Anticholinergic medications work best with BPH patients who have:
small prostate
mainly median lobe hypertrophy
history of urinary retention
mainly irritative symptoms
Correct Answer :
D. mainly irritative symptoms
anticholinergics are to relieve symptoms related to bladder irritability.
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
BPH/LUTS patients when present with mild creatinine elevation, are advised to do:
total and free PSA
renal ultrasonography
creatinine clearance
uroflowmetry
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
In an 80 yrs. diabetic man on insulin for 35 yrs.; what would be the proper sequence of developing the following obstructing BPH/LUTS?
frequency, over-flow incontinence, straining, retention
straining, frequency, over-flow incontinence, retention
straining, frequency, retention, over-flow incontinence
frequency, straining, retention, over-flow incontinence
PSA value has a strong correlation with:
IPSS
post void residual
prostate volume
Q-max at uroflowmetry
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 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 50% reduction of prostate size is expected after a 6-month therapy with:
alfuzosin
silodosin
finasteride
tamsulosin
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 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
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
TURP carries an incidence of retrograde ejaculation of:
62 - 78%
48 - 61%
79 - 93%
34 - 47%
An ED patient on low-dose tadalafil develops BPH. What medication should he avoid?
tamsulosin
alfuzosin
doxazosin
silodosin
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
The lowest re-treatment rate of BPH is for:
TUIP
TURP
HoLEP
HoLRP
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, 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
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
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
When comparing HoLEP to open prostatectomy for a 70 g prostatic adenoma removal; what parameter goes in favor of the latter?
operation time
duration of in-hospital stay
amount of blood transfused
time to catheter removal
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
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
Anticholinergic medications work best with BPH patients who have:
small prostate
mainly median lobe hypertrophy
history of urinary retention
mainly irritative symptoms
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:
Complications related to obstructive BPH/LUTS include all of the following, EXCEPT:
bladder stones
prostate cancer
renal insufficiency
bladder diverticula
On treating BPH, which procedure carries the risk of morcellator injury to the bladder?
PVP
HoLEP
HoLRP
TUMT
Prostatic nodules palpated on DRE might indicate:
tuberculous prostatitis
prostatic cancer
inspissated prostatic abscess
any of the above
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
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
What is false regarding BPH symptomatology?
the size of the prostate correlates well to the degree of obstruction
a decrease of 3 points in IPSS is associated with a subjective perception of improvement
median lobe enlargement gives rise to serious obstructive symptoms
bladder trabeculation is not specific for an obstructing prostate