Functional/BPH/Incontinence Flashcards by Elin Gullberg Bohlin

What is a major contraindication for the implantation of an artificial urinary sphincter for post radical prostatectomy urinary incontinence?

A. Previous radiation therapy
B. Significant detrusor overactivity
C. Previously treated anastomotic stricture
D recurrent elevated prostate-specific antigen

B. Significant detrusor overactivity

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Which result suggests a diagnosis of bladder outflow obstruction most?

A. Qmax 6ml/s, voided volume 50ml, post-micturition residual 150ml
B. Qmax 12ml/s, voided volume 140ml, post-micturition residual 130ml
C. Qmax 12ml/s, voided volume 340ml, post-micturition residual 95ml
D. Qmax 18ml/s, voided volume 150ml, post-micturition residual 200

C. Qmax 12ml/s, voided volume 340ml, post-micturition residual 95ml

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In normal male patients undergoing uroflowmetry, which parameter is independent of the voided volume (Vcomp)?

A. Qmax/(krumelur”check”)Vcomp
B. Qave/(krumelur”check”) Qmax
C. Qmax/Qcomp
D. Vcomp/(krumelur”check”)T100

A. Qmax/(krumelur”check”)Vcomp

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Bladder wall thickness increases:

With age
In patients with bladder outlet obstruction
After TurP

A. All 3 options are correct
B. Only option 2 is correct
C. Only option 1 is correct
D. Options 1 and 2 are both correct

D. Options 1 and 2 are both correct

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Bladder wall mechanical stretch stress alters the expression of several growth factors. In particular it decreases the expression of which of the following?

A. bFGF
B. EGF
C. HB-EGF
D. TGF

D. TGF

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Bladder voiding efficiency is defined as:
A. Voided volume: pre-void bladder volume x 100%
B. Voided volume: cystometric bladder capacity x 100%
C. (Voided volume+residual urine): total bladder capacity x 100%
D. (Voided volume + residual urine): cystomeric bladder capacity x 100%

A. Voided volume: pre-void bladder volume x 100%

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The MTOPS study and the CombAT have evaluated the combination of:

A. Alfa-blockers and desmopressin
B. Alfa-blockers and antimuscarins
C. 5alfa-reductase inhibitors and alfa-blockers
D. 5alfa-reductase inhibitors and antimuscarinics

C. 5alfa-reductase inhibitors and alfa-blockers

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The most appropriate procedure for the correction of genuine Stress Urine incontinence (SIU) due to bladder neck hypermobility is:

A. Colposuspention
B. Sling procedure
C. Mid-urethral tape
D. Urethral bulking agents

C. Mid-urethral tape

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High doses of capsaicin and resiniferatoxin:

A. Have no effect on the A6-fibres
B. Cause cell death of the C-fibres
C. Cause activation of the A6-fibres, leading to detrusor areflexia
D. Cause depletion of the afferent nerve cell’s supply of substance P and neurokinin A

D. Cause depletion of the afferent nerve cell’s supply of substance P and neurokinin A

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Following a CVA a fixed deficit may become apparent. Which dysfunctional symptom is usually associated with this?

A. Urgency
B. Hesitancy
C. Frequency
D. Post-micturition dribbling

A. Urgency

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During urodynamic studies which parameter is not directly measured but calculated?

A. Urethral pressure
B. Detrusor pressure
C. Intravesical pressure
D. Intra-abdominal pressure

B. Detrusor pressure

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Which are the key baseline parameters allowing a stratification of BPH patients according to the risk of progression?

Serum PSA
Prostate size
Serum creatinine
Age and symptom severity

A. Only 1 and 2
B. All exept 1
C. All exept 3
D. All

C. All exept 3

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What is the preferred method for diagnosing a ureteropelvic junction obstruction?

A. Ultrasonography and excretory urography
B. Ultrasonography and CT
C. Diuretic renography and excretory urography
D. Retrograde pyelography and excretory urography

C. Diuretic renography and excretory urography

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Which statement is correct regarding pelvic organ prolapse after incontinence surgery?

A. The rate of cystocele is similar after colposuspension and with TVT
B. The rate of cervical prolapse is similar after colposuspension and with TVT
C. The rate of enterocele is similar after colposuspension and with TVT
D. The rate of rectocele is similar after colposuspension and with TVT

A. The rate of cystocele is similar after colposuspension and with TVT

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The failure rates for urinary incontinence after open colposuspension after 5 years are approximately:

A. 5%
B. 20%
C. 40%
D. 60%

B. 20%

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What is the approximate incidence of pelvic organ prolapse in parous women?

A. 15%
B. 25%
C. 35%
D. 50%

D. 50%

Which of the many botulinum neurotoxin serotypes is most widely used in urology?

A. Neurotoxin A
B. Neurotoxin B
C. Neurotoxin C
D. Neurotoxin D

A. Neurotoxin A

What is the recommended dose of onabotulinum toxin in idiopathic detrussor overactivity?

A. 100 IU
B. 200 IU
C. 300 IU
D. 400 IU

A. 100 IU

In elderly women with potential risk of cognitive dysfunction, which therapy should be avoided in treatment of incontinence?

A. Mirabegron
B. Oxybutinin
C. Electrostimulation
D. Oesteogens

B. Oxybutinin

Which ejaculation problem might be observed with alfa1-adrenoceptor anragonists?

A. Anejaculation
B. Retrograde ejaculation
C. Haematospermia
D. Premature ejaculation

A. Anejaculation

Regarding the efficacy of TurP

A. The probability of requiring a second prostate operation is reported at 1 and 2% per year
B. The complication rate does not increase with prostate size
C. Short-term and long-term mortality rates are higher after open prostatectomy than after TurP
D. Long-term complications include only urethral stricture and retrograde ejaculation

A. The probability of requiring a second prostate operation is reported at 1 and 2% per year

What is correct regarding Detrusor Overactivity (DO) and Bladder Outlet Obstruction (BOO)?

A. In pressure-flow studies the amplitude of DO is not correlated with the grade of BOO
B. All men with urinary urgency and BOO have DO
C. The prevalence of DO becomes higher as BOO increases
D. As patients gets older, prevalence of DO ranges from 10% in men without BOO to 32% in men with the most severe BOO

C. The prevalence of DO becomes higher as BOO increases

Which condition will NOT have direct impact on the reduction of symptoms of urinary incontinence in women?

A. Smoking cessasion
B. Reduction of caffein intake
C. Body mass reduction
D. Pelvic floor muscle training

B. Reduction of caffein intake

A fit 63-year-old man with a 1,5 cm bulbar stricture after TUR of the prostate has had several optical urethrotomies which failed. Which is the most appropriate treatment?

A. A scrotal flap
B. A free skin graft
C. A pedicled penile skin flap
D. An end-to-end anastomosis

D. An end-to-end anastomosis

Of the following options, which is the best indication for transurethral incision of the prostate? A. Presence of a median lobe B. BPH of <30g C. BPH under the age of 65 D. Prostatic cancer with obstruction

B. BPH of <30g

The spinal cord micturition centre is anatomically located at the level of which vertebral body approximately? A. L1 B. L3 C. Th6 D. TH 10

A. L1

The treatment of the female patient with mixed urinary incontinence should start with the management of: A. Stress incontinence B. Urgency incontinence C. The most bothersome symptome D. The less bothersome symptome with the least invasive treatment

C. The most bothersome symptome

What is the definition of bladder pain syndrome in women? A. Cyclic pain, accompanied with dyspareunia and infertility B. Non-cyclic pain, mainly exacerbated by diet, located in the flanks C. Cyclic pain, usually non exacerbated by voiding, located in the pelvis D. Non-Cyclic pain, usually exacerbated by voiding, located in the pelvis

D. Non-Cyclic pain, usually exacerbated by voiding, located in the pelvis

Pressure flow study simultaneous measures: A. Uroflowmetry and intravesical pressure B. Uroflowmetry and intraabdominal pressure C. Uroflowmetry, intravesical and intraurethral pressure D. Uroflowmetry, intravesical and intraabdominal pressures

D. Uroflowmetry, intravesical and intraabdominal pressures

Alfa1-blockers can cause: A. Headache B. Decreased libido C. Erectile dysfunction D. Floppy iris syndrome

D. Floppy iris syndrome

Antimuscarine drugs can cause: A. Diarrhea B. Insomnia C. Headache D. Dry mouth

D. Dry mouth

In studies, the odds-ratio of Intraoperative Floppy Iris Syndrome was much higher for: A. Alfuzosin B. Doxazosin C. Tamsulosin D. Terazosin

C. Tamsulosin

Which statement is correct regarding single incision urethral slings (mini-slings)? A. Long-term results are similar to conventional mod-urethral slings. B. Short-term results (except TVT-secure)are similar to conventional mid-urethral slings. C. There is no comparison for mini-slings and conventional mid-urethral slings D. The complication rate is higher in single-incision slings compared with conventional mod-urethral slings.

B. Short-term results (except TVT-secure)are similar to conventional mid-urethral slings.

Bladder contactility index (BCI) is calculated during urodynamics based on the following two parameters: A. Maximal closing pressure and maximal flow value B. Average flow value and maximal detrusor pressure C. Maximal detrusor pressure and urethral closing pressure D. Maximal detrusor pressure at maximal flow and maximal flow value

D. Maximal detrusor pressure at maximal flow and maximal flow value

Which advice has best evidence of helping patients to relieve urinary stress incontinence? A. Reduce fluid intake B. Lose weight C. Reduce caffeine intake D. Stop smoking

B. Lose weight

Which option is most appropriate for the management of urinary incontinence following radical prostatectomy at 3 months? A. Artificial urinary sphincter B. Male sling C. Pelvic floor physiotheraphy D. Anticholinergic medication

C. Pelvic floor physiotheraphy

A 79-year-old man has medication (alpha-blocket and 5 alpha-resuctase inhibitors) for 5 years. He attends for annual review. His nocturia has increased from two times to three times but otherwise he is unchanged and overall he is not bothered by his symptoms. His urine flow rate is similar to the year before: Qmax 9 mL/S, voided volume 225mL. His residual urine volume has increased last year from 195mL to 330mL. Which statement is correct? A. Watchful waiting is still an option B. Medical management should be abandoned because of increasing residual urine volume C. Bladder outflow surgery is mandatory as there is evidence of deteriorating bladder outflow obstruction D. It would have been better if he had had a transurethral resection of the prostate a year ago

A. Watchful waiting is still an option