Which of the following injectable agents is recommended by the AUA Guidelines in the management of priapism?

How soon after diagnosis should confirmatory biopsy be performed while on AS?

Which of the following renal masses is most amenable to treatment with percutaneous cryoablation?

In which of the following situations should renal mass biopsy NOT be strongly considered prior to intervention?

A 65-year-old patient with a 4.5-cm right renal mass undergoes a robotic-assisted laparoscopic partial nephrectomy. Pathology reveals pT1b clear cell renal cell carcinoma, grade 2, with a focally positive microscopic margin at the renal parenchyma. In which risk category should this patient be classified for follow-up?

A 58-year-old man with advanced colorectal cancer undergoing chemotherapy is found to have new left hydronephrosis on abdominal ultrasound. He reports vague left flank discomfort for several weeks. The serum creatinine is 1.2 mg/dL. The next step is

A 45-year-old patient without comorbidities is set to undergo PCNL for a 2-cm lower pole stone. During the preoperative evaluation, she is found to have a positive urine culture. Current evidence from RCTs suggests she should undergo which of the following regimens prior to PCNL to reduce risk of sepsis?

Based on current evidence, which of the following conditions is not a direct risk factor for infectious complications after URS?

The perioperative intravesical therapy best suited for the management of low grade Ta NMIBC is

The goal of active surveillance in NMIBC is to

Low testosterone is defined by the AUA guidelines as two early morning serum total T levels below

Why should PSA levels be interpreted in the context of simultaneous testosterone (T) levels?

According to the product labeling, testosterone therapy is contraindicated in men with:

The most common significant complication from bladder outlet surgery after radiation for prostate cancer is:

Which of the following is a Food and Drug Administration-approved indication for urethral bulking agent injection?

The 15-year prostate cancer mortality after biochemical recurrence following radical prostatectomy is approximately

Eight years after radical prostatectomy for Gleason 3+4 pT2N0R0 prostate cancer, a 78-year-old man with coronary artery disease and insulin dependent diabetes mellitus has a PSA increase to 0.30 ng/mL with a PSA doubling time of 36 months. The next step is

A 63-year-old man undergoes low-dose brachytherapy for Gleason 3+4 cT1c prostate cancer with a pre-treatment PSA of 4 ng/mL. PSA nadir 9 months after completing treatment is 0.4 ng/mL. His PSA increases to 1.6 ng/mL over the subsequent 24 months, and then declines to 1.0 ng/mL in the following 6 months. The next step is

A urologist is discussing brachytherapy treatment for a 55-year-old patient with localized intermediate-risk prostate cancer. He is an active marathoner and eats a healthy plant-based diet. He is able to have penetrative intercourse 3 times a week without medication and gets nighttime erections. Which of the following factors is associated with preservation of erectile function after brachytherapy?

A 73-year-old African American man with hypertension, diabetes, congestive heart failure, and chronic obstructive pulmonary disease presents to the urologist’s office for routine follow up. He has had annual PSA screening for 10 years and his last PSA was stable at 3.2 ng/mL 1 year ago. He inquires about PSA testing for this visit. Using the Lee Index calculator, his overall 10-year mortality risk is 70%-82%. Which of the following is the appropriate recommendation for this patient?

Risk factors that increase risk for prostate cancer and therefore may be used to modify a patient’s approach to prostate cancer screening include significant family history of prostate cancer, Black race, and

A 59-year-old patient is referred to the urologist’s office for evaluation of a prostate nodule on DRE. His PSA is 2.1 ng/mL and on DRE the urologist notes a concerning, firm, nontender, 1 cm nodule on the right side of the prostate. The patient has past medical history of hypertension, and his father was diagnosed with prostate cancer at age 82. Which of the following is the appropriate next step in management?

A 32-year-old man and his wife have been trying to conceive for 2 years and have not achieved a pregnancy. Her workup is normal. His physical exam is notable for 18 cc testes bilaterally, normal epididymides, palpable vas deferens, and no varicocele. His semen analysis (SA) shows volume 2 mL, concentration of 10 million/mL, and motility 80%. Scrotal US reveals a varicocele. You recommend

In a patient presenting with azoospermia, which of the following findings is most suggestive of nonobstructive azoospermia?

A 45-year-old patient 11 years post T10 spinal injury is on a CIC protocol. After an episode of gross hematuria, CT urogram and cystoscopy are normal. He inquires about the need for surveillance cystoscopy on CIC. How do you counsel him regarding the use of surveillance cystoscopy according to the 2021 AUA/SUFU NLUTD guidelines?

A 64-year-old female with MS presents with urinary frequency and a history of 4 culture-confirmed UTIs in the past year. She has normal renal function, and a PVR of 90 mL. A renal ultrasound is normal and UDS shows detrusor overactivity, normal compliance, and no VUR or detrusor external sphincter dyssynergia. Based on the 2021 AUA/ SUFU NLUTD guidelines, what is the recommended timing of repeat of upper tract imaging and urodynamics?

A 48-year-old female with MS presents with urinary frequency and urgency. Her labs and renal US are normal with 150 mL PVR. Video urodynamics reveals DO, normal compliance, no VUR, and normal storage pressures. After treatment with anticholinergics, she improves. Six years later, she returns with worsening urge incontinence and 3 culture-proven UTIs and PVR of 250 cc. Labs and upper tract imaging are normal. What is the next best step?

A 37-year-old patient develops NLUTD with detrusor hypocontractility after low anterior resection for rectal cancer. Based on the 2021 AUA/SUFU NLUTD guidelines, antibiotic prophylaxis could be considered if he

A 67-year-old male with hypertension and alcoholic cirrhosis presents with a 3-day history of worsening scrotal pain with associated swelling and subjective fevers. He is febrile, blood pressure 105/70, tachycardic, and the glucose is 405. The scrotum is extremely tender, erythematous, and edematous. Bilateral testes are palpable, with fluctuation on the right scrotal wall. There are no skin lesions or crepitus. After administering IV fluids, what is the best next step?

A 15-year-old boy presents with left testicular pain, which started yesterday morning and is worsening. It is as a dull ache at the top of his left testicle that is worse with movement. He was recently hit in the scrotum with a baseball 6 days ago. He had pain right after the impact, but it resolved spontaneously. He is sexually active and sometimes uses condoms. He denies a history of hematuria, dysuria, or urethral discharge. The scrotum is mildly edematous, and the left testis is mildly tender to palpation with a nontender right testis. Urinalysis is normal. On US, there is bilateral flow and left testicular edema without masses.

A 34-year-old female presents with an incidentally found 5-cm AML in the lower pole of her right kidney discovered on a CT scan for severe abdominal pain that has since resolved. She is seeking to become pregnant, and she and her partner have been working with an infertility specialist who has suggested they should proceed with testicular sperm extraction and in vitro fertilization due to male infertility factors. What is the best recommendation for her?

Ultrasound performs suboptimally on all of the following EXCEPT:

Which of the following statements about staging of urothelial carcinoma in cystectomy specimens is TRUE?

Penile squamous cell carcinomas most commonly involve which of the following?

Which of the following antibiotics is NOT a first-line agent recommended by the Infectious Diseases Society of America (IDSA) for the management of acute uncomplicated cystitis?

Which of the following is NOT a mechanism to improve endogenous testosterone levels?

In a 60-year-old man with a 2.5-cm solid, enhancing renal mass and normal laboratory studies, the acceptable next step in management is which of the following?

Based on the literature, the risk of metastatic progression for small renal masses managed with active surveillance is approximately which of the following?

The Pelvic Organ Prolapse Quantification (POP-Q) System is which of the following?

Bladder outlet obstruction (BOO) on urodynamic test is confirmed by which of the following?

PDE-5Is show the best improvement of symptoms when combined with what other medication class?

What type of lower urinary tract symptom is most improved with desmopressin?

The APP is ordering a plain abdominal radiography of the kidneys, ureter, bladder (KUB) for a patient being seen in the ER. The patient is complaining of left lower abdominal pain, hematuria and some nausea. Which statement is correct?

The APP is placing a catheter in a male with an enlarged prostate. Which statement is correct?

49. Mark Spindle has been scheduled for an inpatient cystoscopy and bladder biopsy. A new surgical technician is being orientated to the procedure. She overhears the MD talking to the patient about “trabeculations” in the bladder. The MD performed a TURBT (transurethral resection of the bladder tumor). The pathology confirms papillary urothelial. What does the term “trabeculations” in the bladder most likely refer to?

A patient with bladder cancer, Stage 2, is scheduled for a follow up visit with the APP in 1 week. The APP would recommend:

A 60 year old male with a 30 pack year history of tobacco usage is seen by the APP in clinic with hematuria and right flank pain. A CT Urogram identified a Bosniak IIF renal cyst in the right kidney. Based on your understanding of the Bosniak Classification, your plan is:

The APP is doing preoperative teaching for the patient undergoing a continent cutaneous diversion. Contraindications to this procedure include a patient with:

The APP is called into the ER to see a patient for paraphimosis. The patient needs immediate treatment. Options for reducing the paraphimosis include:

A 60 year old diabetic female underwent a 12 week session of biofeedback and electrical stimulation. She had successful results for 7 months but recently is noting an increase in urgency and urge incontinence episodes. She has returned to your clinic and is seeking an alternate therapy. You consider the option of PTNS therapy. You first review the contraindications for this therapy. Contraindications include:

During the evaluation of a patient with voiding dysfunction, there is a log rhythm that often begins with simple lab tests including urinalysis, urine cultures, complete blood cell count and a metabolic panel. Procedures such as measuring the postvoid residuals (PVR), an uroflow and an urodynamics are also included. Which of the following is NOT a simple lab test?

Mr. Parker a 78-year-old male was seen today for a urodynamic study. After the AP reviewed this study, the AP noted uninhibited detrusor contractions with leaking of urine. Which is true about the best next course of action?

A 60-year-old male was started on finasteride (Proscar for BPH). You are asked to review the medication with the patient. Which of these answers is correct?

A 26-year-old female presents to your office with acute arthralgias, myalgia, nausea, vomiting and a fever of 102.2 F. Her vital signs are as follows: HR 120, BP 100/60, RR 14, Temp 102.2° F, oral. She has tenderness when the ABP taps over her left flank. Her urinalysis shows numerous WBC casts and is leukocyte esterase positive. Which of the following is the most appropriate treatment plan for this patient?

Because this urologic condition (prostatitis) affects such a significant portion of males, it is important for the APP to be familiar with this topic. This urologic condition would be tested under the category of “infections”. How is prostatitis tested and treated?

Mr. Woodright was seen by the APP in clinic and was diagnosed with epididymitis. During the physical exam, the NP palpated the unaffected side 1st. Expected findings of epididymitis could include which of the following?

The emergency room APP is seeing the patient diagnosed with testicular torsion. As the APP is developing their plan of care they are aware that:

Benign prostatic hyperplasia effects about 50% of men between the ages of 51 and 60 and up to 90% of men older than 80. It is considered to be a disease of aging because symptoms typically began around age 50-60. Benign prostatic hyperplasia (BPH) is a benign enlargement of the prostate gland that can result in bladder outlet obstruction and voiding difficulty. As the prostate and largest, the gland presses against and pinches the urethra and may grow up into the bladder. This can result in the bladder's inability to completely empty. Which of the following is considered to be the “gold standard” treatment for BPH?

Sepsis after PCNL best correlates with:

Which of the following pulse sequences is the MOST important for detecting and characterizing prostate cancers in the peripheral zone?

Which of the following newly accepted renal cell carcinomas (RCC) is clinically aggressive?

Which of the following antibiotics is NOT a first-line agent recommended by the Infectious Diseases Society of America (IDSA) for the management of acute uncomplicated cystitis?

Which of the following is an appropriate indication for a catheter?

Hunner lesion disease (HLD) is best treated with which of the following?

Which of the following symptoms common to patients diagnosed with interstitial cystitis is also present in many men with chronic pelvic pain?

Shared decision making is justified in the modern management of erectile dysfunction (ED) because of which of the following?

A 54-year-old male with a known history of a bulbar urethral stricture (never treated) presents to the office with bothersome, worsening slowing urinary flow, straining to void, and feeling of incomplete emptying. Urinalysis is normal. Peak flow is 3 m/sec. Voided volume is 200 ml. Post void residual is 175 ml. The next step should be which of the following?

Which of the following statements is TRUE?

A 26-year-old woman has a pelvic fracture, collapsed lung, and a severe closed head injury following an automobile accident. A retrograde cystogram reveals an extraperitoneal bladder rupture. The next step in management is which of the following?

In a 60-year-old man with a 2.5-cm solid, enhancing renal mass and normal laboratory studies, the acceptable next step in management is which of the following?

A 65-year-old woman presents with bothersome stress urinary incontinence (SUI) that negatively impacts her life (cannot exercise due to SUI) even after pelvic floor physical therapy. She has mild overactive bladder (OAB) symptoms, which are not bothersome. She is otherwise healthy without other medical problems and no prior surgeries. The pelvic exam showed no prolapse and a positive cough stress test. The step for this patient is which of the following?

A man with high volume stress urinary incontinence following salvage radical prostatectomy, the preferred surgical approach is which of the following?

When compared to intravesical mitomycin C, gemcitabine is which of the following?

Compared to open surgery, robot-assisted radical cystectomy (RARC) and urinary diversion is associated with which of the following?

A 65-year-old female with cT2 muscle-invasive urothelial carcinoma with focal squamous differentiation and diffuse carcinoma in situ (CIS), no hydronephrosis, and post status transurethral resection of bladder tumor (TURBT). Which of the following tumor-related factor makes this patient NOT ideal for trimodality bladder-sparing therapy?

The best medical therapy to improve lower urinary tract symptoms (LUTS) secondary for benign prostatic hyperplasia (BPH) is which of the following?

Many technologies for surgical management of benign prostatic hyperplasia (BPH) included size parameters and morphology criteria in their pivotal studies. As understanding prostate anatomy and morphology can impact treatment options, Guideline Statement 5 encourages clinicians to use any one of the following in their work-up EXCEPT:

Prostate cancer screening received a “D” recommendation from United States Preventive Services Taskforce (USPSTF) in 2012, discouraging prostate cancer screening because the potential harms

outweighed the benefits. However, in 2018, USPSTF changed its recommendation from grade “D” to grade “C,” suggesting that prostate cancer screening is appropriate for men between the ages of 55 and 69 as a shared decision between the patient and health care provider. The change in recommendation from grade “D” to grade “C” was driven by which of the following?

The family of inherited genes that increases the risk of developing prostate cancer includes variants in which of the following?

Which of the following was the conclusion of the PROTECT trial “Fifteen-year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer”?

The recently published ARTISTIC meta-analysis evaluated contemporary randomized trials of immediate adjuvant post-operative radiation versus observation and early salvage only if the PSA rises to 0.1 or 0.2 and found which of the following?

The management of de novo high-volume metastatic prostate cancer may include any of the following EXCEPT:

A 4-year-old boy is in a motor vehicle accident. On CT scan his bladder is full and he has not made urine since presentation to the ED. There is blood in the urethral meatus and the chil d is hypotensive. A retrograde urethrogram (RUG) shows complete dissociation between bladder and urethra with large extravasation. The next step is which of the following?