A 64-Year-Old Man Comes to the Office Due to Urinary

question 39

Multiple Choice

A 64-year-old man comes to the office due to urinary frequency, hesitancy, and dribbling.  His symptoms began insidiously 5 years ago and have progressively worsened.  He has to get up 2 or 3 times each night to urinate.  Vital signs are normal.  Examination shows a smooth, symmetrically enlarged prostate without nodules or tenderness.  There is no suprapubic tenderness.  Prostate-specific antigen level is 3.5 ng/mL, creatinine is 1.2 mg/dL, and urinalysis is normal.  The patient is started on a new medication.  After 6 months of therapy, his urinary symptoms improve and prostate volume decreases by 20%.  Which of the following medications is most likely responsible for the decreased prostate volume in this patient?

• A)Finasteride
• B)Phenazopyridine
• C)Tadalafil
• D)Tamsulosin
• E)Tolterodine