p.14
Treatment Options for Prostate Cancer
What is the medical treatment recommendation for patients with an IPSS greater than 8?
Phytotherapy, such as dwarf palm (Serenoa Repens) and African plum.
p.2
Classification of Prostate Cancer
What does a higher Gleason score indicate?
The tumor is more aggressive.
p.44
Bladder Cancer Overview
What is a common cause of bladder trauma associated with multi-system organ injury?
Blunt trauma, often from motor vehicle accidents.
p.43
Treatment Options for Prostate Cancer
What surgical procedure may be performed for kidney issues?
Transabdominal midline laparotomy for repair or removal of the kidney.
p.35
Kidney Stones and Urolithiasis
What is the dosage for Diclofenac when treating renal colic?
Suppository Diclofenac 100mg per rectum or tablet Diclofenac 75mg, taken 2 times per day.
p.34
Kidney Stones and Urolithiasis
What is the first therapeutic step in treating patients with an acute stone episode?
Pain relief is the first therapeutic step.
p.12
Benign Prostatic Hyperplasia (BPH) Etiology
Is there a clear correlation between total prostate volume and symptoms?
No, there is no clear correlation between total prostate volume and symptoms.
p.36
Kidney Stones and Urolithiasis
What is medical expulsive therapy (MET) used for?
MET is used for patients with ureteral stones that are expected to pass spontaneously through urination.
p.12
Benign Prostatic Hyperplasia (BPH) Etiology
Which is more important in treatment decision making: TZ volume or TP volume?
TZ is more important than TP volume in treatment decision making.
p.2
Classification of Prostate Cancer
What does T1c indicate in TNM classification?
Tumor identified by needle biopsy due to elevated PSA.
p.24
Prostate Cancer Etiology
What percentage of all renal tumors does renal cell carcinoma (RCC) account for?
Renal cell carcinoma (RCC) accounts for 85-90% of all renal tumors.
p.47
Diagnosis and Treatment of BPH
What is the management for late treatment of urethral injuries after more than 3 months?
Urethroplasty can be performed end to end or using a mucosal patch.
p.19
Treatment Options for Prostate Cancer
What is a retropubic prostatectomy?
A surgical procedure to remove the prostate gland through an incision in the lower abdomen.
p.4
Risk Factors for Prostate Cancer
What are the risk factors associated with lower urinary tract symptoms (LUTS)?
Risk factors include diabetes and the use of antidiabetic medications, dietary factors, genetic predisposition, localized inflammation, obesity, and metabolic syndrome.
p.47
Diagnosis and Treatment of BPH
What is the surgical treatment required for penetrating urethral trauma?
Surgical treatment is required to remove necrotized tissue, suture the urethral lesion, or spatulate the urethra and suture the ends in the presence of a defect.
p.38
Kidney Stones and Urolithiasis
What are some contraindications for the minimally-invasive kidney stone procedure?
Contraindications include all contraindications for general anesthesia, untreated UTI, atypical bowel interposition, tumor in the access tract area, potential malignant kidney tumor, and pregnancy.
p.44
Bladder Cancer Overview
What is a potential cause of spontaneous bladder rupture?
Underlying pathology such as cancer or obstruction.
p.47
Diagnosis and Treatment of BPH
What is the recommended treatment for complete rupture of the urethra in females?
Immediate surgical treatment by suturing the ends of the urethra.
p.45
Treatment Options for Prostate Cancer
What is the treatment for an extraperitoneal rupture?
Conservative management with catheter drainage for 7-14 days, antibiotics, and cystogram; surgical repair may be needed.
p.37
Kidney Stones and Urolithiasis
What is oral chemolysis efficient for?
Oral chemolysis is efficient for uric acid calculi only.
p.43
Clinical Signs of Prostate Cancer
What are the clinical signs associated with kidney issues?
Flank bruising/mass and flank pain/tenderness.
p.40
Pyelonephritis Etiology
What is a common etiology for chronic pyelonephritis?
Chronic pyelonephritis is more common in people with urinary obstructions caused by UTIs, vesicoureteral reflux, or anatomical anomalies.
p.29
Kidney Stones and Urolithiasis
How does increased intake of Vitamin C affect the risk of kidney stones?
Increased intake of Vitamin C has been associated with a higher risk of stones in men.
p.42
Kidney Stones and Urolithiasis
What is the most common cause of renal trauma?
Blunt trauma, primarily from motor vehicle accidents, falls from heights, and assaults.
p.42
Kidney Stones and Urolithiasis
What percentage of renal trauma cases are due to penetrating injuries?
Less than 20%, primarily from gunshot and stab wounds.
p.30
Kidney Stones and Urolithiasis
What is the significance of the risk status of a stone former?
It defines both the probability of recurrence or (re)growth of stones and is imperative for pharmacological treatment.
p.17
Benign Prostatic Hyperplasia (BPH) Etiology
What is a clinical sign of decreased semen volume in men?
Decreased volume of semen.
p.40
Risk Factors for Prostate Cancer
Who is at increased risk for chronic pyelonephritis?
Increased risk includes anyone with chronic kidney stones or other kidney or bladder conditions, older adults, people with suppressed immune systems (like diabetes, HIV/AIDS, cancer), those with vesicoureteral reflux, and individuals with an enlarged prostate.
p.47
Diagnosis and Treatment of BPH
What is the emergency treatment for partial ruptures of the urethra within 48 hours?
Cystostomy or inserting a Foley catheter under optical control.
p.9
Diagnosis of Prostate Cancer
What is the normal peak flow rate (Qmax) for men?
The normal peak flow rate for men is greater than 15 ml/s.
p.46
Urethral Trauma Etiology
What are the types of posterior urethra injuries?
The types of posterior urethra injuries include stretched but not torn, partial rupture, complete rupture, and complex injuries involving the bladder neck or rectum.
p.46
Urethral Trauma Clinical Signs
What is another clinical sign of urethral trauma?
Urinary retention is another clinical sign of urethral trauma.
p.35
Kidney Stones and Urolithiasis
What is the dosage for Nitrofurantoin in renal colic treatment?
Capsule Nitrofurantoin 100mg, taken 2 times per day.
p.28
Kidney Stones and Urolithiasis
What are the aspects according to which urinary stones can be classified?
Urinary stones can be classified according to stone size, stone location, X-ray characteristics of stone, etiology of stone formation, stone composition (mineralogy), and risk group for recurrent stone formation.
p.40
Kidney Stones and Urolithiasis
What are the indications for laparoscopic kidney-stone surgery?
Indications include complex stone burden, failed previous SWL and/or endourological procedures, anatomical abnormalities, morbid obesity, and nephrectomy in case of non-functioning kidney.
p.9
Diagnosis of Prostate Cancer
What are the components of a physical examination for prostate assessment?
Abdominal palpation, inspection of genitalia and perineum, digital rectal examination (DRE) focusing on enlargement, mobility, margins, and elasticity.
p.35
Kidney Stones and Urolithiasis
What is renal colic?
Renal colic is pain that occurs when a stone blocks your urinary tract.
p.35
Kidney Stones and Urolithiasis
What medication is prescribed for renal colic at a dosage of 0.4mg?
Capsule Tamsulosin 0.4mg, taken 1 time per day.
p.2
Classification of Prostate Cancer
What does T2a indicate in TNM classification?
Tumor involves 1/2 of 1 lobe or less.
p.24
Risk Factors for Prostate Cancer
What are some risk factors for renal cell carcinoma?
Risk factors include smoking, obesity, hypertension, and diabetes mellitus.
p.25
Treatment Options for Prostate Cancer
What surgical options are available for cancer treatment?
Partial nephrectomy, radical nephrectomy.
p.19
Treatment Options for Prostate Cancer
What are some new invasive treatment modalities for prostate issues?
Transurethral laser vaporization/enucleation, transurethral microwave therapy, transurethral needle ablation, prostate ablation with water jet, hot water steam injections, Urolift, prostate embolization, prostatic stents, and botulinum toxin A intraprostatic injections.
p.20
Benign Prostatic Hyperplasia (BPH) Etiology
What are the main paths of progression in prostate disease?
Prostate volume increases, deterioration of lower urinary tract symptoms (LUTS) and quality of life (QoL), deterioration of urinary flow, increased risk of urinary retention, and increased risk of surgery.
p.34
Kidney Stones and Urolithiasis
What should be done if analgesia cannot be achieved medically in acute renal calculi?
Drainage should be performed using stenting, percutaneous nephrostomy, or stone removal.
p.14
Treatment Options for Prostate Cancer
What are the aims of medical treatment for prostate issues?
Effectiveness, rapid onset of action, sustained effect, prevention of detrusor hypertrophy, prevention or delay of disease progression, safety, and suitability for the patient.
p.12
Benign Prostatic Hyperplasia (BPH) Etiology
What correlates with obstruction in prostate evaluation?
TZI correlates with obstruction.
p.9
Diagnosis of Prostate Cancer
What does uroflowmetry (Qmax) evaluate?
It evaluates the probability of obstruction and provides an objective assessment of urinary flow.
p.46
Urethral Trauma Etiology
What is the most common cause of urethral injuries?
Urethral injuries are most common during catheterization.
p.46
Urethral Trauma Etiology
What are the types of anterior urethra injuries?
The types of anterior urethra injuries include partial rupture and complete rupture.
p.25
Treatment Options for Prostate Cancer
What types of immunotherapy are used in cancer treatment?
Anti-PD-1 antibodies, anti-CTLA-4 antibodies, cytokines.
p.6
Clinical Signs of Prostate Cancer
What volume of the prostate is considered an indicator of high probability of progression?
A prostate volume over 30 cc is considered an indicator of high probability of progression.
p.21
Diagnosis and Treatment of BPH
What is cystostomy and when is it indicated?
Cystostomy, or suprapubic catheter placement, is indicated in cases of inability to perform urethral catheterization or if catheterization does not resolve acute urinary retention (AUR).
p.25
Risk Factors for Prostate Cancer
What are two major risk factors for urothelial cancer?
Smoking and alcohol consumption.
p.20
Risk Factors for Prostate Cancer
What factors increase the risk of progression in prostate disease?
The risk of progression is higher when PSA > 1.5 ng/ml and/or prostate volume (PV) > 40 ml.
p.19
Treatment Options for Prostate Cancer
What should be considered for prostates larger than 50-60?
Alpha blockers are not effective; consider 5 alpha reductase inhibitors (5ARI) or a combination with alpha blockers.
p.12
Benign Prostatic Hyperplasia (BPH) Etiology
Does total prostate volume correlate with obstruction?
No, there is no clear correlation between total prostate volume and obstruction.
p.38
Kidney Stones and Urolithiasis
What is a minimally-invasive procedure for kidney stones that involves breaking them up with ultrasound or laser?
It is a procedure where a small scope is placed through the back into the kidney to break up kidney stones using ultrasound and pneumatic probe or laser.
p.38
Kidney Stones and Urolithiasis
What is ureterorenoscopy (URS)?
URS is a procedure where a small, flexible scope is inserted through the urethra into the bladder and ureter to diagnose and treat urinary tract problems, including stones.
p.19
Treatment Options for Prostate Cancer
What is a transvesical prostatectomy?
A surgical procedure to remove the prostate gland through the bladder.
p.26
Risk Factors for Prostate Cancer
What are some risk factors associated with bladder cancer?
Risk factors include consumption of large amounts of analgesics containing fenacetin or acetylsalicylic acid, exposure to aristolochic acid from Aristolochia plants, and heredity.
p.47
Diagnosis and Treatment of BPH
What precaution is recommended during transvaginal surgery for females with urethral injuries?
It is recommended to insert a patch between the vagina and urethra to prevent fistulas.
p.44
Bladder Cancer Overview
What are some clinical signs of bladder trauma?
Inability to void, abdominal pain, abdominal bruising, pelvic mass, peritoneal signs, and shock.
p.18
Treatment Options for Prostate Cancer
What is the gold standard surgical treatment for BPH?
Transurethral resection of prostate (TURP)
p.10
Diagnosis and Treatment of BPH
What is the importance of measuring postvoid residual urine?
PVR is not stable and should be measured repeatedly.
p.7
Benign Prostatic Hyperplasia (BPH) Etiology
What are some causes of LUTS due to obstruction?
Causes include BPH, bladder neck obstruction, stricture of the urethra, and stricture of the orifice of the urethra.
p.18
Treatment Options for Prostate Cancer
What is the expected increase in Qmax after surgical treatment of BPH?
Qmax increases significantly by 125-175%
p.39
Kidney Stones and Urolithiasis
Can URS be performed in patients with bleeding disorders?
Yes, it can be performed with only a moderate increase in complications.
p.13
Risk Factors for Prostate Cancer
What PSA level indicates a higher probability of prostate cancer?
A PSA level greater than 3 ng/ml, especially above 10 ng/ml.
p.1
Diagnosis of Prostate Cancer
What is a common diagnostic test for prostate cancer?
Digital rectal examination (DRE)
p.36
Kidney Stones and Urolithiasis
What medications are included in medical expulsive therapy for ureteral stones?
NSAID tablets, suppositories, and α-blockers are included in MET to help reduce inflammation and the risk of recurrent pain.
p.43
Diagnosis of Prostate Cancer
What is the purpose of angiography in kidney diagnosis?
Used for embolization when bleeding persists, serving as both diagnosis and treatment.
p.26
Clinical Signs of Prostate Cancer
What are the clinical signs of bladder cancer?
Clinical signs include hematuria (micro and macro), dull flank pain, renal colic, asymptomatic disease (10%-15%), weight loss, anorexia, and bone pain.
p.26
Diagnosis of Prostate Cancer
What diagnostic tests are used for bladder cancer?
Diagnostic tests include urine test, intravenous urography, retrograde urography, antegrade pyelography, CT, MRI, ultrasound, cystoscopy, ureteroscopy, nephroscopy, angiography, cytology, and fluorescence in situ hybridization (FISH).
p.26
Treatment Options for Prostate Cancer
What are the treatment options for bladder cancer?
Treatment options include radical nephroureterectomy, open segmental ureterectomy, distal ureterectomy with ureterocystostomy, open laparoscopic or robotic approaches, endoscopic treatment for small tumors, and topical immunotherapy or chemotherapy through a nephrostomy tube.
p.46
Urethral Trauma Clinical Signs
What is a clinical sign of urethral trauma?
Urethral bleeding (urethrorrhagia) is a clinical sign, which occurs while not voiding.
p.42
Kidney Stones and Urolithiasis
What are the clinical signs of renal trauma?
Hematuria (gross or microscopic) and shock (hypotension, tachycardia, oliguria).
p.46
Urethral Trauma Diagnosis
What diagnostic test is used for urethral trauma?
Urethrography is the diagnostic test used for urethral trauma.
p.17
Benign Prostatic Hyperplasia (BPH) Etiology
What are common symptoms associated with breast enlargement in men?
Breast enlargement and tenderness.
p.1
Risk Factors for Prostate Cancer
What dietary factors are associated with an increased risk of prostate cancer?
Diet rich in animal fats and meat and poor in fruits and vegetables
p.27
Diagnosis and Treatment of BPH
What is the primary treatment for Carcinoma In Situ (CIS)?
The primary treatment for CIS typically involves endoscopic or organ-sparing therapy.
p.8
Diagnosis and Treatment of BPH
What drives the treatment for Benign Prostatic Hyperplasia (BPH)?
Symptoms and quality of life (QOL) questionnaire results drive BPH treatment decisions.
p.21
Clinical Signs of Prostate Cancer
What is a clinical sign that always warrants suspicion of bladder cancer?
Gross hematuria is a clinical sign that always warrants suspicion of bladder cancer until proven otherwise.
p.27
Kidney Stones and Urolithiasis
What are the primary components of calcium stones?
Calcium stones are primarily composed of calcium oxalate or, less often, calcium phosphate.
p.3
Treatment Options for Prostate Cancer
What treatment options are available for low-risk prostate cancer with a life expectancy greater than 10 years?
Watchful waiting (active surveillance).
p.39
Kidney Stones and Urolithiasis
What type of baskets are suitable for flexible URS (RIRS)?
Only baskets made of Nitinol are suitable.
p.39
Kidney Stones and Urolithiasis
What are some indications for open surgery in urology?
Complex stone burden, treatment failure of SWL and/or PNL, intrarenal anatomical abnormalities, and more.
p.39
Kidney Stones and Urolithiasis
What is a contraindication for URS?
Untreated UTIs and general considerations with general anesthesia.
p.31
Kidney Stones and Urolithiasis
What is renal colic pain?
Pain that occurs when the stone is migrating.
p.4
Benign Prostatic Hyperplasia (BPH) Etiology
What are some common etiologies of lower urinary tract symptoms (LUTS)?
Common etiologies include Benign Prostatic Hyperplasia (BPH), infections such as cystitis, prostatitis, prostatic abscess, urethral diverticulum, and malignancies like prostate cancer and urinary bladder cancer.
p.40
Kidney Stones and Urolithiasis
What are the indications for laparoscopic ureteral stone surgery?
Indications include large, impacted stones, multiple ureteral stones, concurrent conditions requiring surgery, and failure of other non-invasive or low-invasive procedures.
p.12
Diagnosis and Treatment of BPH
What laboratory investigations are commonly performed for prostate evaluation?
Common laboratory investigations include urinalysis, urine culture, biochemistry (creatinine), and PSA.
p.6
Clinical Signs of Prostate Cancer
What are the indicators of progression in prostate cancer for men over 50 years old?
Indicators include prostate volume and PSA levels.
p.6
Clinical Signs of Prostate Cancer
What are the irritative symptoms of lower urinary tract symptoms (LUTS)?
Irritative symptoms include frequency, urgency, nocturia, and incontinence.
p.6
Clinical Signs of Prostate Cancer
What are the obstructive symptoms of lower urinary tract symptoms (LUTS)?
Obstructive symptoms include hesitancy, poor urinary stream, straining, intermittency, prolonged terminal dribbling, and feeling of incomplete voiding.
p.45
Treatment Options for Prostate Cancer
What are the general principles of treatment for bladder injuries?
ABCs, establish urinary drainage/diversion, and antibiotics.
p.24
Clinical Signs of Prostate Cancer
What symptoms may occur if the inferior vena cava is involved in renal cell carcinoma?
Symptoms may include edema, ascites, and hepatic dysfunction.
p.13
Diagnosis of Prostate Cancer
What does an elevation in PSA serum indicate?
It indicates prostatic structure abnormalities and obstruction of ducts.
p.16
Benign Prostatic Hyperplasia (BPH) Etiology
What is the expected reduction in prostate volume after one year of treatment with 5ARI?
Prostate volume reduces by 20-30%, leading to relief in obstruction.
p.10
Diagnosis and Treatment of BPH
What type of ultrasound examination is used for the prostate?
Transrectal ultrasound examination (TRUS).
p.16
Benign Prostatic Hyperplasia (BPH) Etiology
What is the effect of 5ARI on PSA levels after 6 months of treatment?
PSA level drops down by 50%.
p.17
Treatment Options for Prostate Cancer
What does Tadalafil predominantly relieve in BPH patients?
Symptoms, not objective parameters like Qmax, PVR, or prostate volume.
p.33
Kidney Stones and Urolithiasis
Why might patients who undergo ultrasonography still require a CT scan?
Many patients who undergo ultrasonography may still require a CT scan to confirm stone presence, as ultrasonography is less sensitive than CT.
p.13
Benign Prostatic Hyperplasia (BPH) Etiology
What does a PSA level of 3-10 ng/ml indicate in the case of a large prostate?
It indicates the presence of BPH without cancer.
p.27
Kidney Stones and Urolithiasis
What is Randall's plaque?
Randall's plaque is formed when calcium phosphate crystals extrude at the renal papilla, serving as a nidus for further crystal deposition.
p.3
Benign Prostatic Hyperplasia (BPH) Etiology
What are some unproven factors in the development of BPH?
Smoking, Obesity, Vasectomy.
p.41
Clinical Signs of Prostate Cancer
What is a common urinary symptom in acute pyelonephritis?
Urgent or frequent urination.
p.11
Diagnosis and Treatment of BPH
Is invasive urodynamic investigation routinely recommended in preoperative BPH workup?
No, it is not routinely recommended but may be used in selected cases.
p.12
Benign Prostatic Hyperplasia (BPH) Etiology
Why is prostate volume important in treatment decision making?
Prostate volume is important in treatment decision making for medications and type of surgery.
p.29
Kidney Stones and Urolithiasis
What dietary factors increase the risk of nephrolithiasis?
Low calcium intake, high oxalate intake, high animal protein intake, high sodium intake, low fluid intake.
p.43
Treatment Options for Prostate Cancer
What are the components of conservative management for kidney issues?
ABCs, bed rest until gross hematuria clears, and serial vital signs and CBC.
p.47
Diagnosis and Treatment of BPH
How is a complete rupture of the urethra treated?
Immediate reconstruction of integrity is required.
p.47
Diagnosis and Treatment of BPH
What is the treatment approach for delayed treatment of urethral injuries from 2 days to 2 weeks?
Reconstruction of urethral integrity and urethroplasty by stitching urethral ends.
p.2
Classification of Prostate Cancer
What does N1 indicate in the TNM classification?
Metastasis in regional lymph node(s).
p.35
Kidney Stones and Urolithiasis
What is the dosage for Nospa in the treatment of renal colic?
Tablet Nospa 40mg, taken 2 times per day.
p.25
Prostate Cancer Etiology
Where can urothelial cancer occur?
In all urinary tract organs that have urothelium, including the upper urinary tract and bladder.
p.46
Urethral Trauma Treatment
What is the treatment of choice for complete or partial urethral rupture during blunt trauma?
Cystostomy is the treatment of choice for complete or partial urethral rupture during blunt trauma.
p.16
Benign Prostatic Hyperplasia (BPH) Etiology
What are the two types of 5 alpha reductase that Finasteride and Dutasteride block?
Finasteride blocks 5 alpha reductase type 2, while Dutasteride blocks both types 1 and 2.
p.18
Treatment Options for Prostate Cancer
What are some possible complications of BPH surgery?
Bleeding, infection, urethral stricture (5-9%), and permanent significant urinary incontinence (rare <1-3%)
p.20
Clinical Signs of Prostate Cancer
What is acute urinary retention (AUR)?
AUR is a painful desire and inability to void in case of a full urinary bladder.
p.7
Benign Prostatic Hyperplasia (BPH) Etiology
What can cause LUTS due to impaired detrusor function?
Involuntary detrusor contractions, poor detrusor contractility, and psychogenic voiding dysfunction can cause LUTS due to impaired detrusor function.
p.17
Treatment Options for Prostate Cancer
What is a new indication for Tadalafil in BPH treatment supported by EAU?
Treatment of BPH symptoms.
p.23
Treatment Options for Prostate Cancer
What is the treatment for intermediate risk tumors (Ta G1 or G2, >3cm, multiple tumors)?
Transurethral Resection (TURB) and single intravesical instillation of a chemo agent + 6 weekly intravesical instillation of BCG.
p.3
Treatment Options for Prostate Cancer
What treatments are recommended for high-risk or intermediate-risk prostate cancer?
Radical prostatectomy, External beam radiation therapy, HDR Brachytherapy + external beam radiation therapy.
p.23
Treatment Options for Prostate Cancer
What are the chemotherapy options for metastatic bladder cancer?
Polychemotherapy GC (gemcitabine, cisplatin) or MVAC (methotrexate, vinblastine, doxorubicin, cisplatin).
p.13
Benign Prostatic Hyperplasia (BPH) Etiology
What does a PSA level less than 1.5 ng/ml suggest?
It suggests a low probability of BPH progression, possibly indicating a small prostate.
p.15
Treatment Options for Prostate Cancer
What are the three subtypes of α1 receptors mentioned?
The subtypes are a1A, a1B, and a1D.
p.41
Clinical Signs of Prostate Cancer
What might pus or blood in the urine suggest?
It suggests a possible infection or complication.
p.11
Diagnosis and Treatment of BPH
What is the significance of an Abrams Griffiths (AG) number greater than 40?
It is an indicator of obstruction.
p.29
Kidney Stones and Urolithiasis
What are the urinary risk factors for calcium oxalate stones?
Hypercalciuria, Hyperoxaluria, Hypocitraturia.
p.42
Kidney Stones and Urolithiasis
What surgical procedures may be required to remove obstructions in the kidneys?
JJ stent, nephrostomy, ultrasound drainage/puncture.
p.9
Diagnosis of Prostate Cancer
What volume should be considered for uroflowmetry if the desire to void is normal?
A volume greater than 150 ml should be considered.
p.25
Treatment Options for Prostate Cancer
What are some targeted therapy options for cancer treatment?
VEGF receptor kinase inhibitors, anti-VEGF antibodies, mTOR antibodies.
p.9
Diagnosis of Prostate Cancer
What is the probability of obstruction based on Qmax for men?
<10 ml/s indicates a 90% probability of obstruction, 10-14 ml/s indicates a 67% probability, and >15 ml/s indicates a 30% probability.
p.10
Diagnosis and Treatment of BPH
What does ultrasound examination assess in relation to the prostate?
Prostate volume, shape, third lobe, bladder wall thickness, stones in the bladder, and postvoid residual urine.
p.16
Benign Prostatic Hyperplasia (BPH) Etiology
What are some adverse effects of a blocker?
Dizziness, headache, asthenia, peripheral edemas, first dose orthostatic hypotension, fainting, ejaculatory disorders, nose congestion, somnolence.
p.30
Kidney Stones and Urolithiasis
How can patients be diagnosed with asymptomatic nephrolithiasis?
Patients may be diagnosed when a radiologic imaging study of the abdomen is performed for other purposes or during surveillance imaging in those with a prior history of stones.
p.19
Treatment Options for Prostate Cancer
What is the recommended initial treatment for prostate issues?
Start treatment with medication first.
p.23
Treatment Options for Prostate Cancer
What is the golden standard non-muscle invasive treatment for bladder cancer?
Transurethral Resection (TURP)
p.8
Diagnosis and Treatment of BPH
When should treatment be initiated based on IPSS scores?
Treatment should be initiated for moderate (8-19) or severe (20-35) symptoms.
p.37
Kidney Stones and Urolithiasis
What is Shock Wave Lithotripsy (SWL)?
SWL is a procedure that pulverizes stones in the kidney and ureter into small fragments using short-duration, high-energy shockwaves produced outside the body by a lithotripter.
p.20
Benign Prostatic Hyperplasia (BPH) Etiology
What are the main causes of acute urinary retention?
The main causes include BPH, prostate cancer, urethral stricture, bladder neck contracture, clots in the bladder, and critical phimosis.
p.8
Diagnosis and Treatment of BPH
What types of anamnestic data are considered in the diagnosis of BPH?
Interventions, urinary retention, infections, hematuria, diabetes, neurological diseases, and concomitant medications.
p.21
Clinical Signs of Prostate Cancer
What are other clinical signs of bladder cancer?
Other clinical signs of bladder cancer include dysuria, irritative symptoms, and upper urinary tract obstruction.
p.27
Kidney Stones and Urolithiasis
What are some other types of kidney stones?
Other types of kidney stones include uric acid, struvite (magnesium ammonium phosphate), and cystine stones.
p.17
Diagnosis and Treatment of BPH
What are absolute indications for surgical treatment of BPH?
Repetitive acute urinary retention, bladder stones, repetitive urinary tract infections, renal insufficiency, and repetitive hematuria.
p.1
Diagnosis of Prostate Cancer
What is PCA3 in the context of prostate cancer diagnosis?
A urine test used for prostate cancer diagnosis.
p.15
Treatment Options for Prostate Cancer
Where is the a1A receptor primarily located?
The a1A receptor is localized in the prostatic stroma, accounting for 70% of all a1 receptors.
p.15
Treatment Options for Prostate Cancer
Name some selective α1 adrenoblockers.
Selective α1 adrenoblockers include alfuzosin, doxazosin, prazosin, and terazosin.
p.41
Treatment Options for Prostate Cancer
What are some antibiotic options for treating acute pyelonephritis?
Levofloxacin, ciprofloxacin, cefuroxime, ceftriaxone.
p.22
Diagnosis of Prostate Cancer
What should be done when there's a tumor in the bladder?
Do not perform a biopsy; instead, take histology.
p.35
Kidney Stones and Urolithiasis
What is the recommended dosage for Ketorolac in renal colic treatment?
Tablet Ketorolac 10mg, taken 1 time per day.
p.24
Clinical Signs of Prostate Cancer
What is the classic triad of clinical signs for renal cell carcinoma?
The classic triad includes flank pain, hematuria, and a palpable abdominal renal mass.
p.24
Clinical Signs of Prostate Cancer
What are the characteristics of the renal mass in renal cell carcinoma?
The mass is generally firm, homogenous, and nontender.
p.10
Diagnosis and Treatment of BPH
What is considered clinically significant postvoid residual urine?
Repeatedly found PVR greater than 50 ml.
p.8
Diagnosis and Treatment of BPH
What are the IPSS symptom score categories?
MILD (0-7), MODERATE (8-19), SEVERE (20-35).
p.37
Kidney Stones and Urolithiasis
What urine pH should be maintained for oral chemolysis?
The urine pH should be adjusted to between 6.5 and 7.2.
p.23
Treatment Options for Prostate Cancer
What follow-up procedure is required after treatment for superficial tumors?
Cystoscopy from 3 to 6 months according to the risk of disease progression and recurrence.
p.16
Benign Prostatic Hyperplasia (BPH) Etiology
How much does Qmax increase after treatment with 5ARI?
Qmax increases by 15% (1.3-1.6 ml/s).
p.1
Clinical Signs of Prostate Cancer
What symptoms may indicate tumor progression into the urethra?
Urinary hesitancy, decreased force of urine stream, intermittency.
p.20
Treatment Options for Prostate Cancer
What is the treatment for acute urinary retention in BPH?
Treatment includes intermittent catheterization with α adrenoblockers (tamsulosin 0.4 – 0.8 mg OD) for 2-3 days or permanent catheterization with the same medication.
p.5
Clinical Signs of Prostate Cancer
What symptoms are associated with BPH?
Symptoms include frequency, urgency, nocturia, weak stream, intermittent stream, straining to urinate, and emptying difficulties.
p.27
Kidney Stones and Urolithiasis
What is the supersaturation theory in relation to calcium stone formation?
The supersaturation theory states that stone formation occurs when normally soluble materials like calcium and oxalate supersaturate the urine, leading to crystal formation.
p.31
Kidney Stones and Urolithiasis
What is the most common symptom of nephrolithiasis?
Pain, which can range from a mild ache to intense discomfort requiring parenteral analgesics.
p.3
Benign Prostatic Hyperplasia (BPH) Etiology
What role do androgens play in the etiology of Benign Prostatic Hyperplasia?
Androgens play a very important role.
p.15
Treatment Options for Prostate Cancer
Where can the a1D receptor be found?
The a1D receptor is found in the urinary bladder and spinal cord.
p.41
Diagnosis of Prostate Cancer
What imaging modalities are useful for evaluating acute pyelonephritis?
Computed tomography (CT) scan and ultrasonography.
p.22
Diagnosis of Prostate Cancer
When is a biopsy taken in bladder cancer diagnosis?
When there's positive cytology but negative cystoscopy.
p.10
Diagnosis and Treatment of BPH
What is the postvoid residual (PVR) urine volume in 95% of healthy men?
Less than 12 ml, indicating practically no residual urine.
p.16
Benign Prostatic Hyperplasia (BPH) Etiology
What is the mechanism of action of 5 alpha reductase inhibitors (5ARI)?
They block the activity of 5 alpha reductase, suppressing the concentration of dihydrotestosterone in the blood and prostate.
p.21
Diagnosis and Treatment of BPH
What is the minimum urine volume in the bladder during typical acute urinary retention (AUR)?
In typical AUR, the bladder contains at least 500 ml of urine.
p.24
Diagnosis of Prostate Cancer
What tests are used for the diagnosis of renal cell carcinoma?
Diagnosis can involve urinalysis, CBC, electrolytes, liver function tests, serum calcium, abdominal ultrasound or CT, excretory urography, ultrasonography, CT scanning, MRI, arteriography, and PET scanning.
p.3
Risk Factors for Prostate Cancer
What are the risk groups for prostate cancer based on prognostic factors?
Low risk, Intermediate risk, High risk.
p.17
Treatment Options for Prostate Cancer
What is the dosage of Tadalafil for BPH treatment?
Tadalafil 5 mg once daily.
p.23
Treatment Options for Prostate Cancer
What treatment is recommended for low-risk superficial tumors (Ta G1 or G2)?
Transurethral Resection (TURB) and single intravesical instillation of a chemo agent.
p.5
Benign Prostatic Hyperplasia (BPH) Etiology
What are the components of BPH obstruction?
The components of BPH obstruction are the static component, which involves increased volume of the prostate, and the dynamic component, which involves increased smooth muscle tone due to sympathetic overactivity.
p.16
Benign Prostatic Hyperplasia (BPH) Etiology
What are some adverse effects of 5 alpha reductase inhibitors?
Decreased libido and impotence.
p.18
Treatment Options for Prostate Cancer
What percentage of patients experience significant relief of symptoms after BPH surgery?
77% of patients experience significant relief of symptoms.
p.15
Benign Prostatic Hyperplasia (BPH) Etiology
What is a significant limitation of in vitro effects of plant extracts?
Most in vitro effects have not been confirmed in vivo and the precise mechanisms of action of plant extracts remain unclear.
p.23
Treatment Options for Prostate Cancer
What follow-up tests are required after cystectomy?
Medical examination, urine test, creatinine test, and ultrasound.
p.39
Kidney Stones and Urolithiasis
What should be considered for patients with morbid obesity regarding surgery?
They may require open surgery due to complications with minimally invasive procedures.
p.31
Kidney Stones and Urolithiasis
What are some common symptoms of nephrolithiasis?
Symptoms include pain, hematuria, nausea, vomiting, dysuria, and urgency.
p.41
Diagnosis of Prostate Cancer
What is the purpose of urinalysis and urine culture in diagnosis?
To check for bacteria, concentration, blood, and pus in the urine.
p.22
Diagnosis of Prostate Cancer
What tests are used for diagnosing bladder cancer?
Urinalysis, CBC, Ultrasound, CT, MRI, Cystoscopy, and Fluorescence cystoscopy.
p.8
Diagnosis and Treatment of BPH
What is the International Prostate Symptom Score (IPSS) used for?
The IPSS is used to assess symptoms related to prostate conditions, driving treatment decisions.
p.39
Kidney Stones and Urolithiasis
What is the purpose of a physical examination in urology?
To detect anatomical and congenital abnormalities.
p.45
Treatment Options for Prostate Cancer
What complications can arise from extraperitoneal bladder injuries?
Shock and pelvic abscess.
p.1
Clinical Signs of Prostate Cancer
What are common early clinical signs of prostate cancer?
No clinical signs; cancer mostly arises in the peripheral zone of the gland.
p.27
Kidney Stones and Urolithiasis
What percentage of nephrolithiasis patients form calcium stones?
80% of nephrolithiasis patients form calcium stones.
p.20
Risk Factors for Prostate Cancer
What are some predisposing factors for acute urinary retention in BPH?
Predisposing factors include alcohol, colds, surgical interventions, medications (like cholinoblockers), spicy food, and constipation.
p.18
Treatment Options for Prostate Cancer
What is HoLEP in the context of BPH treatment?
HoLEP stands for holmium laser transurethral enucleation of prostate, an endoscopic procedure for big prostates.
p.15
Benign Prostatic Hyperplasia (BPH) Etiology
Why is phytotherapy controversial in treating male LUTS?
It remains controversial which components of the extracts are responsible for symptom relief in male LUTS.
p.27
Kidney Stones and Urolithiasis
What is the medullary interstitium theory?
The medullary interstitium theory suggests that stone formation starts in the renal medullary interstitium, where calcium phosphate crystals may form and later extrude at the renal papilla.
p.13
Risk Factors for Prostate Cancer
What does a PSA level greater than 10 ng/ml indicate?
It indicates a high probability of prostate cancer.
p.15
Treatment Options for Prostate Cancer
What is the location of the a1B receptor?
The a1B receptor is localized in blood vessels of large caliber.
p.15
Treatment Options for Prostate Cancer
What are subtype selective adrenoblockers for a1A/a1D?
Tamsulosin and silodosin are subtype a1A/a1D selective adrenoblockers.
p.11
Diagnosis and Treatment of BPH
What investigations are indicated for upper urinary tracts in BPH?
IVU, Scintigraphy, CT, MRI.
p.45
Treatment Options for Prostate Cancer
What is the treatment for an intraperitoneal rupture?
Surgical repair via midline laparotomy/cystotomy, two-layer closure of bladder injury, bladder drainage, Foley catheter ± suprapubic catheter for 14 days, perivesical drain, and antibiotics.
p.7
Benign Prostatic Hyperplasia (BPH) Etiology
What PSA level is considered significant in the context of LUTS?
PSA over 1.5 ng/ml is considered significant.
p.17
Treatment Options for Prostate Cancer
What combination is used for treating BPH symptoms?
5ARI combination with α blockers.
p.13
Diagnosis of Prostate Cancer
Is PSA specific to prostate cancer?
No, PSA is prostate specific but not prostate cancer specific.
p.21
Bladder Cancer Overview
What are some risk factors for bladder cancer?
Risk factors for bladder cancer include smoking, being over 65 years of age, being male, family history, occupational exposure to carcinogens, chronic inflammation of the bladder from long-term catheter use, diabetes medications, and obesity.
p.37
Kidney Stones and Urolithiasis
What factors affect the success rate of SWL?
The success rate depends on the size, location, and composition of the stones, the patient’s habitus, and the performance of SWL.
p.37
Kidney Stones and Urolithiasis
What are some contraindications for using SWL?
Contraindications include pregnancy, bleeding diathesis, uncontrolled urinary tract infections, severe skeletal malformations, severe obesity, arterial aneurysm near the stone, and anatomical obstruction distal to the stone.
p.13
Benign Prostatic Hyperplasia (BPH) Etiology
What does a PSA level greater than 1.5 ng/ml suggest?
It suggests a higher probability for future BPH progression.
p.3
Treatment Options for Prostate Cancer
What is the primary hormonal treatment for metastatic prostate cancer?
Testosterone suppression.
p.5
Clinical Signs of Prostate Cancer
What are some difficulties experienced during urination due to BPH?
Difficulties include starting or stopping the urine stream, pain when urinating, weak or interrupted urine stream, and an urgent need to urinate.
p.15
Treatment Options for Prostate Cancer
What is the mechanism of action for α blockers?
The mechanism involves relaxation of smooth muscles in the prostate, bladder neck, and urethra, leading to relief of obstruction and an increase in Qmax.
p.41
Clinical Signs of Prostate Cancer
What does cloudy urine indicate in the context of acute pyelonephritis?
It is a clinical sign of infection.
p.41
Diagnosis of Prostate Cancer
Which bacteria is most commonly found in acute pyelonephritis?
Escherichia coli (75 to 95%).
p.11
Diagnosis and Treatment of BPH
What are the lower urinary tract investigations for BPH?
Urethrography, Cystography, Cystoscopy.
p.33
Kidney Stones and Urolithiasis
What is the imaging of choice for suspected nephrolithiasis?
Non-contrast CT scan is the imaging of choice for suspected nephrolithiasis.
p.19
Treatment Options for Prostate Cancer
What type of medication is effective for smaller prostates?
Alpha blockers are good for not so big prostate.
p.33
Kidney Stones and Urolithiasis
How does non-contrast CT scan compare to ultrasonography in terms of sensitivity for detecting stones?
Non-contrast CT scan is more sensitive than ultrasonography for visualizing stones.
p.44
Bladder Cancer Overview
What is the role of ultrasound in diagnosing bladder trauma?
Screening, but it does not confirm diagnosis.
p.19
Treatment Options for Prostate Cancer
What is the recommended approach after medication for large prostates?
Surgery after medication.
p.33
Kidney Stones and Urolithiasis
What is a key advantage of ultrasonography over non-contrast CT scans?
Ultrasonography is not associated with radiation exposure.
p.5
Benign Prostatic Hyperplasia (BPH) Etiology
What percentage of obstruction caused by BPH is attributed to the dynamic component?
The dynamic component is responsible for 40% of obstruction caused by BPH.
p.13
Diagnosis of Prostate Cancer
When should blood for PSA evaluation be withdrawn?
Before a digital rectal exam (DRE), not after.
p.5
Clinical Signs of Prostate Cancer
What is nocturia?
Nocturia is the frequent need to urinate at night.
p.3
Prostate Cancer Etiology
What lifestyle changes can help in the prevention of prostate cancer?
Healthy lifestyle and diet.
p.39
Kidney Stones and Urolithiasis
What considerations apply for the pediatric population regarding kidney stones?
The same considerations apply as for adults.
p.31
Kidney Stones and Urolithiasis
What condition may mimic flank pain caused by nephrolithiasis?
Pyelonephritis, which presents with flank pain, fever, and pyuria.
p.11
Diagnosis and Treatment of BPH
What is cystometry used for in BPH evaluation?
Measures pressure in the bladder and urinary flow simultaneously; it can prove or rule out the presence of obstruction.
p.45
Treatment Options for Prostate Cancer
What are some complications associated with intraperitoneal bladder injuries?
Urinary frequency, shock, peritonitis, and azotemia.
p.21
Treatment Options for Prostate Cancer
Why is emergency prostate surgery not recommended in cases of acute urinary retention (AUR)?
Emergency prostate surgery in cases of AUR is not recommended due to a higher risk of complications and less favorable results.
p.39
Kidney Stones and Urolithiasis
What should be done with thrombocyte aggregation inhibitors/anticoagulation treatment before URS?
Treatment should be discontinued.
p.13
Diagnosis of Prostate Cancer
What factors can influence PSA levels?
Infection, trauma, acute urinary retention (AUR), prostate volume, biopsy, manipulations in the lower urinary tract, digital rectal exam (DRE), sexual intercourse, and bicycle rides.
p.18
Benign Prostatic Hyperplasia (BPH) Etiology
What is the significance of a high residual volume of urine in BPH?
A high residual volume of urine (>200 ml) indicates a need for surgical intervention.
p.23
Treatment Options for Prostate Cancer
What is the treatment approach for high-risk tumors (G3, T1, Tis)?
TURB + reresection after 4-6 weeks (reTURB) + 6 weekly intravesical instillation of BCG.
p.39
Kidney Stones and Urolithiasis
What should be limited to the treatment of large renal stones?
'Smash and go' strategies.
p.27
Kidney Stones and Urolithiasis
Can a patient have more than one type of kidney stone at the same time?
Yes, a patient may have more than one type of stone at the same time, such as calcium oxalate and uric acid.
p.18
Treatment Options for Prostate Cancer
What are irritative symptoms and how do they change after BPH surgery?
Irritative symptoms decrease slowly over 3-6 months after surgery.
p.15
Benign Prostatic Hyperplasia (BPH) Etiology
When might phytotherapy be considered for a patient?
In case of mild symptoms, if it helps for a particular patient.
p.41
Clinical Signs of Prostate Cancer
What type of pain is associated with acute pyelonephritis?
Pain in the abdomen, back, side, or groin.
p.31
Kidney Stones and Urolithiasis
What is a differential diagnosis for flank pain in nephrolithiasis?
Ectopic pregnancy can occasionally be mistaken for renal colic.
p.41
Treatment Options for Prostate Cancer
What determines the type of antibiotic used for acute pyelonephritis?
Whether or not the bacteria can be identified.
p.22
Diagnosis of Prostate Cancer
When should a cystoscopy be performed?
When it's not clear if a tumor is present from ultrasound and the diagnosis is not clear.
p.33
Kidney Stones and Urolithiasis
What is a disadvantage of using non-contrast CT scans for recurrent nephrolithiasis?
Non-contrast CT scans are associated with radiation exposure, and cumulative radiation doses can be high in patients requiring frequent imaging.
p.7
Benign Prostatic Hyperplasia (BPH) Etiology
What are some complications associated with LUTS?
Complications include bilateral hydronephrosis leading to renal insufficiency, bladder wall hypertrophy and atrophy, bladder stones, infections, bleeding, and bladder diverticula.
p.15
Benign Prostatic Hyperplasia (BPH) Etiology
What does phytotherapy involve?
Phytotherapy comprises the medical use of various extracts of different plants.
p.37
Kidney Stones and Urolithiasis
What is percutaneous nephrolitholapaxy (PNL)?
PNL is a surgical procedure used to remove kidney stones.
p.18
Treatment Options for Prostate Cancer
What is a common indication for prostatectomy in BPH patients?
Prostatectomy is recommended for big prostates when prostate volume (PV) is greater than 70-80 ml.
p.17
Diagnosis and Treatment of BPH
What are relative indications for surgical treatment of BPH?
Poor response to medical treatment and progression of symptoms.
p.41
Clinical Signs of Prostate Cancer
What is a clinical sign of acute pyelonephritis indicated by a temperature?
A fever greater than 38.0°C.
p.31
Kidney Stones and Urolithiasis
What type of hematuria occurs in patients with symptomatic nephrolithiasis?
Gross or microscopic hematuria occurs in the majority of patients.
p.31
Kidney Stones and Urolithiasis
What tests are needed for diagnosing urolithiasis?
A succinct biochemical work-up of urine and blood, along with imaging studies.
p.11
Diagnosis and Treatment of BPH
What are the key volumes measured in the evaluation of BPH?
Total prostate volume and transitional zone volume.
p.17
Treatment Options for Prostate Cancer
What is the unclear mechanism of action for Tadalafil in BPH?
Possibly due to improvement of blood supply to the pelvic organs.
p.13
Diagnosis and Treatment of BPH
What is the normal range for total PSA in BPH?
Total PSA < 3 ng/ml is considered normal.
p.15
Benign Prostatic Hyperplasia (BPH) Etiology
Are phytotherapy treatments recommended by EAU Guidelines?
Phytotherapy is not recommended by EAU Guidelines due to controversies.
p.31
Kidney Stones and Urolithiasis
What causes pain in nephrolithiasis?
Pain is primarily caused by urinary obstruction with distention of the renal capsule.
p.41
Clinical Signs of Prostate Cancer
What symptom indicates painful urination in acute pyelonephritis?
Painful or burning urination.
p.22
Bladder Cancer Overview
What are signs of advanced bladder cancer?
Weight loss and abdominal pain.
p.15
Treatment Options for Prostate Cancer
What are examples of nonselective α1/α2 adrenoblockers?
Phenoxybenzamine is an example of a nonselective α1/α2 adrenoblocker.
p.22
Diagnosis of Prostate Cancer
Why should the bladder be full during an ultrasound?
To identify the bladder easily.
