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
Correct Answer :
D. hyperplasia occurs due to an imbalance between cell death and cell proliferation
the etiology includes excessive fluid intake, alcohol consumption, sexual activity, in addition to what has been mentioned in the question.
Related Questions
On treating BPH, which procedure carries the risk of morcellator injury to the bladder?
PVP
HoLEP
HoLRP
TUMT
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
PSA value has a strong correlation with:
IPSS
post void residual
prostate volume
Q-max at uroflowmetry
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
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 can NOT be assessed during DRE?
sacral cord integrity
pelvic hematoma
pelvic floor muscle tenderness
prostatic median lobe hypertrophy
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
What is (are) the favorite criterion (criteria) to prescribe 5α- reductase inhibitors for BPH cases?
PSA > 1.5 ng/dL
prostate volume > 40 ml
IPSS > 19
a & b
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
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
Prostatic nodules palpated on DRE might indicate:
tuberculous prostatitis
prostatic cancer
inspissated prostatic abscess
any 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
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%
Open prostatectomy is preferred in treating BPH with:
sizable bladder stones
Hutch diverticulum
a suspicion of cancer
a & b
TURP carries an incidence of retrograde ejaculation of:
62 - 78%
48 - 61%
79 - 93%
34 - 47%
BPH/LUTS patients when present with mild creatinine elevation, are advised to do:
total and free PSA
renal ultrasonography
creatinine clearance
uroflowmetry
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 prostatic lobe(s) can be assessed during DRE?
anterior
median
left lateral
all of the above
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
Anticholinergic medications work best with BPH patients who have:
small prostate
mainly median lobe hypertrophy
history of urinary retention
mainly irritative symptoms
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?
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
Which drug reduces the incidence of prostate cancer by 23% with a small increase in high-grade tumor incidence?
cetrorelix
flutamide
dutasteride
zanoterone
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
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
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 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
The lowest re-treatment rate of BPH is for:
TUIP
TURP
HoLEP
HoLRP
Complications related to obstructive BPH/LUTS include all of the following, EXCEPT:
bladder stones
prostate cancer
renal insufficiency
bladder diverticula
What is (are) true concerning IPSS questionnaire?
it focuses on last month`s symptoms
scores of moderate symptoms suggest surgical treatment if the patient`s quality of life was poor
it has been validated and translated to many languages
all of the above