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Abstract: Bladder cancer is a common malignant tumor of the urinary system, with a higher incidence in men than in women. A 72-year-old male patient, who recently presented with intermittent total carnal hematuria with frequency, urgency, and painful urination, came to the hospital and was diagnosed with this disease after completing relevant tests. He was then given radical cystectomy, as well as ibuprofen extended-release capsules, cefadroxil capsules, and levofloxacin tablets for 2 weeks, after which his symptoms improved and his condition was stable.
[Basic information] Male, 72 years old
Type of disease】Bladder cancer
Hospital】Central South University Xiangya Hospital
Date of consultation】June 2022
Treatment plan】Surgery (radical cystectomy) + medication (ibuprofen extended-release capsules, cefadroxil capsules, levofloxacin tablets)
Treatment period】Inpatient treatment for 2 weeks, review after 1 month, long-term follow-up
Treatment effect] Symptoms improved, stable condition
I. Initial consultation
6 months ago, the patient developed a full course of carnal hematuria with a washout-like urine without any obvious cause, and the hematuria was relieved after self-rest, accompanied by urinary urgency, frequency and pain. In February 2022, he visited a local hospital, and cystoscopy showed bladder stones in the bladder, and after cystolithotomy, his symptoms were not significantly relieved. In order to seek further treatment, he came to our outpatient clinic, where CT kidney ureteral bladder scan with enhanced 3D imaging showed nodules and masses in the posterior, inferior and bilateral walls of the bladder, and bladder cancer was considered. The preliminary diagnosis of bladder cancer was made and the patient was admitted to the hospital for treatment. The patient’s general condition was acceptable, her diet was normal, her weight did not change significantly, her stool habit was normal and yellow, there was no urgency, her urine was as described above, she slept normally and her mood was stable.
Treatment history
After the patient was admitted to the hospital, the diagnosis of bladder cancer was confirmed by examination, and surgery was considered as the best treatment option in combination with his medical history and relevant examination results. Under general anesthesia, the prostate and the diseased bladder were completely removed, the lymph nodes were thoroughly cleared, and a new urinary reservoir was created. After the anesthesia wore off, the patient reported unbearable pain and was given ibuprofen extended-release capsules. In addition, the patient was given cephalexin capsules and levofloxacin tablets to prevent the occurrence of infection.
III. Treatment effect
Before treatment, the patient presented with complete carnal hematuria with urinary urgency, frequency and pain. cystoscopy revealed multiple broad basal tumors in the bladder, the largest being 3×3 cm. after radical cystectomy, the bladder and tumors were completely removed. 2 weeks after surgery, the patient’s hematuria disappeared, urination was normal, and the wound healed well. The pain was relieved by taking ibuprofen extended-release capsules after the operation, and no infection occurred after taking antibiotics as prescribed by the doctor. The patient was discharged from the hospital for convalescence and returned to the hospital for review in 1 month.
IV. Notes
I was very happy after the patient was discharged from the hospital, but since the patient had a long recovery period after discharge, in order to have a better recovery, I did not forget to emphasize to the patient that the following points should be noted in life: 1.
1, the diet should be light and easy to digest, eat more fresh vegetables and fruits rich in vitamins, as well as food containing high-quality protein, such as eggs, milk, fish, soy milk, etc..
2, after discharge from the hospital, pay attention to more rest, to develop good habits, early to bed and early to rise, to ensure sufficient sleep, avoid staying up late, overworked.
3.Follow the doctor’s instructions for regular review. If hematuria or abnormal urination occurs again after discharge, you should seek medical attention promptly to prevent the occurrence of related complications.
V. Personal insight
In the treatment of the patient in this case, it was learned from the medical history that the patient had a 50-year history of smoking, about 20 cigarettes per day. Although the recurrence of cancer can be prevented to a great extent after radical cystectomy is performed, smoking can increase the chance of cancer recurrence, so the patient should quit smoking after surgery. The desire to smoke can be relieved with smoking cessation candy or other snacks at the early stage of quitting, and moderate recreational activities, such as chess and dinners, can be distracting if the body allows, and family members should play a supervisory role.