The Language of Medicine
The Language of Medicine
10th Edition
ISBN: 9781455728466
Author: Chabner, Davi-Ellen
Publisher: Elsevier Science Health Science div
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Chapter 9, Problem 5CRPA
Summary Introduction

Introduction:  Benign prostatic hyperplasia (BPH) is the benign growth of cells within the prostate gland. This causes problem to empty the bladder completely. Surgical treatment with transurethral resection of the prostate (TURP) relives the symptoms, but cells may overgrow over the several years.

Case summary: A 70 year old patient is suffering from severe obstructive urinary symptoms with a large postvoid residual. The patient had undergone a TURP for BPH 5 years ago. The patient was recommended for digital rectal examination (DRE). DRE result showed large, bulky, and nodular prostrate, with palpable extension that lead to the left seminal vesicle. His prostate specific antigen (PSA) level was found to be 15 ng/mL (but, its normal value is 0-4 ng/mL). The bone scan was found negative. Bilateral external iliac adenopathy associated with lymph nodes (1.5 cm) was revealed in CT scan. Normal size of lymph node is 1 cm. Their prostatic biopsy showed a poorly differentiated adenocarcinoma. The patient has stage T3N+ disease that is extended to seminal vesicles and nodal metastasis. Recommendation is anti-testosterone hormonal drug treatment.

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