BPH & LUTS

A 66-year-old man has IPSS 22, Qmax 8 mL/s, and PVR 180 mL without infection; first-line pharmacologic therapy?

Which prostate volume and PSA profile supports adding a 5-alpha-reductase inhibitor to an alpha-blocker?

Impact of 5-alpha-reductase inhibitor on PSA after 6–12 months?

For bothersome LUTS with predominant storage symptoms and Qmax 15 mL/s, PVR 40 mL, best initial option?

Which of the following is an absolute indication for surgery in BPH?

Most common mechanism by which alpha-1 blockers improve LUTS?

Which medication improves LUTS and erectile dysfunction concurrently?

A 70-year-old on tamsulosin is scheduled for cataract surgery; key counseling point?

Best test to quantify symptom burden in men with LUTS at baseline and follow-up?

Threshold PVR that raises concern for chronic urinary retention in BPH?

Acute urinary retention in BPH: immediate management?

After initiating finasteride, how long to see meaningful symptom and flow improvement?

Which minimally invasive surgical therapy preserves antegrade ejaculation more often than TURP?

Preferred intervention for very large glands (>80–100 mL) with bothersome LUTS and failures of meds?

A 59-year-old with urgency, frequency, nocturia x4; bladder diary shows nocturnal urine fraction 40%; diagnosis?

Desmopressin for nocturia is contraindicated or used cautiously in which scenario?

Before starting antimuscarinic in male LUTS, what parameter most affects safety?

A 72-year-old with bothersome LUTS, prostate 28 mL, PSA 0.7; best first-line?

Which lifestyle measure has the strongest evidence to reduce nocturia and LUTS?

Finasteride adverse effect to counsel?

A 75-year-old on chronic anticoagulation (DOAC) needs surgical relief of BPH with least bleeding risk; choose?

Storage-predominant LUTS on alpha-blocker with PVR 60 mL; best add-on?

A 68-year-old with recurrent gross hematuria attributed to BPH; medication shown to reduce prostatic bleeding?

Urodynamics is most helpful in which BPH/LUTS scenario?

Which finding suggests median lobe obstruction that may limit PUL candidacy?

Mechanism of beta-3 agonist (mirabegron) in LUTS management?

On exam, a man with LUTS has narrow QRS tachycardia episodes; LUTS plan should avoid which drug class?

A 64-year-old with IPSS 28 and renal ultrasound showing bilateral hydronephrosis from BPH; next step?

Which parameter best correlates with obstruction on noninvasive testing?

A patient on nitrates for angina seeks ED and LUTS relief; which therapy is contraindicated?

Common perioperative complication after TURP managed with saline irrigation?

Advantage of bipolar TURP over monopolar?

What is considered a meaningful improvement in IPSS after therapy?

A 61-year-old with bothersome LUTS and overactive bladder symptoms fails antimuscarinic due to dry mouth; next option?

Which alpha-blocker has higher risk of orthostatic hypotension particularly at initiation?

LUTS differential includes which condition that mimics BPH in young men?

A man with PVR 20 mL has urgency incontinence; most likely mechanism?

After failed trial without catheter (TWOC) post-AUR despite alpha-blocker, next best step?

In men with mixed LUTS and concomitant chronic prostatitis pain syndrome, helpful nonpharmacologic adjunct?

Which minimally invasive water-vapor therapy is an option for moderate BPH?

A 73-year-old with IPSS 26, Qmax 7 mL/s, PVR 320 mL, bilateral hydronephrosis; best definitive step?

Which factor predicts better success of trial without catheter (TWOC) after AUR?

A man on finasteride for 8 months has PSA 1.2 ng/mL; estimated true PSA for cancer risk assessment?

Which combination best reduces BPH progression (AUR or surgery) in large prostates?

A 68-year-old with bothersome LUTS and severe OSA; first lifestyle target at night?

Contraindication to antimuscarinic initiation in male LUTS?

Which minimally invasive surgical therapy is contraindicated in a prominent obstructing median lobe?

A 76-year-old with frailty, chronic anticoagulation, prostate 60 mL, refractory LUTS; procedure with best hemostasis?

Post-TURP day 1: confusion, hypertension, bradycardia, hyponatremia; diagnosis?

A 55-year-old with small prostate (22 mL) and severe storage LUTS; best initial medication?

Ejaculatory dysfunction is most frequent after which BPH procedure?

Which finding most strongly suggests detrusor underactivity rather than BOO?

A patient on tamsulosin develops dizziness on standing; next step?

Best imaging to quantify prostate size noninvasively for planning?

A 70-year-old with recurrent UTIs, bladder stones, and high PVR from BPH; management?

After starting mirabegron, which safety parameter should be monitored in hypertensive patients?

For prostates >100 mL with severe LUTS, which surgical option yields durable outcomes across sizes?

Which medication class can precipitate AUR in men with BPH and high PVR?

A 63-year-old with bothersome LUTS and ED on nitrates; safest LUTS medication?

Post-TURP persistent dysuria and weak stream 3 months later; next evaluation?

A 74-year-old with chronic urinary retention opts for long-term catheter; preferred route to minimize urethral complications?

Which statement about PAE (prostatic artery embolization) is accurate?

Intravesical prostatic protrusion (IPP) significance in BPH?

A 69-year-old with IPSS 19, Qmax 10, PVR 80, prostate 45 mL, desires medication with sexual preservation; best option?

Which perioperative measure reduces bleeding risk during TURP/HoLEP?

BPH-related hematuria recurs despite medical therapy; next definitive option?

Which parameter is part of the IPSS questionnaire?

A 58-year-old with severe LUTS wants to preserve ejaculation; which option best maintains it?

BNI (bladder neck incision) is most effective in which scenario?

With 5-ARI therapy, which PSA trend is concerning for cancer?

Daytime frequency with small voided volumes and normal PVR; best initial tool?

For men with BOO and detrusor overactivity on urodynamics, best combined therapy?

Which commonly used herbal agent has limited but some evidence for LUTS improvement?

After PUL, common early adverse effect is:

A man with neurologic disease has urgency incontinence and low PVR; best first-line?

Which measurement on uroflow suggests BOO?

A 65-year-old with catheter-dependent retention after multiple failed TWOC; next best step?

Most frequent long-term complication after TURP?

In men considering surgery, which pre-op test helps predict postoperative incontinence risk?

Which statement about Aquablation is correct?

Baseline labs before starting desmopressin for nocturia should include which critical test?

After starting desmopressin in an older patient, when should sodium be rechecked?

Which patient is best suited for watchful waiting alone?

For predominant nocturia due to nocturnal polyuria, first-line nonpharmacologic step?

A 62-year-old with prostate 95 mL and severe LUTS; which procedure provides size-independent durable relief?

Which scenario favors bladder neck incision (BNI) over resection/enucleation?

A man with glaucoma asks about antimuscarinics; safest approach?

Persistent storage LUTS on alpha-blocker; PVR 50; best next step?

A 68-year-old has bothersome LUTS, ED, and prostate 35 mL; medication addressing both?

Which MIST commonly preserves ejaculation better than TURP/HoLEP?

Which factor predicts poorer response to alpha-blocker therapy?

An elderly man on antimuscarinic develops confusion and constipation; next step?

Which perioperative strategy lowers risk of TURP syndrome?

After PUL, when do most patients experience symptom improvement?

Contraindication to office water-vapor therapy (Rezūm) includes:

A man with IPSS 28, Qmax 6, PVR 380 fails meds; best definitive option for rapid relief and durability?

Which medication class directly shrinks prostate volume over months?

In men with BOO and proven detrusor underactivity, surgical outcomes may be limited because:

Which statement about Aquablation is accurate?

What defines a successful trial without catheter (TWOC)?

In men desiring fertility, which BPH treatment is least likely to impair ejaculation?

First-line evaluation for male LUTS includes which combination?

A 74-year-old with daytime polyuria (>40 mL/kg/24 h) and LUTS; best initial intervention?

Which alpha-blocker has the most ejaculatory dysfunction risk?

Catheter-dependent retention with recurrent UTIs and bladder stones; priority?

What IPSS change is typically considered clinically meaningful improvement?

For mixed LUTS with high PVR and DO on urodynamics, safest pharmacologic plan?

Which postoperative issue is more common after enucleation than PUL?

Indication for urodynamics prior to surgery is strongest when:

Which lab trend on 5-ARI mandates evaluation for cancer?

A man with LUTS and microhematuria; next appropriate step?

In men with BOO and recurrent UTIs, which intervention reduces infection risk long-term?

Which finding suggests overflow incontinence rather than OAB?

Expected effect of 5-ARI on prostate volume after 6–12 months?

Which test best documents obstruction severity noninvasively?

In men with LUTS on diuretics for heart failure, strategy to reduce nocturia?

Which surgical option has the highest immediate resection efficiency for very large glands with short anesthesia time?

After HoLEP, a common transient symptom during recovery is:

Which patient factor increases risk of postoperative urinary retention after antimuscarinic therapy?

For men with bothersome LUTS, small prostate, and confirmed OAB without BOO, which procedure is least appropriate?