During retropubic radical prostatectomy, what complication could be encountered on dividing the dorsal vein complex anteriorly?
incontinence
retrograde ejaculation
impotence
anejaculation
Correct Answer :
A. incontinence
incontinence due to injury to the striated urethral sphincter.
Related Questions
Regarding chemotherapy for prostate cancers, nonsteroidal antiandrogens will result in:
elevated LH, elevated testosterone, elevated estrogen
elevated LH, elevated testosterone, declined estrogen
declined LH, declined testosterone, elevated estrogen
declined LH, elevated testosterone, declined estrogen
What fraction of men with a PSA value between 4 and 10 ng/mL has an organ-confined prostate cancer?
¼
½
Regarding radical prostatectomy, the commonest site of positive surgical margins is the:
apex
posterior
postero-lateral
anterior
What are the clinical parameters of tissue ablation achieved by cryotherapy for cancer cells destruction?
the number of freezing cycles
the lowest temperature achieved
the existence of regional heat sinks
all of the above
What is the commonest complication of high-intensity focused ultrasound on treating localized prostate cancer?
temporary incontinence
vasculogenic impotence
urinary retention
hyper-reflexive detrusor
What are the possible complications of CO2 pneumoperitoneum during laparoscopic/robotic prostatectomy?
hypoxia and acidosis
tachycardia and tachypnea
bradycardia and hypotension
hypercarbia and oliguria
BPH patients on finasteride longer than 6 months are expected to have:
decreased t-PSA but increased f-PSA
decreased t-PSA but unaltered f-PSA
decreased t-PSA and decreased f-PSA
any of the above
Following bilateral orchiectomy for prostate cancer, testosterone will:
initially drop to nadir, and then recover over 2 weeks
decline by 50% within 2 weeks and then normalize
decline by 90% within 24 hours
decline by 70%
What condition does NOT appear as a hypoechoic lesion in the prostate on TRUS?
prostate cancer
corpora amylacea
transitional zone
tuberculous prostatitis
What if false concerning the prostate cancer marker PCA3?
entails a genetic analysis of cells in the voided urine
urine sample is collected after a firm massage of the prostate
helps screen patients who are at intermediate risk of cancer
helps avoid the inconvenience of prostate biopsy
What is the primary mechanism of prostate tissue ablation using high-intensity focused ultrasound?
disruption of protein synthesis
coagulative necrosis
cell wall destruction
DNA damage
Which PSA value interpretation is incorrect?
> 50% of men with PSA > 10 ng/mL have the disease beyond the prostate
pelvic lymph node involvement is found in PSA > 20 ng/mL
70% of men with a PSA between 4 and 10 ng/mL have organ-confined disease
80% of men with PSA < 4 ng/mL have organ-confined disease
Regarding treating prostate cancer patients, watchful waiting is a reasonable option for:
patients who have a life expectancy ≤ 10 yrs. and/or well to moderately differentiated cancer
≥ 70 yrs. of age
PSA < 10 ng/mL, ratio < 0.22
patients with good performance status
Fill the blanks: on treating prostate cancer patients, the median time from PSA failure to the development of metastatic disease after radical prostatectomy is approximately (…) yrs. and from the time of metastases to death is approximately (…) yrs..
4, 2 respectively
8, 5 respectively
6, 3 respectively
7, 4 respectively
What is true about the usefulness of Gleason scoring system?
used to stage prostate cancer
a specimen of grade 3 + 4 is worse than 4 + 3
a sum of 6 suggests an intermediate risk for aggressive cancer
it has a role in guiding the appropriate treatment options
What class of prostate cancer medications causes an initial increase in LH, FSH levels and consequently a rise in testosterone level for few weeks?
GnRH agonists
antiandrogens
antimicrotubular
bisphosphonates
What is false regarding the diagnosis of prostate cancer?
most cases are identified by screening asymptomatic men
physical examination alone cannot reliably differentiate benign prostatic conditions from cancer
most diagnosed cases have normal DRE and PSA values
prostate biopsy establishes the diagnosis
What is false regarding the histology of prostatic cancers?
benign glands are different from malignant glands, as they contain basal cells
adenosis in the transitional zone carries 15% increase in cancer risk
the prostate has no discrete histologic capsule
intraductal carcinoma is morphologically worse than high-grade PIN and is typically associated with high-grade carcinoma
What is false concerning thawing procedure to treat prostate cancer cells?
slow thawing is more effective than rapid thawing
the most common complication is erectile dysfunction
for effective thawing a minimum temperature of − 25° C and a double freeze/thaw cycle with urethral warming are recommended
the two most common modalities employed in focal therapy are highintensity focused ultrasound and cryosurgery
For prostate cancer patients, what do Partin tables predict?
survival rate
pathologic stage
extracapsular extension
lymph node involvement
What is against using TRUS-guided therapy for focal prostate cancer?
it overdiagnoses clinically insignificant cancers
it misses clinically significant cancers in the anterior or apical regions
it may underrepresent true cancer burden
all of the above
What is the first-line chemotherapeutic agent for metastatic castration-resistant prostate cancer?
bisphosphonate
docetaxel
sipuleucel-T
enzalutamide
All of the following modalities are used as salvage therapies after failing radiation therapy for prostate cancer treatment, EXCEPT:
cryotherapy
chemotherapy
brachytherapy
radical prostatectomy
What is true surrounding PSA?
black individuals produce more PSA than whites
ejaculation can lead to a false decrease in PSA
pro-PSA is the serum proactive form of PSA molecule
prostate cancer cells make more PSA than normal prostate tissues do
Clinically significant prostate cancer is defined as:
volume ≥ 0.5 mL and/or a Gleason score of ≥ 3 + 4
volume ≥ 0.8 mL and/or a Gleason score of ≥ 4 + 4
volume ≥ 1.5 mL and/or a Gleason score of ≥ 4 + 3
volume ≥ 1.0 mL and/or a Gleason score of ≥ 3 + 3
Partin tables are probability tables for the determination of pathologic stages of prostatic cancers based on:
preoperative clinical stage, PSA level, and Gleason sum
seminal vesicle invasion, lymph node metastases, and Gleason sum
positive surgical margins, capsular penetration, and PSA level
PSA level, perineural invasion, vascular metastasis, and Gleason sum
What is false concerning prostate cancer?
the most common cause of mortality in men with prostate cancer is cardiac disease
is the second most common cause of cancer death in males
androgens have a pivotal role in prostate cancer development
low protein and high carbohydrate diet play a role in the development of prostate cancer
In which of the following PSA readings prostate cancer is least suspected?
PSA velocity of 0.35 ng/mL/y, when the PSA is ≤ 2.5 ng/mL
PSA velocity of 0.75 ng/mL/y, when the PSA is 4 10 ng/mL
t-PSA is 2.8 ng/mL, f-PSA 0.94 ng/mL
t-PSA is 3.7 ng/mL, f-PSA 0.51 ng/mL
Ectopic expression of PSA occurs in all of the following, EXCEPT:
thyroid gland
breast tissue
adrenal glands
renal carcinomas
What pathologic findings after radical prostatectomy are predictive for occult metastases?
seminal vesicle invasion and lymph node metastases
positive surgical margins and seminal vesicle involvement
capsular penetration and lymph node metastases
rectal and bladder neck involvement