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Chapter 40: Urology

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Which of the following is INCORRECT concerning the anatomy of the penis?

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A. The paired corpora spongiosum functions as one ­compartment due to vascular interconnections.

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B. Priapism is defined as a persistent erection of more than 4 hours’ duration.

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C. The corpora cavernosum are enclosed by the tunica albuginea.

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D. The corpora cavernosum and spongiosum are surrounded by Bucks fascia.

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Answer: A

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The corpora cavernosum are the paired, cylinder-like structures that are the main erectile bodies of the penis. The corpora cavernosum consist of a tough outer layer called the tunica albuginea and spongy, sinusoidal tissue inside that fills with blood to result in erection. The two corpora cavernosum have numerous vascular interconnections, so they function as one compartment. Surrounding all three bodies of the penis are the outer dartos fascia and the inner Buck fascia. (See Schwartz 10th ed., p. 1652.)

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Which of the following is true about bladder cancer?

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A. For patients with bladder cancer invading into the bladder muscle (T2 lesion) immediate radiotherapy followed by surgery offers the best chance of cure.

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B. Patients with limited lymph node involvement may be cured by surgery alone.

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C. Continent neobladders have yet to be successfully utilized in patients undergoing cystectomy.

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D. Intravesical chemotherapy prior to surgery is routinely used for bladder cancers invading into the bladder muscle (T2 lesion).

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Answer: B

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For patients who have disease invading into bladder muscle (T2), immediate (within 3 months of diagnosis) cystectomy with extended lymph node dissection offers the best chance of survival. Patients with limited lymph node involvement may be cured with surgery alone. Patients have multiple reconstructive options, including continent and noncontinent urinary diversions. The orthotopic neobladder has emerged as a popular urinary diversion for patients without urethral involvement. This diversion type involves the detubularization of a segment of bowel, typically distal ileum, which is then refashioned into a pouch that is anastomosed to the proximal urethra (neobladder) or to the skin (continent cutaneous diversion). Patients with non–muscle-invasive bladder cancer (confined to the bladder mucosa or submucosa) can be managed with transurethral resection alone and adjuvant intravesical (instilled into the bladder) chemotherapy/immunotherapy. (See Schwartz 10th ed., pp. 1653–1654.)

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Which of the following is true concerning testicular cancer?

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A. Most common malignancy in men between 15 and 35 years.

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B. Most commonly presents ...

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