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Abstract: A 62-year-old male patient with no obvious cause of incomplete urination, frequent urination, and low urine volume per voiding for 3 years, presented to our hospital 3 months ago with lower abdominal discomfort and increased frequency of urination. The patient’s symptoms improved after 1 week of hospitalization with doxazosin mesylate extended-release tablets and finasteride tablets, and he was discharged from the hospital to take the medication and was re-examined in 1 month.
Basic Information】Male, 62 years old
Disease Type】Prostate enlargement
Hospital】Central South University Xiangya Hospital
Date of Consultation】April 2022
Treatment plan】Oral medication (doxazosin mesylate extended-release tablets, finasteride tablets)
Treatment period】Inpatient treatment for 1 week, review after the first month, then every 6 months
Treatment effect] Symptoms improved and the disease was stable
I. Initial consultation
The patient complained of incomplete urination, frequent urination, low urine volume per urination, nocturia 2 times/night, no painful urination and no visual hematuria, treated with oral medication (specific details unknown), symptoms improved. 3 months ago, no obvious cause of lower abdominal discomfort, increased urination, in order to further in the diagnosis and treatment, to our outpatient clinic, anal finger diagnosis: into the finger about 7cm from the anal edge, 3-6 o’clock direction can be The prostate gland was palpable, size II°, tough, movable, no tenderness, no nodules were found in the bilateral lobes, no bleeding in the retreating fingers, CT examination showed that the prostate gland was enlarged, size about 45mm×31mm×39mm, and patchy calcification foci were seen in it. The patient was initially diagnosed with prostatic hyperplasia in combination with his clinical symptoms. The patient was found to have a number of circular hypodense foci in both kidneys by CT examination, the largest being 17mm×12mm, and was advised to follow up and observe without treatment considering the absence of relevant symptoms.
II. Treatment history
The patient completed CT, ultrasound, rectal examination and other related examinations to clarify the diagnosis of prostatic hyperplasia. After communication with the patient, pharmacological treatment was carried out. The α-blocker doxazosin mesylate extended-release tablets were used to induce relaxation of urethral smooth muscle and improve urinary symptoms. Finasteride tablets, a 5α-reductase inhibitor, were used to lower the androgen dihydrotestosterone in the body, which in turn inhibited prostate enlargement and contributed to its size reduction. After 1 week of inpatient treatment, the patient’s symptoms improved and he was discharged from the hospital to continue taking medication outside of the hospital and to be reviewed after 1 month and every 6 months thereafter, with prompt medical attention if there is any discomfort.
III. Treatment effect
The patient was admitted to the hospital with no obvious cause for lower abdominal discomfort, increased urination, and an enlarged prostate gland measuring approximately 45 mm x 31 mm x 39 mm on imaging, and after 1 week of treatment with doxazosin mesylate extended-release tablets and finasteride tablets, the lower abdominal discomfort was significantly relieved, and he was discharged from the hospital to take medication. The patient complained of normal urination, no incomplete urination and frequent urination, and a repeat CT examination showed that the prostate was smaller than before, but still enlarged.
The patient recovered well.
The patient’s condition improved and he was very happy, and I was happy for the patient.
1.After discharge from the hospital, the patient should take the medication according to the doctor’s prescription.
2, strengthen self-observation, once the number of urination, urine volume, urine properties and other changes, should pay attention to, promptly seek medical attention.
3, diet should be light and easy to digest, avoid the intake of garlic, ginger, pepper and other spicy stimulating food, quit smoking and alcohol.
4, you can drink more water during the day to replenish water, and reduce the amount of water at night, you can avoid frequent urination affect the night rest.
V. Personal insight
Men often develop prostate enlargement after the age of 35, and clinical symptoms appear after the age of 50, with frequency, urgency, painful urination, difficulty in urination, incomplete urination and urinary retention as the main manifestations, so high-risk groups should be examined regularly to detect prostate-related diseases in time and inhibit the development of the disease. If any of these symptoms appear, you should seek medical attention for active treatment. The patient in this case is a 62-year-old male, who was treated 3 years after the onset of his symptoms. If he had sought medical attention at the onset of his symptoms, he could have largely reduced his discomfort and improved his quality of life.