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
Correct Answer :
A. increased intravesical pressure
due to the androgen/estrogen imbalance, intra-prostatic levels of estrogen increase in men with BPH.
Related Questions
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 (are) the indication(s) of upper urinary tract imaging in men with LUTS?
hematuria
recurrent urinary tract infection
renal insufficiency
all of the above
In men with obstructive BPH, what will NOT resolve after TURP?
bladder trabeculation
significant PVR
low peak flow rate
high IPSS
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
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
IPSS decreases after successful TURP because:
PSA decreases
the prostate size decreases
the complaints resolve
the Q.O.L improves
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 class(es) of medications decrease(s) IPSS questionnaire points?
calcium channel blockers
antihistamines
antidepressants
cold medications containing pseudoephedrine
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 carries an incidence of retrograde ejaculation of:
62 - 78%
48 - 61%
79 - 93%
34 - 47%
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
BPH/LUTS patients when present with mild creatinine elevation, are advised to do:
total and free PSA
renal ultrasonography
creatinine clearance
uroflowmetry
Open prostatectomy is preferred in treating BPH with:
sizable bladder stones
Hutch diverticulum
a suspicion of cancer
a & b
An ED patient on low-dose tadalafil develops BPH. What medication should he avoid?
tamsulosin
alfuzosin
doxazosin
silodosin
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
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 true regarding BPH and androgens?
as a man ages, the responsiveness of prostate cells to androgenic stimuli decreases
adrenal androgens have no role in BPH development
type-1 steroid 5 α-reductase is functionally active in the hair follicle
all of the above
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
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
What can NOT be assessed during DRE?
sacral cord integrity
pelvic hematoma
pelvic floor muscle tenderness
prostatic median lobe hypertrophy
Complications related to obstructive BPH/LUTS include all of the following, EXCEPT:
bladder stones
prostate cancer
renal insufficiency
bladder diverticula
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 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
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
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?
The lowest re-treatment rate of BPH is for:
TUIP
TURP
HoLEP
HoLRP
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 (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