoneal); Urethral trauma (anterior vs posterior); Testicular torsion emergency salvage (<6 hours); Fournier gangrene radical debridement; and Anterior urethral strictures (EPA vs buccal mucosa graft urethroplasty).

How to Pass the TiSBU Urologia Exam

What You Need to Know

Passing score: Minimum composite passing score of 60% (6.0 on a 10.0 scale) in the theoretical and theoretical-practical stages, as established in the annual SBU/AMB notice (Edital)
Assessment: Annual national board certification administered by the Comissão de Seleção e Título de Especialista (CSTE) of the Sociedade Brasileira de Urologia (SBU) with the AMB. Prova Teórica: multiple-choice questions covering all domains of clinical and surgical urology. Prova Teórico-Prática: clinical case vignettes, imaging (CT, MRI, ultrasound, urodynamic tracings), and surgical technique scenarios. Prova Prática / Análise Curricular: evaluation of surgical skills, training curriculum, and academic output.
Time limit: 4 to 5 hours for the theoretical examination session (with separate dedicated scheduling for theoretical-practical and practical assessments)
Exam fee: R$ 880,00 (taxa de inscrição do Exame Seriado Pró-TiSBU Nível R3, Edital nº 001/2026); a taxa de confecção do título cobrada pela AMB é informada à parte (R$ 930,00 vigentes)

Keys to Passing

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TiSBU Urologia Study Tips from Top Performers

1Master Modern Oncological Staging & Classifications: Memorize PI-RADS v2.1 mpMRI scoring parameters, ISUP 2014/2019 Grade Groups (1-5), Bosniak 2019 cystic renal mass criteria (IIF vs III vs IV), and AAST renal trauma grading (I-V).

2Internalize Prostate Cancer Systemic Therapies: Know the landmark trial indications for triplet therapy in mHSPC (PEACE-1 with abiraterone, ARASENS with darolutamide), PARP inhibitors in mCRPC with BRCA1/2 mutations (PROfound trial), and 177Lu-PSMA-617 radioligand therapy (VISION trial).

3Systematize 24-Hour Urine Metabolic Evaluation: Understand diagnostic thresholds and pharmacological mechanisms for hypercalciuria (thiazides), hypocitraturia (potassium citrate), hyperuricosuria (allopurinol/alkalinization), cystinuria (tiopronin), and enteric hyperoxaluria.

4Interpret Complex Urodynamic Tracings: Practice calculating the Bladder Outlet Obstruction Index (BOOI = PdetQmax - 2*Qmax), Bladder Contractility Index (BCI), Detrusor Leak Point Pressure (DLPP cutoff 40 cmH2O), and identifying detrusor sphincter dyssynergia (DSD).

5Review Endourological Laser & Access Principles: Differentiate Holmium:YAG (2100 nm pulsed photothermal) vs Thulium Fiber Laser (1940 nm continuous/pulsed superfine dusting), ureteral access sheath trauma grades (Traxer), and PCNL intercostal puncture complications.

6Memorize Pediatric & Reconstructive Timelines: Review cryptorchidism orchiopexy timing (6-18 months), hypospadias repair principles (TIP/Snodgrass), posterior urethral valve emergency management, and anastomotic vs substitution urethroplasty indications.

Frequently Asked Questions

What is the TiSBU and why is it essential for urologists in Brazil?

The Título de Especialista em Urologia (TiSBU) is the official medical specialist certification awarded by the Sociedade Brasileira de Urologia (SBU) and the Associação Médica Brasileira (AMB). Passing the TiSBU examination allows physicians to register their specialized qualification (Registro de Qualificação de Especialista - RQE) in Urology with the Regional Medical Councils (CRMs) and Federal Council of Medicine (CFM), which is legally required to practice and advertise formally as a urologist throughout Brazil.

What are the eligibility pathways to sit for the TiSBU examination?

Candidates must be fully licensed physicians with active registration in a Regional Medical Council (CRM) and fulfill one of the official pathways: (1) Completion of an accredited Medical Residency Program (CNRM/MEC) in Urology; (2) Completion of an SBU-accredited Urology Training Program (Programa de Treinamento em Urologia credenciado pela SBU); or (3) Proven clinical and surgical practice in Urology for at least double the duration of official residency (6 years), accompanied by documented institutional surgical logs and curricular evaluation as stipulated in the annual SBU/AMB notice (Edital).

What is the difference between the TiSBU and the Pró-TiSBU?

The TiSBU is the comprehensive unified board examination taken after concluding urology residency or training. The Pró-TiSBU is a serialized annual evaluation process administered during the three years of residency (R1, R2, R3). Residents who achieve qualifying cumulative scores across all three annual Pró-TiSBU stages and fulfill all institutional requirements can directly attain the specialist title upon residency completion.

How is the unified TiSBU examination structured across its stages?

The unified exam is conducted by the Comissão de Seleção e Título de Especialista (CSTE) and traditionally comprises: (1) Phase 1 — Prova Teórica (Objective Theoretical Exam), containing multiple-choice questions covering all urological subspecialties and clinical guidelines; (2) Phase 2 — Prova Teórico-Prática (Theoretical-Practical Exam), presenting clinical case vignettes, imaging studies (CT, MRI, ultrasound, urodynamic graphs), and surgical dilemmas; and (3) Phase 3 — Practical assessment and Curricular Analysis (Análise Curricular).

Which clinical guidelines and textbooks form the core bibliographic reference for the TiSBU?

The examination is based on the official Diretrizes da Sociedade Brasileira de Urologia (SBU), the latest edition of Campbell-Walsh-Wein Urology, and updated international guidelines from the European Association of Urology (EAU) and American Urological Association (AUA). Key topics include modern oncology staging (PI-RADS v2.1, Bosniak 2019, ISUP Grade Groups), endourological instrumentation, urodynamics, WHO 2021 semen parameters, and AAST trauma classifications.

Why is this OpenExamPrep practice bank presented in English?

This practice bank is an English-language MCQ study adaptation designed for comprehensive board preparation, international urology fellows, and Brazilian candidates who wish to master global urological literature in English. All authentic Brazilian terminology, SBU guideline criteria, and anatomical landmarks are preserved inline.