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Abstract: The patient in this case is an elderly male who was diagnosed with prostate alveolar adenocarcinoma 1 year ago in an outside hospital. After 1 year of antiandrogenic treatment, the patient underwent surgery and came to our hospital. After the relevant examination, laparoscopic radical prostate cancer surgery was performed electively. The patient recovered well after surgery and was discharged 10 days after surgery, and is now under continuous follow-up.
Basic information】Male, 67 years old
Type of disease】Prostate cancer
Hospital】Xiang Ya Hospital of Central South University
Date of consultation】March 2022
Treatment plan】Surgical treatment (laparoscopic radical prostate cancer surgery) + intravenous injection (cefuroxime sodium for injection)
Treatment period】Hospitalization for 10 days, continuous follow-up
Treatment effect] The lesion was successfully removed and the disease was controlled.
I. Initial consultation
The patient, male, 67 years old, 1 year ago the patient was seen in an outside hospital due to discomfort symptoms such as urinary frequency and urgency, and underwent ultrasound-guided prostate puncture in the outpatient clinic of the hospital, the postoperative pathological result was prostatic follicular adenocarcinoma with Gleason score 7, after which the patient started treatment with bicalutamide tablets + goserelin acetate extended release implant for 1 year. The patient came to our outpatient clinic because he wanted to undergo surgical treatment. The outpatient clinic performed an anal examination in knee-thoracic position, the sphincter was moderately loose and tight, the prostate was II° enlarged, the central sulcus disappeared, it was hard, the surface was not smooth, light tenderness, mobility was possible, and there was no blood in the finger sleeve. The patient was then admitted to our department with prostate cancer in combination with previous examinations and underwent the next treatment.
II. Treatment history
After the patient was admitted, MRI examination was completed, suggesting multiple nodular abnormal signal foci in the peripheral zone of the prostate, which was consistent with prostate cancer and the possibility of bilateral seminal vesicle gland invasion. After communicating with the patient and his family, the patient was treated with laparoscopic radical prostatectomy in accordance with his condition and personal wishes. The urinary catheter was left in place after the operation, and after the patient returned to the ward safely, cardiac monitoring was given to closely observe the patient’s vital signs, as well as the condition of the incision, the nature of the drainage fluid and urine, and the volume of urine, and the antibiotic cefuroxime sodium for injection was routinely applied to prevent postoperative infection.
III. Treatment results
The patient’s surgery was relatively smooth, and the lesion was successfully removed and returned to the ward. Continuous cardiac monitoring was performed, and the vital signs were stable, and no postoperative complications occurred. The color and shape of urine and drainage fluid were within the normal range. The patient reported that he had no abnormal sensation after the operation and felt good about himself, and resumed anal venting on the third day after the operation and gradually resumed normal diet.
IV. Precautions
Although the patient was relatively old, the operation went smoothly and the postoperative recovery was good. I also put aside my worries about the patient and felt happy for his improvement. Since the patient was discharged with a catheter after surgery, the patient needs to be reminded that he should avoid pressing the line under his body or pulling the catheter when resting in bed or sitting at ordinary times to avoid blockage or dislodgement of the catheter, which may cause infection or urethral injury. In addition, patients and family members should also pay attention to the color of urine in daily life. If the color of urine is red, they should be alert to the presence of infection and need to follow up promptly. Finally, the perineal area should be kept hygienic and cleaned with iodine volts every day. If the perineal area is red and swollen, prompt medical consultation should also be made.
V. Personal insight
Patients who are diagnosed with prostate cancer do not need to be anxious and panic, there is still a possibility of cure for their condition. As in the case of the patient in the article, he is a low-risk to medium-risk patient. Radical prostatectomy is feasible, and with proper care and a healthy attitude, a better outcome can usually be achieved.