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
Correct Answer :
A. peak flow rate of ≤ 12 mL/sec
the poor flow rate is an indicative of obstruction.
Related Questions
On treating BPH, which procedure provides the best tissue preservation for pathological examination?
TURP
TUIP
HoLEP
HoLRP
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 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
To achieve better hemostasis in prostate laser surgery, what is the ideal wavelength that is easily absorbed by hemoglobin?
532 nm
694 nm
755 nm
1064 nm
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:
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
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
Preferably, what is the last part of the prostate to be removed while performing TURP?
bladder neck
apex
median lobe
para-collecular
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
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?
TURP carries an incidence of retrograde ejaculation of:
62 - 78%
48 - 61%
79 - 93%
34 - 47%
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
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?
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 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 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
Prostatic nodules palpated on DRE might indicate:
tuberculous prostatitis
prostatic cancer
inspissated prostatic abscess
any of the above
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
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
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 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. 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:
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
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
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
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
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
Open prostatectomy is preferred in treating BPH with:
sizable bladder stones
Hutch diverticulum
a suspicion of cancer
a & b
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
A 50% reduction of prostate size is expected after a 6-month therapy with:
alfuzosin
silodosin
finasteride
tamsulosin