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BPH — USMLE Step 3 MCQ

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EasyAmbulatory Medicine / Primary CareBPHUSMLE Step 3

A 67-year-old man reports urinary hesitancy, weak stream, and nocturia for 1 year. Digital rectal examination shows a smooth enlarged prostate. Urinalysis is normal, postvoid residual is low, and prostate-specific antigen is age appropriate. Symptoms are bothersome. Which of the following is the most appropriate next step in management?

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Correct answer: D — Start an alpha-1 blocker

An alpha-1 blocker improves lower urinary tract symptoms from benign prostatic hyperplasia when symptoms are bothersome and there is no complication requiring surgery.

Reference: AUA Benign Prostatic Hyperplasia Guideline