Urology (Prometric)

A 15-month-old boy has hypospadias with documented ventral penile curvature of 42 degrees during operative assessment. Which principle should guide correction of the curvature?

A 57-year-old man with documented nocturnal polyuria is starting desmopressin after appropriate assessment. Baseline serum sodium is normal. Which fluid-intake instruction should accompany treatment?

A 72-year-old hospitalized man with an indwelling urinary catheter has Candida albicans repeatedly isolated from urine. He is afebrile, has no urinary symptoms, is not neutropenic, and no urological procedure is planned. What is the most appropriate management?

A 67-year-old man develops a nonobliterative bladder neck stenosis nine months after transurethral surgery for benign prostatic obstruction. Cystoscopy confirms that a small lumen remains. Which first-line treatment is appropriate?

A 67-year-old woman has persistent urgency urinary incontinence despite bladder training and cannot tolerate antimuscarinic medication. She wants a neuromodulatory option that does not require implantation of a permanent device. Which treatment is appropriate?

During filling cystometry, a patient coughs repeatedly. Each cough produces simultaneous equal upward deflections in intravesical pressure and abdominal pressure, while calculated detrusor pressure remains essentially unchanged. How should these deflections be interpreted?

A 27-year-old man has severe voiding lower urinary tract symptoms despite alpha-blocker therapy. Video pressure-flow testing shows high detrusor pressure, reduced urinary flow, narrowing at the bladder neck during voiding and relaxation of the external urethral sphincter. Which diagnosis best explains the findings?

An 8-year-old recurrent stone former has a screening urinary calcium-to-creatinine ratio of 0.27. Serum calcium is normal and the child is clinically stable. Which next step is appropriate before confirming hypercalciuria?

A kidney transplant recipient has incidentally detected transplant renal artery narrowing estimated at 35%. Blood pressure is well controlled, serum creatinine is stable and Doppler surveillance shows preserved graft perfusion. Which management is appropriate?

A 66-year-old man is stone-free after successful treatment of a radiopaque upper-tract calculus and has no metabolic abnormality or other high-risk feature. Which imaging principle is preferred during routine follow-up to limit cumulative radiation exposure?