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Question 10#

Which of the following is true concerning BPH?

A. Consequences of BPH include gross hematuria, chronic infection, bladder calculi, urinary retention, and paraphimosis
B. Medical treatment includes alpha blockers
C. Transurethral resection can lead to transurethral resection syndrome
D. Electrovaporization of the prostate should be avoided because of the danger of closed -space thermal injury

Correct Answer is A

Comment:

Besides voiding symptoms, consequences of BPH include gross hematuria, infections due to incomplete emptying, bladder calculi, and urinary retention. Over time, incomplete emptying may lead to chronic bladder overdistention that can result in a de-functionalized bladder. Medical treatment of BPH is usually the first step. Alpha blockers act on a-receptors in the smooth muscle of the prostate and decrease its tone. Transurethral resection of the prostate is the mainstay of endoscopic surgical BPH treatment. It is extremely effective at improving flow and decreasing residual urine. Complications are rare but include incontinence and excessive fluid absorption of the hypotonic irrigating solution used during resection, resulting in the transurethral resection syndrome. It is due to hyponatremia and fluid overload, and although rare, can result in death. Mental status changes and pulmonary edema are managed by diuresis and sodium supplementation with hypertonic saline in severe cases. Because of these rare, but potentially dangerous side effects, laser or electrovaporization of the prostate has grown popular. It is associated with very limited fluid absorption, and saline can be used because there is no monopolar electrocautery.