The Life Long Learning Exam for Urology Consists of:
The Lifelong Learning Level (LLL) 2 General Exam is comprised of 90 questions equally divided between Core Urology and a self-selected specific content module.
Core Urology (45 Questions)
- all General Urology, FPMRS Level 2, and Peds Level 2 applicants will take the 45 question Core Urology module.
General Urology LLL Level 2 applicants will also choose one of the following specific content modules:
- Urologic Oncology & Diversion (45 Questions)
- Urolithiasis, Laparoscopy and Robotics (45 Questions)
- Erectile Dysfunction, Andrology, Infertility (45 Questions)
- Office Based Urology (45 Questions)
Please Note: For the General Urology LLL Level 2 exam, approximately 30% of all questions will come from the last 5 years SASP and pertinent AUA Guidelines for the specific content module chosen.
Topics that will be covered on the various modular exams including the core are listed below:
Core Urology
- Office Based Urology - 33%
- Urinary Tract Infection: Cystitis, Prostatitis, Pyelonephritis
- Guidelines
- Dx, (Chemical Analysis), Rx
- Dx and Rx of sexually transmitted disease
- Microscopic hematuria -Guidelines
- Proteinuria – Dx and Evaluation
- LUTS -Guidelines
- When and how to use PSA screening
- Antibiotic prophylaxis - Guidelines
- DVT Prophylaxis
- Postoperative Complications & Trauma - 37%
- Ureteroscopy complications
- ESWL complications
- TRUS prostate biopsy complications
- Traumatic renal, bladder, urethral, and geneital injuries
- Dx and Triage
- Vesicovaginal- ureterovaginal fistula
- Dx and Triage
- Penile fracture: Dx and Triage
- Nerve injuries
- Positional nerve injuries
- Nerve injuries following surgery
- obturator, illioinguinal, femoral, etc
- Metabolic urgencies and emergencies
- Hyponatremia
- Myoglobinuria (positional)
- Postop Addisonian crisis, etc
- Imaging, radiation and patient safety - 30%
- methods to reduce exposure of physician to radiation
- How to alter ultrasound techniques for better visibility
- Patient safety- outpatient concerns
- Sterilization of scopes etc.
- Dx and treatment of autonomic dysreflexia
- Opioid abuse
Oncology & Urinary Diversion
- Upper tract disease - 35%
- Adrenal Pathology (Dx - Treatment)
- Benign
- Malignant
- Concepts on Chemotherapy
- Renal Tumors
- Benign
- Malignant
- Concepts on Chemo-Immunotherapy
- Ablative Rx of renal tumors
- Observation protocols for renal tumors
- Genetic Risk Factors
- Upper Tract Urothelial disease
- Lower Tract disease - 45%
- Bladder Tumors
- Benign
- Malignant
- Concepts on Chemotherapy
- intravesical therapy
- Prostate Cancer
- PSA monitoring
- Malignant
- Dx and Rx
- Observation protocols
- Androgen resistant prostate cancer
- Concepts on Chemo-Immuno therapy
- Penile Cancer
- Dx, Rx
- When to pursue lymphadenectomy
- Rudimentary concepts on Chemotherapy
- Testicular Cancer
- Dx, management
- Rudimentary Concepts on Chemotherapy
- Urinary diversions – 20%
- Patient selection
- Postoperative complications (fistulas and strictures)
- Dx and Management
- Metabolic complications including vitamin deficiencies
Calculus Disease, Laparoscopy, Robotics & Upper Tract Obstruction
- Upper Tract Obstruction - 20%
- UPJ obstruction
- Dx and management
- Retroperitoneal Fibrosis
- Dx, management- surgical and medical
- Ureteral strictures and fistulas post endoscopy
- Dx and management
- Complications of long term indwelling ureteral stents
- Renal and Ureteral Calculi - 55%
- Dx- including metabolic evaluation
- Rx
- All forms, SWL, PCN, ureteroscopy, etc
- Medical therapy for underlying metabolic abnormalities
- Recommended follow-up following stone extraction
- Complications of PCN, ECSWL, Laparoscopy and Robotics - 25%
- Ureteral stricture post ureteroscopy Dx and Rx
- Ureteral perforation: Dx and Rx
- PCN complications
- Bleed
- Bowel perforation
- Urinoma
- ECSWL- complications
- Robotic complications
- Diminished blood flow
- Reduced urine output
- Air embolism
- Complications of trocar placement
Erectile Dysfunction, Andrology and Infertility
- Impotence-Andrology-Androgen Deficiency - 50%
- Androgen deficiency
- Dx, when to treat
- ED
- Dx
- Medical therapy
- Concepts on Chemo-Immunotherapy
- Use and contraindications of medical therapy
- use in cardiac patients
- injectable therapy, use and contraindications
- ED- Surgical treatment- IPP
- who to consider- contraindications for usage
- complications of placement and management
- long term complications
- Peyronnie’s disease
- Diagnosis
- Medical therapy
- Surgical therapy
- Complications of surgical therapy
- Priapism
- Etiologies
- High flow vs low flow
- sickle cell Rx
- Medical causes both drugs and malignancy as etiology
- Treatment
- Infertility - 50%
- Diagnosis and Rx
- Obstructive causes
- Dx and Treatment
- Findings and significance of findings at time of vaso-vasostomy
- Association of Cystic fibrosis with vassal anomalies and significance
- Endocrinologic causes
- Dx and Treatment
Office Based Urology
- BPH - urethral obstruction - LUTS (male and female) - 25%
- BPH
- Dx
- Medical treatment BPH
- Surgical Treatment BPH
- Urethral strictures-stenosis
- Pelvic Fracture Urethral Injuries
- Dx
- Treatment
- Urethral stricture (Anterior)
- Dx
- Treatment
- LUTS - male and female
- Dx (UDS when is it necessary?)
- Behavioral management
- Pharmacological management
- Options for refractory UUI/OAB (OnabotulinumtoxinA, neuromodulation)
- Stress Incontinence
- Behavioral and functional treatment
- Surgical treatment (bulking agents, slings)
- Sexual dysfunction – ED - 20%
- Androgen deficiency
- Dx
- Medical therapy
- Erectile Dysfunction
- Use and contraindications of medical therapy
- use in cardiac patients
- Injectable therapy, use and contraindications
- Rx priapism
- Neoplasia - 30%
- Low grade bladder tumor
- Dx, management ,Rx, including intravesicular therapy
- Prostate Cancer (Dx- observation protocols, antiandrogen therapy)
- Bx, MRI, observation protocols, antiandrogen therapy
- Renal and Ureteral Calculi (does not include metabolic evaluation) - 25%
- Dx - Stones
- Rx
- All forms, SWL, PCN, ureteroscopy, etc
- Medical therapy for underlying metabolic abnormalities, e.g. uric acid calculi
- Recommended follow-up following stone extraction