BPH/LUTS patients when present with mild creatinine elevation, are advised to do:
total and free PSA
renal ultrasonography
creatinine clearance
uroflowmetry
Correct Answer :
B. renal ultrasonography
to check whether or not renal insufficiency is due to obstruction.
Related Questions
a. no risk of dilutional hyponatremia
operating on patients with multiple bladder diverticula
operating on patients who cannot flex their hips and/or knees
unfavorable tissue preservation for pathological examination
. What is (are) the contraindication(s) to open prostatectomy for prostatic adenoma?
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 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 most serious complication of TURP is:
damage to the internal sphincter
damage to the external sphincter
bladder perforation
damage to a ureteral orifice
PSA value has a strong correlation with:
IPSS
post void residual
prostate volume
Q-max at uroflowmetry
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
What is (are) the indication(s) to prescribe α-adrenergic inhibitors for BPH patients?
peak flow rate of ≤ 12 mL/sec
prostate volume > 40 ml
PSA > 1.5 ng/dL
b & c
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:
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
What drug prevents recurrent gross hematuria secondary to BPH?
enoxaparin
silodosin
finasteride
tolterodine
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:
What is false concerning IPSS questionnaire?
is specific for prostate symptom
is a seven-question, self-administered questionnaire that yields a total score that ranges from 0 to 35
a sum of 20 on IPSS scale is severe
it covers both voiding and storage symptomatology
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
TURP carries an incidence of retrograde ejaculation of:
62 - 78%
48 - 61%
79 - 93%
34 - 47%
What can NOT be assessed during DRE?
sacral cord integrity
pelvic hematoma
pelvic floor muscle tenderness
prostatic median lobe hypertrophy
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
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 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 capsular perforation rate in prostate vaporization surgery?
0.2 1%
1.2 2.1%
2.3 3.4%
3.7 5.6%
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 false concerning bladder and prostate histology in BPH?
obstruction results in bladder smooth muscle hypertrophy and myofibroblasts deposition
BPH occurs chiefly in the transitional zone and periurethral tissues
BPH microscopical changes begin in early thirties
histologic findings of chronic prostatitis are common in BPH
a. management of concomitant Hutch diverticulum
removing small bladder stones
better access to prostatic fossa
technically, easier trigonization
. When comparing retropubic to suprapubic prostatectomy for removing prostatic adenoma, the former has the advantage of:
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
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
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
Anticholinergic medications work best with BPH patients who have:
small prostate
mainly median lobe hypertrophy
history of urinary retention
mainly irritative symptoms
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
IPSS decreases after successful TURP because:
PSA decreases
the prostate size decreases
the complaints resolve
the Q.O.L improves
Complications related to obstructive BPH/LUTS include all of the following, EXCEPT:
bladder stones
prostate cancer
renal insufficiency
bladder diverticula
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