Editing CUA: Male LUTS & BPH (2018) (section)

== Answers ==

# What is the mandatory work-up of a male patient with LUTS? Recommended? Optional?
#* Mandatory: H+P, urinalysis +/- culture
#* Recommended: symptom questionnaire, PSA
#* Optional: PVR, uroflow, voiding diary, cytology, sexual function questionnaire, serum creatinine
# What are the domains of the IPSS score?
#* '''FUNWISE''' Frequency, urgency, nocturia, weak stream, intermittency, straining, emptying + QOL
# What is the IPSS score for mild, moderate, severe LUTS?
#* Mild: 1-7
#* Moderate: 8-18
#* Severe: 19-35
# What are risk factors for BPH progression?
## Age
## PSA
## LUTS severity
## Prostate volume
# Which lifestyle recommendations are described to improve LUTS?
## Fluid restriction particularly prior to bedtime
## Avoidance of caffeinated beverages, spicy foods
## Avoidance/monitoring of some drugs (e.g., diuretics, decongestants, antihistamines, antidepressants)
## Timed or organized voiding (bladder retraining)
## Pelvic floor exercises
## Avoidance or treatment of constipation
# What are potential side effects of alpha-blockers? 5-ARIs?
#* Alpha-blockers (5): retrograde ejaculation, dizziness, headache, nasal congestion, priapism
#* 5-ARIs (4): erectile dysfunction, decreased libido, ejaculatory dysfunction, gynecomastia
# What prostate size have 5-ARIs been shown to be of benefit?
#* >30g
# When should desmopressin be considered in the treatment of BPH? Which patients should have sodium testing and what is the timing?
#* In men with nocturia secondary to nocturnal polyuria
#* All men taking melts and men age ≥ 65 taking disintegrating tablets
# What are the indications for surgical intervention of BPH?
## Recurrent or refractory urinary retention
## Recurrent urinary tract infections (UTIs)
## Bladder stones
## Recurrent hematuria
## Renal dysfunction secondary to BPH
## Symptom deterioration despite medical therapy
## Patient preference
#* The presence of a bladder diverticulum is not an absolute indication for surgery unless associated with recurrent UTI or progressive bladder dysfunction
# List complications of TURP?
#* Intra-operative: bleeding, perforation, TUR syndrome, infection,
#* Early post-operative: urinary retention, retrograde ejaculation, incontinence
#* Late post-operative: failure to improve symptoms, bladder neck contracture, urethral stricture
# What are the standard first-line surgical therapies for BPH?
## Monopolar TURP
## Bipolar TURP
# What treatments are r prostates that are 30-80g?
## Monopolar TURP
## Bipolar TURP
## Greenlight PVP
## HoLEP
## BPKVP
## Thulium laser
## Diode laser
## Urolift
## Rezum
## TUMT
## Aquablation
# What are potential benefits of bipolar over monopolar TURP?
## Reduction in the risk of dilutional hyponatremia (TUR syndrome)
## Improvements in intraoperative visibility
## May result in shorter catheterization times
# What are the indications for open simple prostatectomy?
## Moderate to severe LUTS with prostate size > 80
## Undergoing concomitant bladder procedure (e.g. diverticulectomy)
## Unable to be put in dorsal lithotomy position (e.g. severe hip disease)
# What patient is an ideal candidate for transurethral incision of the prostate?
#* Prostate volume <30 cc without a middle lobe and interested in preserving ejaculatory dysfunction
# In which patients should a Uro-lift be considered? Rezum?
#* Uro-lift: Men interested in preserving ejaculatory function with prostate <80 and no median lobe
#* Rezum: Men interested in preserving ejaculatory function with prostate <80 with or without