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
Correct Answer :
C. perform cystogram and manage accordingly
cystogram diagnoses the likelihood of bladder perforation. Abdominal exploration is only for intraperitoneal perforations.
Related Questions
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
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
Which of the following is a risk factor for developing upper urinary tract tumors?
obesity
consuming artificial sweeteners
asbestosis
analgesic abuse
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
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
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
In what percentages do upper tract urothelial tumors develop in patients with a bladder urothelial cancer?
2 - 4%
4 - 6%
6 - 8%
8 - 10%
For radical cystectomy, thromboembolism prophylaxis is required:
immediately before operation
immediately before incision and post-operative for 1 day
immediately before incision and post-operative for 15 days
immediately before incision and post-operative for 30 days
What is the most effective adjuvant intravesical therapy for bladder tumors?
cisplatin
BCG
mitomycin C
5-fluorouracil
In women, what is the commonest type of cancers occurring in the proximal urethra?
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
Evaluation of painless hematuria includes all of the following,
EXCEPT:
urine cytology
CT urography
cystoscopy
renal function tests
What is the commonest type of tumors occurring in the penile urethra?
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
While resecting a large bladder tumor located at the right lateral wall, the surgeon observes a bladder perforation, what should next step be?
continue the procedure as perforations at this site do no harm
abort the procedure and leave a urethral catheter
convert tumor removal to open method and repair the defect
perform abdominal exploration and manage accordingly
What is the most common sarcoma of the bladder?
leiomyosarcoma
rhabdosarcoma
carcinosarcoma
neurosarcoma
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
What gene mutation is common in carcinoma-in-situ of urinary bladder?
RB
cyclin A
HRAS
CD-44
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
On diagnosing bladder cancers, what advantage does urine cytology has over tumor markers?
high specificity
high sensitivity
high reliability
strong validity
Immediately following transurethral resection of bladder tumors, intravesical installation of which material(s) is(are) contraindicated?
epirubicin
mitomycin c
BCG
none of the above
Partial penectomy for urethral cancer is indicated in:
infiltrative proximal penile urethral carcinomas
infiltrative distal penile urethral carcinomas
recurrent proximal penile urethral carcinoma after laser resection
T3/N2/M0 at bulbar urethra
What is the commonest type of tumor occurring in urethral diverticuli?
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
What might occur while resecting a bladder mass at the posterolateral wall?
bladder perforation
obturator nerve reflex
vesico-ureteral reflux
terrible bleeding
What is true regarding inverted papilloma of the bladder?
the standard treatment is transurethral resection
the prognosis for inverted papilloma is pathetic, with a recurrence rate of approximately 65%
the likelihood of synchronous urothelial carcinoma is 26%
has been shown to harbor p53 gene mutations
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
What percentage of bladder cancers is squamous cell type in origin?
2%
5%
70%
90%
Common benign urethral tumors include all of the following,
EXCEPT:
leiomyoma
hemangioma
fibroepithelial polyp
lymphangioma
What is false concerning upper tract urothelial tumors?
rarely diagnosed at autopsy
the peak incidence occurs between ages 70 and 80
they occur twice as frequently in men as in women
none of the above
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
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 (are) the classic presentation(s) of bladder cancers?
irritative bladder symptoms
obstructive bladder symptoms
palpable suprapubic mass on physical examination
painless profuse hematuria