Immediately following transurethral resection of bladder tumors, intravesical installation of which material(s) is(are) contraindicated?
epirubicin
mitomycin c
BCG
none of the above
Correct Answer :
C. BCG
the risk of systemic absorption of BCG and sepsis are very significant immediately post operatively.
Related Questions
What is the imaging modality of choice in the evaluation of a suspected urethral cancer?
ascending urethrography
voiding cystourethrography
MRI
IVU
What is false regarding the symptomatology of urethral cancers?
obstructive LUTS are common presentations and occur in association with carcinoma in situ
might present as perineal abscesses and fistulae
could be asymptomatic
venereal diseases increase the risk of urethral cancers
What might occur while resecting a bladder mass at the posterolateral wall?
bladder perforation
obturator nerve reflex
vesico-ureteral reflux
terrible bleeding
Partial cystectomy for bladder tumors can be performed when the following criterion(a) is(are) met:
the lesion is solitary and no associated CIS
physically, a surgical margin of 2-cm can be obtained
the resected area should be far enough from ureteral orifices and the bladder neck
all of the following
Which of the following statements concerning lymphatic drainage of the male urethra is true?
the anterior urethra drains into the inguinal and pelvic nodes
the posterior urethra drains into the pelvic nodes
the proximal two-thirds drain into the external and internal iliac nodes
the distal one-third drains into the obturator nodes
Bladder tumors with hydronephrosis are:
often of high-grade sarcomas
often associated with muscularis propria invasion
due to vesical polyps occluding ureteric orifices
should be resected but not diathermized
Common benign urethral tumors include all of the following,
EXCEPT:
leiomyoma
hemangioma
fibroepithelial polyp
lymphangioma
Risk factors for recurrence and progression of bladder cancers include the following:
multifocality
high tumor grade and advanced stage
presence of CIS
all of the above
What is the commonest type of primary urethral tumors?
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
Regarding bladder neoplasia, squamous metaplasia differs from squamous dysplasia as the latter is/has:
well-differentiated tumor with broad-based invasive font
marked atypia distributed on wide areas of superficial urothelium
atypia is present
no atypia but marked degenerative epithelial changes
What type of bladder cancers might be caused by Schistosoma haematobium infection?
transitional cell carcinoma
squamous cell carcinoma
adenocarcinoma
small cell carcinoma
Concerning upper tract urothelial tumors, what is the single most important predictor of outcome?
tumor stage
tumor grade
lymphovascular invasion
lymph node spread
In what percentages do upper tract urothelial tumors develop in patients with a bladder urothelial cancer?
2 - 4%
4 - 6%
6 - 8%
8 - 10%
What is the ideal vesical tumor patient for bladder preservation?
patients with carcinoma in situ
patients with completely resected solitary tumor
patients with preserved kidney and liver functions after 2 courses of BCG
patients with leiomyosarcoma
What is the commonest type of tumor occurring in urethral diverticuli?
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
Which of the following is a risk factor for developing upper urinary tract tumors?
obesity
consuming artificial sweeteners
asbestosis
analgesic abuse
The treatment of nonmuscle-invasive bladder cancer begins with:
single intravesical chemotherapy
TURBT
intravesical BCG vaccine
multiple bladder biopsies
Intravesical installation of BCG should NOT be given soon after bladder tumor resection (TURBT) because:
there will be no target tumor tissue to work on
post-op. hematuria interacts unfavorably with BCG composition
of the risk of systemic absorption and sepsis
of the high risk of BCG reflux to kidneys while bladder irrigation
The treatment of T2/Nx/M0 prostatic urethral cancer is:
en bloc resection involving total penectomy, cystoprostatectomy, resection of the pubic rami and urogenital diaphragm, with pelvic lymphadenectomy. In addition, creating a urinary diversion.
total penectomy involving removal of the penis, urethra, and penile root
partial penectomy involving excision of the malignant lesion with 2-cm margins
transurethral resection or fulguration
Bladder cancer patients who once failed BCG vaccine, should:
undergo cystectomy
try mitomycin c
take a second course of BCG
take a second course of BCG + quinolones
What gene mutation is common in carcinoma-in-situ of urinary bladder?
RB
cyclin A
HRAS
CD-44
What is false concerning carcinoma-in-situ (CIS) of urinary tract?
frequently found in association with high-grade or extensive TCC
has a rate of progression to muscle invasion of 10-25%
significant areas of CIS are easily missed by routine cystoscopy
treatment begins with TURBT
While deeply resecting a large bladder tumor, the surgeon noted loss of bladder distension, what should next step be?
increase the irrigation fluid and pursue the procedure
abort the procedure and leave a urethral catheter
perform cystogram and manage accordingly
perform abdominal exploration and manage accordingly
What is the most common sarcoma of the bladder?
leiomyosarcoma
rhabdosarcoma
carcinosarcoma
neurosarcoma
The most significant prognostic factors for survival in female urethral cancers are:
sensitivity to chemotherapy and age at presentation
anatomic location and extent of the tumor
histologic type of the tumor and sensitivity to radiotherapy
tumors stage and grade
In what percentages of patients do bilateral upper tract tumors occur either synchronously or metachronously?
0.6 - 2%
2 - 6%
6 - 10%
12 - 16%
What is the commonest manifestation of upper tract urothelial carcinomas?
obstructive uropathy
painless hematuria
pain radiating to the groin
locally advanced tumor
Carcinoma-in-situ of the prostatic urethra mostly occurs at the:
mid prostate to the verumontanum at the 5 and 7 oclock positions
lateral margins of the prostate at the 10 and 2 oclock positions
entire area distal to the urethral crest
area between ejaculatory duct openings and prostatic utricle
Evaluation of painless hematuria includes all of the following,
EXCEPT:
urine cytology
CT urography
cystoscopy
renal function tests
Which of the following does NOT predispose to bladder cancer?
working with organic chemicals and dyes
abuse of pain-control medications especially phenacetin
exposure to arsenic and aromatic amines
schistosomiasis