American Board of Internal Medicine (ABIM) Certification Practice Exam

For mild lower urinary tract symptoms due to benign prostatic hyperplasia, what is the recommended approach?

1. Immediate surgery

2. Observation with conservative therapy

3. Medication management

4. Urology referral

The correct answer is: Observation with conservative therapy

For mild lower urinary tract symptoms (LUTS) resulting from benign prostatic hyperplasia (BPH), the recommended approach is observation with conservative therapy. This strategy is based on the understanding that many individuals with mild symptoms may not experience significant impairment in quality of life or progression of their symptoms. Observation allows for the monitoring of the patient's symptoms over time, and it can include education about the condition and lifestyle modifications that may alleviate some symptoms without the need for immediate intervention. Conservative therapy might encompass changes such as adjusting fluid intake, avoiding irritants like caffeine and alcohol, and potentially pelvic floor exercises. This approach is often appropriate for patients who have symptoms that do not severely impact their daily activities or overall well-being. During this period of observation, if symptoms worsen or become bothersome, other treatment options such as medication management or further interventions can be explored. This stepwise approach helps ensure that patients are not subjected to unnecessary treatments or surgical interventions when their symptoms are mild and manageable.