A 55 yrs. male patient with familial BPH, IPSS 9, PSA 23ng/ml, prostate size 31 cc, PVR 54 cc, on watchful waiting management. Next step should be:
tamsulosin 0.8 mg
reassurance
repeat total and free PSA
diagnostic cystoscopy
Correct Answer :
C. repeat total and free PSA
repeat PSA. In case prostate cancer is suspected go for TURP, prostate biopsy.
Related Questions
On measuring the prostate volume during endoscopy:
each centimeter over the normal 2-cm prostate urethral length equates
an additional 12 g in prostate weight
each centimeter over the normal 2.5-cm prostate urethral length equates
an additional 10 g in prostate weight
A 55 yrs. male patient with familial BPH, IPSS 9, PSA 23ng/ml, prostate size 31 cc, PVR 54 cc, on watchful waiting management. Next step should be:
tamsulosin 0.8 mg
reassurance
repeat total and free PSA
diagnostic cystoscopy
What is false concerning TURP syndrome?
symptoms begin with a serum sodium of less than 120 mEq/L
the mortality is 2.7-5.8 %
manifestations rely on acute changes in the intravascular volume and plasma solute concentrations
the preferred height of irrigating fluid is 60 cm above the patient
In BPH patients, which of the following measures reduces PSA value by one-half?
2 weeks after performing prostatic urethral lift
6-month treatment with 5α-reductase inhibitors
after placing a stent in the prostatic urethra
immediately after removing one-half of the prostate by TURP
Which of the following is NOT classified as a complicated LUTS?
LUTS with neurologic disease
LUTS with post-void dribble
LUTS with suspicious DRE
LUTS with hematuria
What is the capsular perforation rate in prostate vaporization surgery?
0.2 1%
1.2 2.1%
2.3 3.4%
3.7 5.6%
An ED patient on low-dose tadalafil develops BPH. What medication should he avoid?
tamsulosin
alfuzosin
doxazosin
silodosin
What is (are) the possible complication(s) of prostate stents?
hematuria and infections
migration and encrustation of the stent
irritative urinary symptoms and painful ejaculation
all of the above
A 50% reduction of prostate size is expected after a 6-month therapy with:
alfuzosin
silodosin
finasteride
tamsulosin
What is false concerning the diagnosis of BPH?
IPSS cannot be used to establish the diagnosis of BPH/LUTS
prostate biopsy is essential in diagnosing BPH and excluding cancers
PSA and uroflowmetry help diagnose the condition
none of the above
What is false concerning needle ablation therapy of the prostate (TUNA)?
prostate sizes of up to 70 ml can be treated
not recommended in patients with metallic artificial hip
retreatment rates are lower than for TURP
can be performed in an office-based setting
as adjuncts therapy in BPH cases?
men with storage symptoms
men with ED
failed combination of α-adrenergic blocker and 5α-reductase inhibitor
a & b
Transurethral incision of the prostate (TUIP):
is only indicated in small prostates
complications are related to the amount of lost blood and removed chips
is a minimal procedure where no risk of rectal injury or retrograde ejaculation have been reported
it entails making 1 or 2 incisions along all prostate lobes except the apical
PSA value has a strong correlation with:
IPSS
post void residual
prostate volume
Q-max at uroflowmetry
Complications related to obstructive BPH/LUTS include all of the following, EXCEPT:
bladder stones
prostate cancer
renal insufficiency
bladder diverticula
c. each centimeter over the normal 2.5-cm prostate urethral length equates
an additional 15 g in prostate weight
each centimeter over the normal 1.5-cm prostate urethral length equates
an additional 5 g in prostate weight
. When comparing suprapubic to retropubic prostatectomy for removing prostatic adenoma, the former allows:
A BPH patient presents with retention of urine. He is Catheterized. Later, he underwent TURP. When would the highest PSA value be?
before catheterization
after catheterization and before TURP
immediately after TURP
2 weeks after TURP
What is (are) the favorite criterion (criteria) to prescribe 5α- reductase inhibitors for BPH cases?
PSA > 1.5 ng/dL
prostate volume > 40 ml
IPSS > 19
a & b
What class(es) of medications decrease(s) IPSS questionnaire points?
calcium channel blockers
antihistamines
antidepressants
cold medications containing pseudoephedrine
In men with LUTS, which of the following is NOT a compelling indication for upper urinary tract imaging?
urolithiasis
receiving chemotherapy
upper tract surgery
painless hematuria
What is true regarding BPH and androgens?
as a man ages, the responsiveness of prostate cells to androgenic stimuli decreases
adrenal androgens have no role in BPH development
type-1 steroid 5 α-reductase is functionally active in the hair follicle
all of the above
Which statement is false concerning transurethral microwave therapy (TUMT) for BPH treatment:
induces nerve degeneration in the prostate and tissue necrosis
frequently results in transient urinary retention
frequently leads to erectile dysfunction
the high-energy platform is superior to the low-energy with regard to clinical efficacy
On treating BPH, which procedure carries the risk of morcellator injury to the bladder?
PVP
HoLEP
HoLRP
TUMT
What is true concerning epithelial and stromal cells in BPH?
there is an increase in the number of epithelial and stromal cells
there is an increase in the size of epithelial and stromal cells
in BPH, epithelial to stromal cells ratio is 1:2
all of the above
What prostatic lobe(s) can be assessed during DRE?
anterior
median
left lateral
all of the above
What is false concerning the pathogenesis of BPH?
intra-prostatic levels of estrogen decrease in men with BPH
stimulation of the adrenergic nervous system results in a dynamic increase in prostatic urethral resistance
inflammation may play a role through cytokines to promote cell growth
hyperplasia occurs due to an imbalance between cell death and cell proliferation
What statement is true regarding post-void residual of urine (PVR)?
nearly all men have PVR of less than 12 ml
it predicts the outcome of surgical treatment
it correlates well with BPH/LUTS
it is diagnostic for bladder outlet obstruction
What drug prevents recurrent gross hematuria secondary to BPH?
enoxaparin
silodosin
finasteride
tolterodine
TURP carries an incidence of retrograde ejaculation of:
62 - 78%
48 - 61%
79 - 93%
34 - 47%
Which drug reduces the incidence of prostate cancer by 23% with a small increase in high-grade tumor incidence?
cetrorelix
flutamide
dutasteride
zanoterone