a. operation cost
smaller incisions with a shorter hospital stay
lower risk for blood transfusion
none of the above
. What is the first-line management of uncomplicated LUTS due to large prostate?
Correct Answer :
B. lower risk for blood transfusion
the combination therapy is the preferred management.
Related Questions
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 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
TURP syndrome is more likely to occur when:
the irrigating fluid is at a pressure exceeding 10 mm Hg
the prostate volume is > 45 cc
the resection time is > 90 minutes
all of the above
What drug prevents recurrent gross hematuria secondary to BPH?
enoxaparin
silodosin
finasteride
tolterodine
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
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
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
a. lesser chance of post-operative urethral stricture
milder postoperative hematuria
tension-free bladder closure
extra-peritoneal approach
. When comparing TURP to open prostatectomy for removing prostatic adenoma, the latter has the following advantages, EXCEPT:
IPSS decreases after successful TURP because:
PSA decreases
the prostate size decreases
the complaints resolve
the Q.O.L improves
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 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
What is the initial response of the detrusor muscle to obstruction?
increased intravesical pressure
increased detrusor pressure
increase collagen deposition in the detrusor
detrusor smooth muscle hypertrophy
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
In men with obstructive BPH, what will NOT resolve after TURP?
bladder trabeculation
significant PVR
low peak flow rate
high IPSS
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 (are) the indication(s) of upper urinary tract imaging in men with LUTS?
hematuria
recurrent urinary tract infection
renal insufficiency
all of the above
The most serious complication of TURP is:
damage to the internal sphincter
damage to the external sphincter
bladder perforation
damage to a ureteral orifice
Which statement best describes the natural history of BPH:
worsening of LUTS and BPH over time
patients die of other reasons before serious complications occur
physically, the space of prostatic fossa limits the gland enlargement
ultimately, the gland will degenerate and undergo apoptosis
a. small fibrous glands
the presence of prostate cancer
previous prostatectomy
all of the above
. Robot-assisted laparoscopic prostatectomy for prostatic adenoma has the following advantage over 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
An ED patient on low-dose tadalafil develops BPH. What medication should he avoid?
tamsulosin
alfuzosin
doxazosin
silodosin
Open prostatectomy is preferred in treating BPH with:
sizable bladder stones
Hutch diverticulum
a suspicion of cancer
a & b
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
TURP carries an incidence of retrograde ejaculation of:
62 - 78%
48 - 61%
79 - 93%
34 - 47%
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
In BPH patients, follow up PSA is of value because:
it helps predict the response to 5α-reductase inhibitors
it monitors LUTS/BPH progression
BPH patients are at higher risk of developing prostate cancer
a & b
Preferably, what is the last part of the prostate to be removed while performing TURP?
bladder neck
apex
median lobe
para-collecular
Anticholinergic medications work best with BPH patients who have:
small prostate
mainly median lobe hypertrophy
history of urinary retention
mainly irritative symptoms
Prostatic nodules palpated on DRE might indicate:
tuberculous prostatitis
prostatic cancer
inspissated prostatic abscess
any of the above
What is false concerning BPH and androgenic hormones?
the most potent androgenic hormones in BPH development is DHT
type-2 steroid 5 α-reductase, is most commonly found in the prostate
castrated individuals before puberty will not develop BPH
as a man ages, the number of androgen receptors in the prostate decreases