@UrologyQuiz Quiz5 Follow-up MCQs: (ANSWERS BELOW!) 1.

One of the following IS TRUE regarding hypergranulation: A) Infection is a relatively common association B) Skin excoriation/trauma is a cause C) Topical steroids are a good first line treatment option and should always be tried D) Cancer (SCC, Urothelial carcinoma etc.) must ALWAYS be excluded with biopsy 2. ALL are accepted reasonable treatments of hypergranulation tissue: A) Observation B) Aggressive debridement C) Lasering D) Antibiotics

3) What is the MOST ACCURATE comment about Hypergranulation at an SPC exit site: A) Is inevitable in long-term SPC sites B) Always needs active treatment C) Means the catheter size might need to be changed D) Is a risk factor for cancer development at SPC site

ANSWERS
Q1 Answer B: Skin excoriation/trauma is definitely a cause of hypergranulation and is a good first line treatment to remove the cause; A) Infection is actually not a relatively common association yet many unnecessary wound swabs are taken and st actively treated; steroids are rarely a good 1 line treatment option and are reserved for refractory cases; D) Cancer must occasionally be excluded with biopsy Q2 Answer A: Observation is an accepted first line option- it may settle down or not get worse (removing precipitants also done etc.); B) and C) Lasering and debridement to be avoided; D) Antibiotics only if true infection as they tend to be overused Q3 Answer C: Loose or tight catheters may contribute to hypergranulation so may necessitate change in size; A) and B) incorrect whilst D) Is partly true that SCC risk increased in bladder after years but not necessarily SPC site

By @lawrentschuk Editor-in-Chief @UrologyQuiz Assoc. Professor Nathan Lawrentschuk, University of Melbourne AUSTRALIA