On treating BPH, which procedure provides the best tissue preservation for pathological examination?
TURP
TUIP
HoLEP
HoLRP
Correct Answer :
C. HoLEP
HoLEP provides enucleation of prostate lobes which is the ultimate way to deliver intact prostate specimens for examination.
Related Questions
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
A 50% reduction of prostate size is expected after a 6-month therapy with:
alfuzosin
silodosin
finasteride
tamsulosin
Open prostatectomy is preferred in treating BPH with:
sizable bladder stones
Hutch diverticulum
a suspicion of cancer
a & b
The most serious drawback of anticholinergic drugs on BPH patients is:
renal insufficiency
urinary retention
dry mouth
painless hematuria
On treating BPH, which procedure provides the best tissue preservation for pathological examination?
TURP
TUIP
HoLEP
HoLRP
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?
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
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:
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
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
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
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 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
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
Prostatic nodules palpated on DRE might indicate:
tuberculous prostatitis
prostatic cancer
inspissated prostatic abscess
any of the above
Which drug reduces the incidence of prostate cancer by 23% with a small increase in high-grade tumor incidence?
cetrorelix
flutamide
dutasteride
zanoterone
The lowest re-treatment rate of BPH is for:
TUIP
TURP
HoLEP
HoLRP
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
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
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 can NOT be assessed during DRE?
sacral cord integrity
pelvic hematoma
pelvic floor muscle tenderness
prostatic median lobe hypertrophy
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
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?
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 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
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
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
BPH/LUTS patients when present with mild creatinine elevation, are advised to do:
total and free PSA
renal ultrasonography
creatinine clearance
uroflowmetry
What prostatic lobe(s) can be assessed during DRE?
anterior
median
left lateral
all of the above
What drug prevents recurrent gross hematuria secondary to BPH?
enoxaparin
silodosin
finasteride
tolterodine