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
Correct Answer :
C. immediately after TURP
TURP is an extremely traumatic procedure to prostate cells and thus releases tremendous amounts of PSA to the circulation.
Related Questions
Prostatic nodules palpated on DRE might indicate:
tuberculous prostatitis
prostatic cancer
inspissated prostatic abscess
any of the above
Which statement is false regarding TURP syndrome?
occurs because of absorption of non-sodium-containing irrigating fluid
occurs only on using unipolar TURP
results in brain edema due to dilutional hyponatremia
positioning the patient in anti-Trendelenburg helps prevent the syndrome
Preferably, what is the last part of the prostate to be removed while performing TURP?
bladder neck
apex
median lobe
para-collecular
What prostatic lobe(s) can be assessed during DRE?
anterior
median
left lateral
all of the above
a. urethral stricture
bladder stones
BPH
prostatitis syndrome
. What is (are) the indication(s) of antimuscarinic agents and PDEIs
What is false regarding BPH genetics?
BPH is an inheritable and progressive disease
familial BPH presents at an older age when compared to sporadic cases
approximately 90% of men in their 80s have histologic evidence of BPH
BPH tends to be more severe and progressive in black men when compared to whites
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
Which statement(s) describe(s) the bladders response to an obstructing prostate?
it may develop detrusor instability with irritative LUTS
it may develop poor compliance with frequency and urgency symptoms
it may develop poor detrusor contractility with obstructive LUTS
all of the above
The probability of developing acute urinary retention is related to:
the neurological status of the patient
PVR
severity of obstructive LUTS
all of the above
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
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
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
The lowest re-treatment rate of BPH is for:
TUIP
TURP
HoLEP
HoLRP
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:
On treating BPH, which procedure carries the risk of morcellator injury to the bladder?
PVP
HoLEP
HoLRP
TUMT
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 is the likelihood that PSA level in men with acute urinary retention due to urethral stricture will decrease after catheterization?
never
unlikely
likely
always
What is false regarding prostate embolization for BPH?
the aim is to occlude the internal iliac vessels
there is a considerable radiation risk during the procedure
bilateral embolization provides better results
eye protection is not required
How to manage priapism that occurs during endoscopic surgery?
corporal aspiration
corpora injection with an α-adrenergic agent
corpora injection with an α-adrenergic blocker
no treatment required
What is (are) the indication(s) of upper urinary tract imaging in men with LUTS?
hematuria
recurrent urinary tract infection
renal insufficiency
all of the above
Open prostatectomy is preferred in treating BPH with:
sizable bladder stones
Hutch diverticulum
a suspicion of cancer
a & b
On treating BPH, which procedure provides the best tissue preservation for pathological examination?
TURP
TUIP
HoLEP
HoLRP
a. α-adrenergic blocker
combination of α-adrenergic blocker and 5α-reductase inhibitor
watchful waiting
TURP
. What is the commonest cause of LUTS in men beyond middle age?
What class(es) of medications decrease(s) IPSS questionnaire points?
calcium channel blockers
antihistamines
antidepressants
cold medications containing pseudoephedrine
What is true regarding the use of α-blockers and the development of Intraoperative Floppy Iris Syndrome (IFIS)?
complicates approximately 0.7% of cataract surgery cases
manifests as poor preoperative pupil dilation, iris prolapse, and progressive intraoperative miosis
it could persist long after the discontinuation of tamsulosin
intraoperative lidocaine reduces its incidence in patients taking α- adrenergic inhibitors
In BPH patients, total PSA level correlates to:
the glandular component of the prostate
the IPSS questionnaire points
the PVR
the transitional zone volume
What is true regarding mirabegron, the β3 agonist, in treating BPH?
achieves better results when combined with antimuscarinic
enhances detrusor contractility resulting in higher Q-max
enhance detrusor relaxation during bladder-filling phase
increases voiding pressure that poses risk on renal function
Which statement is false regarding laser enucleation of the Prostate (HoLEP)?
provides tissue preservation for pathological examination
treats any size of prostatic adenoma
follows anatomic planes to remove the prostate in lobes
urinary incontinence is a significant drawback after HoLEP
BPH patients with severe irritative symptoms or microscopic hematuria should:
go for urine cytology testing
go for PSA testing
go for TRUS
use anticholinergic medication
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