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
Correct Answer :
C. it could persist long after the discontinuation of tamsulosin
mirabegron is an advanced bladder sedative that relaxes the detrusor without impairing its contractility.
Related Questions
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 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
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
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 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
What is false concerning BPH and androgenic hormones?
the most potent androgenic hormones in BPH development is DHT
type-2 steroid 5 α-reductase, is most commonly found in the prostate
castrated individuals before puberty will not develop BPH
as a man ages, the number of androgen receptors in the prostate decreases
On treating BPH, which procedure carries the risk of morcellator injury to the bladder?
PVP
HoLEP
HoLRP
TUMT
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
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 (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 prostatic lobe(s) can be assessed during DRE?
anterior
median
left lateral
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
Which of the following is NOT classified as a complicated LUTS?
LUTS with neurologic disease
LUTS with post-void dribble
LUTS with suspicious DRE
LUTS with hematuria
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 can NOT be assessed during DRE?
sacral cord integrity
pelvic hematoma
pelvic floor muscle tenderness
prostatic median lobe hypertrophy
The most serious complication of TURP is:
damage to the internal sphincter
damage to the external sphincter
bladder perforation
damage to a ureteral orifice
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 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
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 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
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 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
Open prostatectomy is preferred in treating BPH with:
sizable bladder stones
Hutch diverticulum
a suspicion of cancer
a & b
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
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
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 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 drug prevents recurrent gross hematuria secondary to BPH?
enoxaparin
silodosin
finasteride
tolterodine
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
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