An 83-year-old male patient presented with a reduced caliber and force at the urinary stream.
There were no relevant comorbidities such as diabetes mellitus, heart failure and neurologic disorders.
Physical examination showed a dullness to percussion on the suprapubic area suggested bladder distention. Consistency of prostatic parenchyma was benign, and no suspicious nodule was handled at the dorsal surface of prostrate in DRE.
The serum PSA was 7.120 ng/ml. Comprehensive analysis of blood parameters was virtually normal, except serum creatinine level was 4.72 ng/ml. Pyuria was detected at urine analysis, but urine culture was sterile.
Transabdominal ultrasound showed bilateral, severe hydronephrosis secondary to globe vesicale and prostate was measured as 680 ml by TRUS.
What is your answer?
- What will be your diagnostic approach?
- What treatment approach will you adopt?
Case sourced from.
Bosanac C, Cicek MC. A huge benign prostatic hyperplasia presenting with renal failure. J Surg case Rep. 2015; 2015: rjv060.