Urology: upper tract urothelial carcinoma: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Urology: upper tract urothelial carcinoma

Sample item

A 65-year-old man has painless haematuria. CT urography shows a filling defect in the renal pelvis, and ureteroscopic biopsy shows high-grade urothelial carcinoma. What is the standard operation?

ATransurethral resection of the bladder onlyBNephroureterectomy with excision of a bladder cuffCSimple nephrectomy aloneDPartial nephrectomy only

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Nephroureterectomy with excision of a bladder cuff

Urothelium lines the whole upper tract, so the ureter and its orifice must be removed with the kidney to prevent recurrence in the stump. The bladder cuff is excised with the ureteric orifice.

Option by option

A. Transurethral resection of the bladder only
TURBT treats bladder tumours, not the renal pelvis.
B. Nephroureterectomy with excision of a bladder cuff (correct)
Correct. Whole-tract excision with a bladder cuff is standard for high-grade upper tract disease.
C. Simple nephrectomy alone
Leaving the ureter allows recurrence in the stump.
D. Partial nephrectomy only
Partial nephrectomy leaves the urothelium at risk.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Nephroureterectomy with excision of a bladder cuff. Urothelium lines the whole upper tract, so the ureter and its orifice must be removed with the kidney to prevent recurrence in the stump.

Why is "Transurethral resection of the bladder only" not the answer?

TURBT treats bladder tumours, not the renal pelvis.

Why is "Simple nephrectomy alone" not the answer?

Leaving the ureter allows recurrence in the stump.

Why is "Partial nephrectomy only" not the answer?

Partial nephrectomy leaves the urothelium at risk.

What concept does this question test?

It tests Urology: upper tract urothelial carcinoma in General Surgery. The bladder cuff is excised with the ureteric orifice.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Urology: upper tract urothelial carcinoma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.