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
B. patients die of other reasons before serious complications occur
peak flow rate of ≤ 12 mL/sec
prostate volume > 40 ml
PSA > 1.5 ng/dL
b & c
combination of α-adrenergic blocker and 5α-reductase inhibitor
watchful waiting
TURP
. What is the commonest cause of LUTS in men beyond middle age?
PSA > 1.5 ng/dL
prostate volume > 40 ml
IPSS > 19
a & b
before catheterization
after catheterization and before TURP
immediately after TURP
2 weeks after TURP
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
0.2 1%
1.2 2.1%
2.3 3.4%
3.7 5.6%
calcium channel blockers
antihistamines
antidepressants
cold medications containing pseudoephedrine
prostatic infarction
prostate infection
bladder overdistention
all of the above
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
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
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
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:
α1-a
α1-b
α2-a
α2-b
never
unlikely
likely
always
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
LUTS with neurologic disease
LUTS with post-void dribble
LUTS with suspicious DRE
LUTS with hematuria
sizable bladder stones
Hutch diverticulum
a suspicion of cancer
a & b
go for urine cytology testing
go for PSA testing
go for TRUS
use anticholinergic medication
bladder stones
prostate cancer
renal insufficiency
bladder diverticula
IPSS
post void residual
prostate volume
Q-max at uroflowmetry
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
prostate sizes of up to 70 ml can be treated
not recommended in patients with metallic artificial hip
retreatment rates are lower than for TURP
can be performed in an office-based setting
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
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
PSA decreases
the prostate size decreases
the complaints resolve
the Q.O.L improves
bladder trabeculation
significant PVR
low peak flow rate
high IPSS
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
the neurological status of the patient
PVR
severity of obstructive LUTS
all of the above
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
corporal aspiration
corpora injection with an α-adrenergic agent
corpora injection with an α-adrenergic blocker
no treatment required