What is the commonest complication of high-intensity focused ultrasound on treating localized prostate cancer?
temporary incontinence
vasculogenic impotence
urinary retention
hyper-reflexive detrusor
Correct Answer :
C. urinary retention
HIFU results in acute swelling of the prostate gland and urinary retention that last 1 to 2 weeks.
Related Questions
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 true regarding seminal vesicles` involvement in prostate cancer?
is almost always due to direct extension (T2c)
it is involved in 85% of positive surgical margins following radical prostatectomy
it carries a poor prognosis
none of the above
For prostate cancer patients, what do Partin tables predict?
survival rate
pathologic stage
extracapsular extension
lymph node involvement
What is the likelihood that prostate cells die in a single freeze cycle of cryotherapy when tissue temperature reaches colder than - 400 C?
never
unlikely
likely
always
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 true regarding prostatic tissue levels of hK2?
intensely expressed in benign prostatic epithelium
increased in poorly differentiated prostate cancer tissue
helps differentiate benign from malignant causes of high t-PSA
is an organ but not pathology specific marker
In which of the following situations prostate biopsy is most indicated?
normal DRE, abnormal PSA
abnormal DRE, abnormal PSA
abnormal DRE, normal PSA
hyperechoic areas on TRUS
During retropubic radical prostatectomy, what complication could be encountered on dividing the dorsal vein complex anteriorly?
incontinence
retrograde ejaculation
impotence
anejaculation
Genetically, what are the changes associated with poor survival in prostate cancer patients?
loss of one or both copies of the tumor suppressor gene PTEN
TMPRSS2ERG chromosome fusion
P53 mutations and overexpression of MYC
all of the above
What are the possible complications of CO2 pneumoperitoneum during laparoscopic/robotic prostatectomy?
hypoxia and acidosis
tachycardia and tachypnea
bradycardia and hypotension
hypercarbia and oliguria
What is the proper pre-treatment risk stratification of prostate cancer for a patient with T2a, PSA < 11 ng/mL, and no Gleason score > 6?
low risk
intermediate risk
high risk
data not adequate
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 true concerning TRUS prostatic biopsy?
hematospermia might persist for 4 6 weeks after taking biopsies
quinolone antibiotics prophylaxis eliminate possible infections
the right lateral decubitus position is commonly preferred
only hypoechoic lesions should be biopsied
In which of the following cases PSA testing is NOT indicated:
72 yrs. man newly diagnosed BPH with normal DRE
2 weeks post TURP for obstructing cancerous prostate
screening for prostate cancer in 75 yrs. old Caucasian man
43 yrs. man with obstructive LUTS, who had a first-degree relative diagnosed with prostate cancer before age 65
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 is the first-line chemotherapeutic agent for metastatic castration-resistant prostate cancer?
bisphosphonate
docetaxel
sipuleucel-T
enzalutamide
Which factor is closely related to the return to urinary continence function after radical retropubic prostatectomy?
pathologic tumor stage
performing nerve-sparing surgery
patient`s age
performing internal sphincter micro-dissection
Regarding treating prostate cancer patients, watchful waiting strategy involves:
periodic PSA testing
periodic TRUS
all of the above
none of the above
What is false regarding prostate adenocarcinoma in the peripheral zone?
85% of prostate adenocarcinomas are located in the peripheral zone
15% of them are multifocal
they tend to extend outside the prostate through the perineural space
the presence of perineural invasion does not worsen the prognosis
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
What is the likelihood that patients with positive surgical margins after radical prostatectomy will be cured for prostate cancer?
never
unlikely
likely
always
Genetically, increased risk of prostate cancer has been found in men with:
variants in the 8q24 region on chromosome 8, in sporadic cases
alterations on chromosome 1, chromosome 17, and the X chromosome, in some familial cases
the human prostate cancer gene is on the X chromosome
all are true
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
Which of the following tests has the highest positive predictive value for prostate cancer?
PSA
digital rectal examination
transrectal ultrasonography
human kallikrein 2
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
Screening for prostate cancer is recommended for men who are:
at average risk, aging 50 yrs., and have at least a 10-year life expectancy
aging 40 yrs., and had a first-degree relative diagnosed with prostate cancer before age 65
aging 40 yrs., African Americans
all of the above
What is false concerning TRUS prostatic biopsy?
a 12-core biopsy is the standard
in preparation for the procedure, a self-administered enema is suggested
sepsis might complicate the procedure
the biopsy path is best visualized in the coronal plane
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
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
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