A 75-Year-Old Man Comes for Follow-Up 6 Months After Radical

question 5

Multiple Choice

A 75-year-old man comes for follow-up 6 months after radical prostatectomy for prostate cancer.  He continues to have occasional episodes of involuntary loss of urine with activities such as straining or lifting heavy objects.  The patient was an avid golfer but stopped after the surgery due to urinary leakage.  He has no dysuria, nocturia, or hematuria.  The patient did not undergo radiation therapy.  He has a history of hypertension and type 2 diabetes mellitus.
The blood pressure is 130/80 mm Hg and pulse is 68/min.  The abdomen is soft and nontender without palpable masses.  There is decreased sensation to light touch and pinprick on bilateral feet.  Ankle reflexes are absent and muscle strength is normal.  Post-void residual volume is low.
Prostate-specific antigen level is undetectable and urinalysis findings are within reference range.
Which of the following is the best next step in managing this patient?

• A)MRI of lumbosacral spine
• B)Pelvic floor exercises with biofeedback
• C)Retrograde urethrogram
• D)Sildenafil therapy
• E)Tolterodine therapy

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Definitions:

Psychosocial Function

Refers to an individual's psychological development in, and interaction with, a social environment.

Career Function

The aspects of a job or role that aid in an individual's career advancement, including opportunities for training, networking, and professional growth.

Mentoring Relationship

A professional relationship in which an experienced person (the mentor) provides guidance, advice, and support to a less experienced person (the mentee).

Orientation Program

A structured introduction for new employees to familiarize them with organizational policies, culture, and procedures.