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100+ Free FRCS Urol Practice Questions

Pass your Intercollegiate Specialty Fellowship Examination in Urology (FRCS Urol) exam on the first try — instant access, no signup required.

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A 70-year-old man reports predominantly nocturia (waking 3 times nightly to void) with otherwise mild daytime symptoms. A frequency-volume chart shows that more than a third of his 24-hour urine output occurs at night. What is the most likely contributing diagnosis?

A
B
C
D
to track

Sample FRCS Urol Practice Questions

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

1A 64-year-old man has a PSA of 6.8 ng/mL and an MRI showing a PI-RADS 4 lesion. Transperineal biopsy reveals Gleason 3+4=7 (ISUP grade group 2) in 3 of 12 cores. According to NICE NG131 risk stratification, into which category does this disease fall?
A.Low risk
B.Locally advanced
C.High risk
D.Intermediate risk
Explanation: NICE NG131 classifies localised prostate cancer using PSA, ISUP grade group and clinical T stage. PSA 10-20 OR Gleason 7 (ISUP 2-3) OR cT2b defines intermediate risk. This man has ISUP grade group 2, placing him firmly in the intermediate-risk category.
2A 58-year-old man with newly diagnosed metastatic, hormone-sensitive prostate cancer (high-volume, CHAARTED criteria) is starting androgen deprivation therapy. Based on current UK practice and STAMPEDE evidence, which addition to ADT offers the greatest overall survival benefit in this setting?
A.Bicalutamide monotherapy
B.External beam radiotherapy to the prostate
C.Docetaxel chemotherapy or an androgen-receptor pathway inhibitor
D.Immediate radical prostatectomy
Explanation: In metastatic hormone-sensitive prostate cancer, treatment intensification by adding docetaxel or an ARPI (e.g. abiraterone, enzalutamide, apalutamide) to ADT improves overall survival, with the benefit most marked in high-volume disease per STAMPEDE and CHAARTED. ADT alone is no longer adequate first-line.
3A 70-year-old man with castration-resistant prostate cancer has bone-only metastases and rising PSA despite abiraterone. Genomic testing reveals a germline BRCA2 mutation. Which targeted agent is specifically indicated for BRCA-mutated metastatic CRPC?
A.Olaparib (a PARP inhibitor)
B.Cabazitaxel
C.Radium-223
D.Sipuleucel-T
Explanation: PARP inhibitors such as olaparib exploit synthetic lethality in tumours with homologous recombination repair defects, including BRCA1/2 mutations. The PROfound trial demonstrated improved radiographic progression-free and overall survival with olaparib in HRR-mutated mCRPC after an ARPI.
4A 67-year-old man undergoes TURBT for a 2.5 cm solitary papillary bladder tumour. Histology shows high-grade pT1 urothelial carcinoma with no muscle in the specimen. What is the most appropriate next step?
A.Immediate radical cystectomy
B.Surveillance cystoscopy at 3 months
C.Start a 6-week induction course of intravesical BCG immediately
D.Re-resection (re-TURBT) within 2-6 weeks
Explanation: For high-grade T1 disease, or any resection where detrusor muscle is absent, a re-TURBT at 2-6 weeks is mandated to ensure complete resection and accurate staging, as understaging to muscle-invasive disease is common. BCG should follow an adequate re-resection.
5Following TURBT for a small, solitary, low-grade pTa bladder tumour in a 55-year-old woman, which intervention reduces the risk of early tumour recurrence with the strongest evidence base?
A.A single immediate post-operative instillation of intravesical mitomycin C
B.A 6-week induction course of intravesical BCG
C.Adjuvant systemic cisplatin-based chemotherapy
D.Maintenance intravesical interferon
Explanation: A single immediate (within 24 hours, ideally 6 hours) post-operative instillation of a chemotherapeutic agent such as mitomycin C reduces recurrence in low-risk NMIBC by destroying circulating tumour cells and treating microscopic residual disease. It is the recommended adjuvant for low-risk Ta tumours.
6A 62-year-old man with muscle-invasive (cT2N0M0) bladder urothelial carcinoma and good renal function is being counselled before radical cystectomy. What is the most appropriate evidence-based recommendation regarding peri-operative systemic therapy?
A.Adjuvant radiotherapy to the pelvis
B.No systemic therapy; proceed directly to surgery
C.Neoadjuvant cisplatin-based combination chemotherapy
D.Neoadjuvant carboplatin monotherapy
Explanation: Neoadjuvant cisplatin-based combination chemotherapy (e.g. gemcitabine-cisplatin or MVAC) before radical cystectomy confers a roughly 5-8% absolute overall survival benefit in muscle-invasive bladder cancer and is recommended for cisplatin-eligible patients.
7A 48-year-old woman has an incidentally detected 3.5 cm enhancing solid renal mass. Imaging shows no metastases and a normal contralateral kidney. What is the most appropriate management of this cT1a renal tumour?
A.Radical nephrectomy
B.Renal artery embolisation
C.Active surveillance with serial imaging
D.Partial nephrectomy (nephron-sparing surgery)
Explanation: For a small (cT1a, <4 cm) renal mass, partial nephrectomy is the gold standard where technically feasible because it provides equivalent oncological control to radical nephrectomy while preserving renal function and reducing long-term cardiovascular and chronic kidney disease risk.
8A complex cystic renal lesion on CT shows multiple thick septa with measurable enhancement of the septal walls but no enhancing soft-tissue nodule. According to the Bosniak classification, which category best describes this lesion and what is the implication?
A.Bosniak II - benign, no follow-up
B.Bosniak IIF - probably benign, requires surveillance imaging
C.Bosniak III - indeterminate, surgically significant malignant risk
D.Bosniak IV - clearly malignant, contains enhancing soft-tissue nodule
Explanation: Bosniak III lesions have thickened or multiple enhancing septa/walls without a discrete enhancing nodule, carrying roughly a 50% malignancy risk; they are surgically significant and generally warrant intervention or close evaluation. The presence of measurable enhancement in walls/septa distinguishes III from IIF.
9A 60-year-old man has a 9 cm right renal cell carcinoma with tumour thrombus extending into the renal vein but not reaching the inferior vena cava, and no nodal or distant disease. What is the TNM (8th edition) clinical T stage?
A.T2a
B.T3b
C.T3a
D.T4
Explanation: In the AJCC/UICC 8th edition, T3a includes tumours that extend into the renal vein or its segmental branches, or invade perirenal/renal sinus fat but not beyond Gerota's fascia. Renal vein thrombus without IVC involvement defines T3a.
10A 26-year-old man presents with a painless right testicular lump. Ultrasound confirms a 3 cm intratesticular solid mass. After staging bloods, what is the correct initial surgical management?
A.Trans-scrotal biopsy of the mass
B.Scrotal orchidectomy
C.Testis-sparing partial orchidectomy
D.Radical inguinal orchidectomy
Explanation: A solid intratesticular mass in a young man is testicular cancer until proven otherwise and is managed by radical inguinal orchidectomy with early high cord ligation. The inguinal approach avoids violating scrotal lymphatic drainage and tumour seeding.

About the FRCS Urol Exam

The FRCS Urol is the Intercollegiate Specialty Fellowship Examination in Urology required for CCT and consultant practice as a urologist in the UK and Ireland. Section 1 is a computer-based written examination of two 120-question single-best-answer papers delivered at Pearson VUE centres, leading to the Section 2 structured clinical and oral examination.

Assessment

Section 1 is two computer-based Single Best Answer papers of 120 questions each (240 SBA), sat on the same day; passing Section 1 grants eligibility for the Section 2 structured clinical/oral examination.

Time Limit

Section 1: two papers of 2 hours 15 minutes each (4 hours 30 minutes total).

Passing Score

No fixed percentage; the eligibility-to-proceed mark is set per sitting by the modified Angoff method (one standard deviation added to the Angoff cut score). No negative marking.

Exam Fee

Combined fee GBP 2,000 (Section 1 GBP 580; Section 2 GBP 1,420) up to 31 December 2026; GBP 2,070 from 1 January 2027. (Joint Committee on Intercollegiate Examinations (JCIE))

FRCS Urol Exam Content Outline

34%

Urological Oncology

Prostate, bladder, kidney, testicular and penile cancer plus upper tract urothelial carcinoma: NICE/EAU risk stratification, staging, surgery, intravesical and systemic therapy.

14%

Stone Disease and Urinary Tract Infection

Stone pathophysiology and metabolic evaluation, ESWL, ureteroscopy and PCNL, medical expulsive therapy, UTI, urosepsis and Fournier's gangrene.

11%

Imaging, Technology and Transplant

Uroradiology and nuclear renography, endoscopic and energy technology, surgical principles, urethral reconstruction and renal transplantation.

10%

Functional and Female Urology

Stress and urgency incontinence, overactive bladder, neurogenic bladder, urodynamics, pelvic organ prolapse and bladder pain syndrome.

9%

BPH and LUTS

Benign prostatic enlargement, IPSS assessment, alpha-blockers and 5-ARIs, TURP and HoLEP, TUR syndrome and acute urinary retention.

8%

Emergency and Trauma Urology

Testicular torsion, renal, bladder and urethral trauma, penile fracture, clot retention and iatrogenic ureteric injury.

7%

Andrology

Erectile dysfunction, male infertility, Peyronie's disease, priapism, varicocele, vasectomy and acute scrotal conditions.

7%

Paediatric Urology

Undescended testis, posterior urethral valves, vesicoureteric reflux grading, hypospadias, PUJ obstruction and the paediatric acute scrotum.

How to Pass the FRCS Urol Exam

What You Need to Know

  • Passing score: No fixed percentage; the eligibility-to-proceed mark is set per sitting by the modified Angoff method (one standard deviation added to the Angoff cut score). No negative marking.
  • Assessment: Section 1 is two computer-based Single Best Answer papers of 120 questions each (240 SBA), sat on the same day; passing Section 1 grants eligibility for the Section 2 structured clinical/oral examination.
  • Time limit: Section 1: two papers of 2 hours 15 minutes each (4 hours 30 minutes total).
  • Exam fee: Combined fee GBP 2,000 (Section 1 GBP 580; Section 2 GBP 1,420) up to 31 December 2026; GBP 2,070 from 1 January 2027.

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

FRCS Urol Study Tips from Top Performers

1Weight your revision toward uro-oncology, which dominates the blueprint, but ensure you can apply current NICE and EAU guidelines to vignette-style single-best-answer questions rather than recalling isolated facts.
2Drill the eight examined domains (oncology, stones/UTI, functional/female, BPH/LUTS, andrology, paediatrics, emergency/trauma, imaging/technology/transplant) so no area is neglected, since Section 1 samples the whole curriculum.
3Practise timed single-best-answer questions to build pace for 240 questions in 4.5 hours, and review the official JCIE Urology sample questions and syllabus blueprint to calibrate to the real exam style.

Frequently Asked Questions

What is the format of FRCS Urol Section 1?

Since January 2021, Section 1 consists of two computer-based Single Best Answer (SBA) papers of 120 questions each (240 total), each lasting 2 hours 15 minutes and sat on the same day at a Pearson VUE test centre. There is no negative marking.

How is the FRCS Urol Section 1 pass mark determined?

There is no fixed percentage pass mark. The eligibility-to-proceed mark is standard-set for each sitting using the modified Angoff method (with one standard deviation added to the Angoff cut score), so the threshold varies with question difficulty.

How much does the FRCS Urol examination cost?

The combined Section 1 and Section 2 fee is GBP 2,000 (GBP 580 for Section 1 and GBP 1,420 for Section 2) for examinations up to 31 December 2026, rising to GBP 2,070 from 1 January 2027, per the JCIE.

Who administers the FRCS Urol exam and what does passing it allow?

The exam is governed by the Joint Committee on Intercollegiate Examinations (JCIE) on behalf of the four surgical Royal Colleges. Passing both sections is required for the Certificate of Completion of Training (CCT) and consultant urology practice in the UK and Ireland.