This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Urology, Subject name: Anatomy
Cystoscopic findings in TB bladder are all except 
Select and explain. 
A. Thimble bladder, B. Golf hole ureter, C. Whitish efflux from the ureteric holes, D. Cobblestone mucosa
C: Whitish efflux from the ureteric holes
Answer: C: Whitish efflux from the ureteric holes 
Explanation: Bladder tuberculosis is almost always secondary to renal tuberculosis The disease stas at the ureteric opening, the earliest evidence being pallor of the mucosa due to submucosal edema. Subsequently tiny white transluscent tubercles develop all over. Gradually these tubercles enlarge and may ulcerate (but do not cause bladder perforation). These tubercles lend 'cobblestone' appearance on cystoscopy. There is considerable submucous fibrosis which causes diminished capacity of bladder. Scarred & fibrosed, small capacity bladder is k/a thimble bladder. The fibrosis which usually stas around the ureter, contracts to cause a pull at the ureters. This either leads to a stricture or displaced, dilated and rigid wide mouthed ureter k/a golf hole ureters. this almost always leads to ureteral reflux.