Urology · NEET PG Preparation Surgery
A 65-year-old man undergoes evaluation for lower urinary tract symptoms. His IPSS score is 22 (severe), and prostate-volume on transrectal ultrasound…
Practice question from Urology (NEET PG Preparation Surgery), with the correct answer and a step-by-step solution.
medium · MCQ · Q-DBB36E
A 65-year-old man undergoes evaluation for lower urinary tract symptoms. His IPSS score is 22 (severe), and prostate-volume on transrectal ultrasound is 60 cc. He has persistent post-void residual urine of 180 mL and has experienced two episodes of acute urinary retention despite being on a maximal dose of an alpha-1 blocker (tamsulosin) and a 5-alpha-reductase inhibitor (finasteride) for 9 months. What is the definitive management of choice?
- A.Add a phosphodiesterase-5 inhibitor (tadalafil)
- B.Switch finasteride to dutasteride
- C.Transurethral resection of the prostate (TURP) or simple prostatectomyCorrect answer
- D.Clean intermittent self-catheterization (CISC) indefinitely without surgery
Solution
Absolute indications for surgical intervention in benign prostatic hyperplasia (BPH) include refractory urinary retention, recurrent urinary tract infections, recurrent gross hematuria of prostatic origin, bladder stones, and renal insufficiency secondary to BPH. Since this patient has failed medical therapy and suffered recurrent urinary retention, surgical management such as TURP or simple prostatectomy is indicated.
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