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Abstract: The onset of prostatic hyperplasia is mostly related to the age of the patient, and with increasing age there is an imbalance in the secretion of androgens in the body, thus predisposing the prostate cells to proliferation. A 75-year-old male patient with a history of prostatic hyperplasia for 8 years was troubled by frequent urination, urinary urgency, urinary dripping, increased nocturia, and inability to urinate. After undergoing transurethral resection of the prostate in our hospital, urination returned to normal and discomfort was relieved, and his condition was stable.
Basic Information】Male, 75 years old
Disease Type】Prostate enlargement
Hospital】Central South University Xiangya Hospital
Time】May 2022
Treatment plan】Surgical treatment (transurethral resection of the prostate) + intravenous injection (Ceftriaxone sodium for injection)
Treatment period】1 week of hospitalization, 1 month of follow-up, long-term follow-up
Treatment effect]: Symptoms improved, stable condition
I. Initial consultation
The patient complained of frequent urination, urgent urination, dripping urine, increased nocturia, 4-5 times per night, thinner urine line, shorter urinary stroke, less urine volume per urination, no painful urination, no visual hematuria, no chills and fever, no palpitations and chest tightness, no cough and shortness of breath, no nausea and vomiting, no diarrhea and constipation, no abdominal pain and bloating, no dizziness and weakness, and was diagnosed as He was diagnosed with prostatic hyperplasia at a local hospital and his symptoms improved with medication (details unknown). 2 months ago, he again had difficulty urinating and came to our hospital for consultation. The ultrasound examination showed that the prostate gland was 67x56x54mm in size, with an enlarged contour, a fuller shape, a less than smooth surface, varying intensity of internal echogenicity, and multiple strong light spots visible inside. The nodule was 27x20mm, located on the left side of the inner gland, with slightly high echogenicity, regular morphology, clear borders, coarse internal light spots, and uneven distribution. The patient was found to have multiple cysts in both kidneys, which were considered to be small in size, so no targeted treatment was carried out for the time being, and the patient was followed up and observed.
II. Treatment history
The patient was admitted to the hospital and underwent prostate puncture and the results of the pathological examination were: benign prostatic hyperplasia, and after communication with the patient it was determined that transurethral resection of the prostate should be performed. The patient was put under general anesthesia, the urethra was dilated and the electrodes were placed, the prostate tissue was removed and taken out of the body, the device was withdrawn after the operation and the catheter was left in place to drain the urine. After the operation, the patient’s bladder was flushed through the catheter to avoid blood clotting and blocking the catheter, and blood pressure, pulse, respiration and urine output were closely observed for any abnormalities. Ceftriaxone sodium for injection was used intravenously to prevent the occurrence of postoperative infection.
III. Treatment effect
The patient had difficulty in urination before admission for treatment, and enlarged prostate was seen on imaging. After admission, transurethral resection of the prostate was performed with antibiotic therapy and no infection occurred. The patient was discharged from the hospital after 5 days of post-operative bladder irrigation and had normal urination. 1 month later, he returned to the hospital for a follow-up CT examination and saw that the size of the prostate was normal and that the patient had no symptoms of urinary frequency, urgency, dribbling and increased nocturia. The patient was discharged from the hospital and insisted on regular re-examination and timely medical attention if there was any discomfort.
IV. Precautions
The patient’s condition improved after surgery, as a doctor I feel very pleased, in order to get a better recovery, in life also need to pay attention to the following points.
1, a reasonable diet, pay attention to supplementation of vitamins and dietary fiber, prevention of constipation, so as not to force defecation caused by increased abdominal pressure, resulting in secondary bleeding, constipation can go to the hospital to relieve constipation.
2. Sexual life should be avoided for 6 weeks after surgery, heavy physical labor should be restricted, and strenuous exercise, such as running, rope skipping, and long-distance walking, should be avoided.
3.Patients should properly perform postoperative anal sphincter contraction exercises, which can promote the recovery of urinary function.
4, pay attention to more rest, develop good sleep habits, and avoid staying up late.
V. Personal insight
Prostatic hyperplasia is a common cause of urinary difficulties in elderly men, and the patient in this case was treated surgically to fundamentally solve the problem of urinary discomfort. To prevent disease recurrence, patients also need to strengthen their life management. Avoid taking atropine, belladonna tablets and other drugs that can easily cause urinary retention on a daily basis, and inform your doctor if your condition requires it, and use diuretics in conjunction with them to reduce symptoms. Develop good drinking habits, with a daily water intake of 1000-2000mL, but be careful not to hold urine as this may induce acute urinary retention.