Adenomul de prostata - Tratamentul minim-invaziv TURis - Dr. Vitalie Mogoreanu, medic primar urolog
Prostatic biopsy showed benign Prostata-Adenom-Foren hyperplasia. We Prostata-Adenom-Foren retropubic open prostatectomy, since macrohematuria continued and he was also suffering from lower urinary tract symptoms. The adenoma was completely enucleated in one piece. Histological Prostata-Adenom-Foren also demonstrated prostatic fibromuscular hyperplasia.
This is the 15th-heaviest adenoma ever reported in English-language journals. Transurethral surgical techniques or other Prostata-Adenom-Foren invasive approaches are performed for Prostata-Adenom-Foren with small to medium-sized prostates.
However, open surgery is recommended Prostata-Adenom-Foren markedly Prostata-Adenom-Foren prostatic hyperplasia. Minimally invasive Prostata-Adenom-Foren for benign prostatic hyperplasia BPH have been developed. However, simple open prostatectomy is a recommended method for extremely enlarged prostatic Prostata-Adenom-Foren.
Here, we report a case with a g adenoma that was enucleated by retropubic open prostatectomy. A year-old man was admitted to our hospital with a complaint of Prostata-Adenom-Foren macrohematuria. The result of his urinary cytology was class I. On digital rectal examination, the prostate Prostata-Adenom-Foren found to be grossly enlarged. The serum prostate-specific antigen PSA level was 9. Cystourethroscopy demonstrated bleeding from the prostatic urethra.
A computed tomography Prostata-Adenom-Foren of his abdomen and pelvis Prostata-Adenom-Foren a considerably heterogeneous enlarged prostate measuring mL.
On T 1 - and T 2 -weighted magnetic resonance imaging MRIa heterogeneous prostate with sharply marginated nodules was found. The urinary bladder was superiorly pushed Figure 1. Drip-infusion pyelography showed a normal upper urinary tract with a huge shadow defect of the urinary Prostata-Adenom-Foren Figure 2.
A prolonged and narrow prostatic urethra was observed by retrograde vesicourethrography Figure 3. Total international prostate symptom score IPSS was 14 points, and quality-of-life index was 4. Uroflowmetry UFM demonstrated maximum urinary flow rate and average urinary flow rate to be Histological examination using transrectal biopsies showed stromal hyperplasia without evidence of malignancy.
Thus, he was Prostata-Adenom-Foren as Prostata-Adenom-Foren giant prostatic hyperplasia and underwent retropubic Prostata-Adenom-Foren prostatectomy through a lower abdominal midline Prostata-Adenom-Foren. As expected, a markedly enlarged prostate with smooth surface could be seen in the pelvic cavity.
The urinary bladder was superiorly displaced. The large adenoma was completely enucleated in one piece. The operation time was Prostata-Adenom-Foren minutes, and blood loss during surgery was mL including urine.
He did not need a blood transfusion. There was no apparent operative complication. Histological examination demonstrated prostatic fibromuscular hyperplasia. Vesicourethrography at postoperative day 7 showed that the prostatic urethra was obviously wider than before operation. IPSS was 11 points and quality-of-life score was 1.
Prostata-Adenom-Foren results of Prostata-Adenom-Foren UFM were found to be maximum urinary flow rate of Prostata-Adenom-Foren The serum PSA level decreased to 1. Macrohematuria disappeared about 2 weeks after operation. Magnetic resonance image of a sagittal view revealed a heterogeneous prostate with sharply marginated nodules T 2 Prostata-Adenom-Foren image.
Notes: The estimated prostate size was mL. The urinary bladder was superiorly pushed Prostata-Adenom-Foren. Drip-infusion pyelography demonstrated normal upper urinary tract with a huge shadow defect of the urinary bladder. BPH is Prostata-Adenom-Foren pathologic process that can cause lower urinary tract symptoms. Etiology of prostatic growth demonstrates that prostate size increases slowly and steadily with aging.
Prostata-Adenom-Foren this case, preoperative MRI revealed a mL prostate, and actual weight was g. Although we thought that the increment in the PSA level was probably due to the enlarged prostate adenoma, we performed a biopsy ten specimens to rule out prostatic cancer.
The result showed no malignant cells. Surgical treatment for men with BPH is reserved for those who do Prostata-Adenom-Foren respond well to medical therapy or who have complications such as urinary retention. In this case, we considered that there was a surgical indication since macrohematuria continued and he was Prostata-Adenom-Foren from lower urinary tract symptoms. They include holmium laser enucleation of the prostate, Prostata-Adenom-Foren electrovaporization of the prostate, transurethral microwave Prostata-Adenom-Foren, and others.
Prostata-Adenom-Foren et al stated that g is regarded as the limit of Prostata-Adenom-Foren for those Prostata-Adenom-Foren invasive procedures. SinceProstata-Adenom-Foren minimally invasive simple Prostata-Adenom-Foren techniques have been Prostata-Adenom-Foren.
McCullough et al published the data that laparoscopic simple prostatectomy for patients with BPH was less invasive compared to open prostatectomy. As for the prostate size, the average preoperative prostatic volume was In Prostata-Adenom-Foren, robotic simple prostatectomy was first reported by Sotelo et al. Urinary flow rate, postvoid residual urine, and IPSS scores were also improved by robotic prostatectomy. Operation time and estimated blood loss were Prostata-Adenom-Foren to those seen in the laparoscopic group.
However, Sutherland and colleagues reported that they could not successfully perform Prostata-Adenom-Foren simple prostatectomy for a man with severe prostatomegaly galthough a maximal limit was not placed on Prostata-Adenom-Foren adenoma size during the preoperative evaluation. Thus, we considered that simple prostatectomy was the recommended treatment for men with enlarged prostate, including giant Prostata-Adenom-Foren.
This may be Prostata-Adenom-Foren the snippet Prostata-Adenom-Foren in a figure legend, contains special characters or spans Prostata-Adenom-Foren sections of the article.
Int J Gen Med. Published online Dec 5. PMID: This is an Open Access article which permits Prostata-Adenom-Foren noncommercial use, provided the Prostata-Adenom-Foren work is properly cited.
This article has been cited by other articles in Prostata-Adenom-Foren. Abstract We report a rare case of giant prostatic hyperplasia treated by open surgery. Keywords: benign prostatic enlargement, benign prostatic hyperplasia, giant, retropubic open prostatectomy. Introduction Minimally invasive surgeries for benign prostatic hyperplasia BPH have been developed. Case report A year-old man was admitted to our hospital with a complaint of asymptomatic macrohematuria.
Open in a separate window. Figure 1. Figure 2. Figure 3. Vesicourethrography showed a prolonged and narrow prostatic urethra. Figure 4. Discussion BPH is a pathologic process that can cause lower urinary tract symptoms. Footnotes Disclosure The authors report no conflicts of interest in this work. References Prostata-Adenom-Foren.
Lower urinary tract symptoms, prostate volume and uroflow in norwegian community men. Eur Urol. A case Prostata-Adenom-Foren giant prostatic hyperplasia. Outline Prostata-Adenom-Foren JUA clinical guidelines for benign prostatic hyperplasia. Int J Urol. Recent advances in the Prostata-Adenom-Foren treatment of benign prostatic hyperplasia. Ther Adv Urol. Male lower urinary tract symptoms LUTSincl.
Laparoscopic versus open simple prostatectomy: an evaluation of morbidity. J Endourol.