Consider the following conditions -1. Urinary flow rate less than 10cc / second 2.Residual volume of urine > 100cc 3.Serum level of prostatic specific antigen > 10 mmol / litre 4. Trabeculated urinary bladder Which of the above are indications of TRUP for BHP?

**Core Concept**
The Transurethral Resection of the Prostate (TURP) is a surgical procedure used to treat Benign Prostatic Hyperplasia (BPH) when medical management fails. The indications for TURP are based on the severity of urinary obstruction and its impact on the patient's quality of life.

**Why the Correct Answer is Right**
The correct answer includes criteria that indicate severe urinary obstruction and its consequences. A urinary flow rate less than 10cc/second and a residual volume of urine > 100cc suggest significant bladder outlet obstruction. Elevated serum levels of prostate-specific antigen (PSA) > 10 mmol/L are not a direct indication for TURP but can indicate prostate cancer or prostatitis, which may require further evaluation. Trabeculated urinary bladder is a sign of chronic bladder outlet obstruction leading to bladder hypertrophy and trabeculation.

**Why Each Wrong Option is Incorrect**
**Option A:** While urinary frequency and nocturia are symptoms of BPH, they are not specific indications for TURP.
**Option B:** Elevated PSA levels can indicate prostate cancer, but they are not a direct indication for TURP.
**Option C:** Hematuria can be a symptom of BPH, but it is not a specific indication for TURP.

**Clinical Pearl / High-Yield Fact**
Remember that the decision to perform TURP should be based on a comprehensive evaluation of the patient's symptoms, urinary flow rates, and bladder function.

**Correct Answer:** A. Urinary flow rate less than 10cc/second, Residual volume of urine > 100cc, Trabeculated urinary bladder

✓ Correct Answer: C. 1,2 and 4