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Sample Saudi Board Urology Practice Questions

Try these sample questions to review concepts for the Saudi Board Urology exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old female presents with severe urinary urgency, frequency (voiding 14 times per day), and urge incontinence. Multichannel urodynamic study demonstrates involuntary detrusor contractions during the filling phase with an amplitude of 35 cm H2O, which the patient cannot suppress and which is accompanied by urinary leakage. What is the urodynamic diagnosis?
A.Detrusor overactivity (DO)
B.Detrusor underactivity (DU)
C.Urodynamic stress incontinence (USI)
D.Detrusor sphincter dyssynergia (DSD)
Explanation: According to the International Continence Society (ICS) standardization, detrusor overactivity (DO) is a urodynamic observation characterized by involuntary detrusor muscle contractions during the bladder filling cystometry phase, which may be spontaneous or provoked and which the patient cannot completely suppress. When DO occurs in the presence of a clinically relevant neurological condition (e.g., spinal cord injury, multiple sclerosis), it is designated neurogenic detrusor overactivity (NDO); otherwise, it is idiopathic DO.
2A 32-year-old male with a complete T6 traumatic spinal cord injury (sustained 2 years ago) presents for annual urologic evaluation. Multichannel video-urodynamic testing reveals high-amplitude neurogenic detrusor contractions occurring simultaneously with involuntary spastic contractions of the external striated urethral sphincter, generating intravesical pressures exceeding 85 cm H2O. What is this condition, and what is the primary upper urinary tract risk if left untreated?
A.Detrusor sphincter dyssynergia (DSD); risk of hydronephrosis, vesicoureteral reflux, and irreversible renal parenchymal failure
B.Acontractile detrusor; risk of acute testicular infarction
C.Primary bladder neck obstruction; risk of urethral diverticulum
D.Stress urinary incontinence; risk of urinary tract calculus formation
Explanation: DSD is involuntary activation of the urethral or periurethral striated sphincter during a detrusor contraction in a neurologic disorder. A suprasacral cord injury can disrupt coordinated emptying and generate high bladder pressures. Upper-tract risk depends on the overall pressure, compliance, reflux, and emptying pattern rather than a single universally diagnostic leak-point cutoff.
3A 70-year-old male with mild cognitive impairment and overactive bladder syndrome (OAB) requires pharmacological therapy after failing behavioral modifications. Which of the following OAB medications is a selective beta-3 adrenergic receptor agonist that does not cause central nervous system anticholinergic cognitive decline or dry mouth?
A.Mirabegron
B.Oxybutynin
C.Tolterodine
D.Solifenacin
Explanation: Mirabegron is a beta-3 agonist that promotes detrusor relaxation during storage without using an antimuscarinic mechanism. It is useful when anticholinergic adverse effects are a concern. It still has its own precautions, including blood-pressure effects and possible urinary retention in susceptible patients, so absence of antimuscarinic action is not a guarantee of no adverse effects.
4A 48-year-old female with refractory idiopathic overactive bladder and urge incontinence that failed oral antimuscarinics and beta-3 agonists undergoes intradetrusor injection of onabotulinumtoxinA (100 Units). What is the cellular molecular mechanism of action of botulinum toxin A in suppressing detrusor overactivity?
A.Cleavage of synaptosome-associated protein of 25 kDa (SNAP-25), preventing SNARE-mediated vesicular exocytosis of acetylcholine at the neuromuscular junction
B.Competitive blockade of post-junctional muscarinic M3 receptors on detrusor smooth muscle
C.Direct covalent inhibition of acetylcholinesterase in the synaptic cleft
D.Stimulation of nitric oxide synthase in the urothelial lining
Explanation: Botulinum toxin A cleaves presynaptic SNAP-25, interfering with SNARE-mediated vesicle fusion and acetylcholine release. Its bladder effects include reduced detrusor activation and modulation of sensory signaling. Clinical chemodenervation is temporary because functional neurotransmission recovers; the treatment does not permanently abolish bladder innervation.
5In a patient undergoing Sacral Neuromodulation (SNM / InterStim) lead placement under local anesthesia with fluoroscopic guidance, through which sacral neural foramen is the tined lead ideally placed, and what motor response confirms optimal stimulation of that sacral nerve root?
A.S3 foramen; motor response of great toe plantar flexion ('bellows' contraction of the pelvic floor and plantarflection of the hallux)
B.S1 foramen; motor response of ankle dorsiflexion
C.S2 foramen; motor response of hip external rotation alone
D.S4 foramen; motor response of knee extension
Explanation: Sacral neuromodulation targets the S3 nerve root, which carries the primary parasympathetic and somatic innervation to the bladder, pelvic floor, and external urethral sphincter. The tined lead is advanced through the posterior S3 sacral foramen under fluoroscopy. Correct placement at S3 is verified by stimulating the lead to elicit: (1) a somatic motor response consisting of plantar flexion of the great toe (hallux) and/or fan-like bellows movement of the perineum/pelvic floor, and (2) sensory stimulation perceived in the vagina, scrotum, or rectum.
6An adult woman leaks urine with coughing and exercise. Urodynamics demonstrates leakage with increased abdominal pressure without a detrusor contraction, and bladder emptying is normal. After unsuccessful conservative treatment, which diagnosis and established surgical option best fit the findings?
A.Stress urinary incontinence; a synthetic midurethral sling after counseling about alternatives and mesh risks
B.Detrusor overactivity; intradetrusor botulinum toxin as the primary treatment for the observed leakage
C.Overflow incontinence; intermittent catheterization as the primary treatment
D.Bladder pain syndrome; cystoscopic fulguration of presumed Hunner lesions
Explanation: Leakage during increased abdominal pressure without a detrusor contraction defines urodynamic stress incontinence. A midurethral sling is an established surgical option, alongside alternatives such as an autologous fascial sling or colposuspension. A single leak-point pressure does not reliably establish urethral hypermobility or fully characterize sphincter function.
7A 68-year-old male develops severe post-prostatectomy stress urinary incontinence (requiring 5 large pads per day) 18 months following radical prostatectomy. Conservative pelvic floor muscle rehabilitation for 12 months has failed. Cystoscopy confirms normal anastomotic caliber with no strictures. What is the gold standard surgical intervention to restore continence in severe male stress urinary incontinence?
A.Implantation of an Artificial Urinary Sphincter (AUS, e.g., AMS 800)
B.Transurethral injection of polydimethylsiloxane bulking agent
C.Transobturator male sling alone
D.Permanent suprapubic cystostomy
Explanation: The Artificial Urinary Sphincter (AUS, AMS 800) is the undisputed gold standard surgical treatment for moderate-to-severe male stress urinary incontinence following radical prostatectomy or transurethral surgery. The three-component device consists of an occlusive cuff placed around the bulbar urethra, a pressure-regulating balloon (typically 61-70 cm H2O) placed in the prevesical space, and a control pump located in the dependent scrotum. Male slings are reserved for mild post-prostatectomy incontinence (1-2 pads/day).
8A 35-year-old male presents with severe obstructive voiding symptoms (Qmax 4.5 mL/s, straining, spraying) following multiple prior internal urethrotomies. Retrograde urethrography (RUG) combined with voiding cystourethrography (VCUG) demonstrates a 4.5-cm dense stricture of the mid-bulbar urethra. According to American Urological Association (AUA) guidelines, what is the definitive reconstructive procedure of choice?
A.Substitution urethroplasty using a dorsal or ventral onlay buccal mucosal graft (BMG)
B.Repeat direct vision internal urethrotomy (DVIU) with high-dose steroid injection
C.Blind dilation with filiforms and followers every 2 weeks
D.Permanent placement of an expandable metallic urethral stent (UroLume)
Explanation: AUA and EAU guidelines state that repeat endoscopic treatment (DVIU or dilation) after failure of a prior urethrotomy has a long-term recurrence rate of >80-95% and is not recommended. For bulbar urethral strictures > 2 cm, primary excision and primary anastomosis (EPA) causes penile chordee and chordee-like tension. Substitution urethroplasty using a free autologous graft—specifically a dorsal or ventral onlay Buccal Mucosa Graft (BMG)—is the gold standard procedure with durable long-term success rates exceeding 85-90%.
9A 24-year-old male sustains a pelvic ring fracture in a high-speed motor vehicle collision resulting in a complete posterior urethral distraction defect (pelvic fracture urethral injury / PFUI) at the bulbomembranous junction. Following suprapubic catheter drainage and 4 months of stabilization, open delayed perineal anastomotic urethroplasty is performed. What are the four progressive sequential surgical steps (the 'elaborated perineal approach' of Webster) required to bridge a distraction gap without tension?
A.Step 1: Extensive distal urethral mobilization; Step 2: Separation of the corporeal cavernosa (crural separation); Step 3: Inferior pubectomy; Step 4: Supracrural re-routing of the urethra
B.Step 1: Scrotal flap harvest; Step 2: Suprapubic cystostomy revision; Step 3: Total prostatectomy; Step 4: Bladder neck closure
C.Step 1: Obturator foramen bypass; Step 2: Rectus muscle flap; Step 3: Gracilis transfer; Step 4: Skin grafting
D.Step 1: Internal urethrotomy; Step 2: Catheter traction; Step 3: Balloon dilation; Step 4: Urethral stenting
Explanation: George Webster's elaborated perineal approach for posterior urethral distraction defects follows an escalating four-step sequence to bridge the fibrous gap and allow a tension-free mucosa-to-mucosa bulboprostatic anastomosis: Step 1: Mobilization of the anterior urethra from the penoscrotal junction to the stricture (bridges up to 2-3 cm); Step 2: Separation of the corporeal bodies in the midline (crural separation; gains 1-2 cm); Step 3: Wedge resection of the inferior pubic symphysis (inferior pubectomy; gains 1-2 cm); Step 4: Supracrural re-routing of the mobilized urethra around the lateral side of the corporal body.
10A 44-year-old female presents with continuous, involuntary watery vaginal leakage starting 10 days after an uncomplicated total abdominal hysterectomy for uterine fibroids. Physical examination reveals clear fluid pooling in the upper vaginal vault. A 'double-dye' test is performed: oral phenazopyridine (which turns urine orange) is administered, followed by intravesical instillation of dilute methylene blue via a Foley catheter while vaginal tampons are placed. The tampon shows deep blue staining at its apex. What is the diagnosis?
A.Vesicovaginal fistula (VVF)
B.Ureterovaginal fistula (UVF)
C.Severe stress urinary incontinence
D.Peritoneal fluid transudation
Explanation: The double-dye test differentiates a vesicovaginal fistula (VVF) from a ureterovaginal fistula (UVF). Intravesical methylene blue instillation stains the vaginal pack BLUE if a communication exists between the bladder and vagina (VVF). If a ureterovaginal fistula is present, the bladder dye will not reach the vagina, but orally administered phenazopyridine (excreted via the kidneys through the ureter) will stain the pack ORANGE. If both are present, blue and orange stains appear. Deep blue staining confirms a vesicovaginal fistula.

About the Saudi Board Urology Exam

Independent English-language MCQ study adaptation by OpenExamPrep for the Saudi Board Final Written Examination in Urology. Practice voiding dysfunction, stones, transplantation, tumors, pediatric urology, prostate and adrenal disease, infection, reproductive health, trauma, and reconstruction. This is not an official translation, an official-format simulation, or a substitute for structured oral, procedural, or supervised clinical practice. OpenExamPrep is not affiliated with or endorsed by SCFHS.

Exam sponsor: Saudi Commission for Health Specialties (SCFHS). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Written MCQs followed by a separate final clinical examination comprising eight 10-minute SOE stations. The current clinical blueprint specifies structured oral stations, rather than a mixed OSCE/SOE station count.

Time Limit

Written-paper duration not confirmed in the public specialty sources reviewed; check the admission notice.

Passing Score

70%, with conditional adjustment to a minimum of 65% as specified in the written blueprint

Exam / Certification Fees

Not confirmed in the public specialty sources reviewed; check SCFHS registration.

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

5%

Anatomy/Physiology and Pathophysiology

Anatomy and physiological mechanisms.

5%

Basics of Urologic Surgery

Operative principles, technology, and safety.

10%

Infections/Inflammation

Urinary and genital infection and inflammation.

10%

Reproductive/Sexual Health

Fertility, andrology, and sexual function.

13%

Urine Transport/Storage and Emptying

Continence, voiding dysfunction, and transport.

10%

Trauma/Reconstruction

Injury assessment and reconstructive decisions.

12%

Renal Failure/Transplantation and Urolithiasis

Stones, renal failure, and transplantation.

12%

Benign and Malignant GU Neoplasm

Tumor biology, diagnosis, staging, and treatment.

11%

Prostate/Adrenal

Prostate disease and adrenal disorders.

12%

Pediatric Urology

Congenital and childhood disorders.

Preparing for the Saudi Board Urology Exam

What You Need to Know

  • Passing score: 70%, with conditional adjustment to a minimum of 65% as specified in the written blueprint
  • Assessment: Written MCQs followed by a separate final clinical examination comprising eight 10-minute SOE stations. The current clinical blueprint specifies structured oral stations, rather than a mixed OSCE/SOE station count.
  • Time limit: Written-paper duration not confirmed in the public specialty sources reviewed; check the admission notice.
  • Exam / certification fees: Not confirmed in the public specialty sources reviewed; check SCFHS registration. Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Saudi Board Urology: Suggested Study Strategy

1Use the current written blueprint and check SCFHS notices for sitting-specific logistics.
2Review primary guidelines for stones, trauma, infections, oncology, and pediatric urology.
3Practice staging and pathology interpretation without merging criteria from different versions.
4Prepare structured oral responses and procedural skills separately from MCQ study.

Frequently Asked Questions

What is the current written format?

The SCFHS blueprint posted in February 2026 specifies two papers of 100–125 single-best-answer MCQs each, with up to 10% unscored calibration items added. The written duration and applicable fee were not verified in the reviewed public specialty documents.

Is the final clinical examination an OSCE?

The current Urology clinical blueprint specifies eight structured oral examination (SOE) stations, each lasting 10 minutes. Passing the written exam and satisfying SCFHS training requirements precede this separate clinical assessment.

What is the passing score?

The written blueprint sets 70%. If fewer than 70% of candidates pass before approval, the score is lowered one mark at a time toward a 70% pass rate or a 65% score, whichever comes first. It cannot be lowered below 65%.

Is this an official English examination simulation?

No. This is an independent English-language MCQ study adaptation. The reviewed public specialty sources do not explicitly confirm permitted assessment languages, so no official English sitting or translation is claimed. The bank does not replace oral, procedural, or supervised clinical preparation.