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Abstract: The patient in this case is a 72-year-old male who presented with abnormal urination 1 year ago and was treated conservatively at a local hospital, with improvement of discomfort. At the beginning of this year, a review at the local hospital revealed elevated PSA, so a biopsy puncture and pathological examination were performed, and the examination results suggested prostate cancer, and for further treatment, he came to our hospital and decided to undergo surgery after the relevant examinations.
Basic information】Male, 72 years old
Type of disease】Prostate cancer
Hospital】Xiang Ya Hospital of Central South University
Date of consultation】June 2022
Treatment plan】Surgical treatment (laparoscopic radical prostatectomy) + medication (cefuroxime sodium for injection)
Treatment Period】Hospitalization for 2 weeks, continuous follow-up
Treatment effect] The disease was controlled and the PSA value decreased.
I. Initial consultation
The patient, male, 72 years old, reported that he had a history of diabetes mellitus, and his blood glucose could be controlled with oral metformin hydrochloride extended-release tablets. In the beginning of 2012, the patient’s PSA was found to be elevated with a TPSA of 10.977ng/ml and F-PSA of 1.833ng/ml, and a trans-perineal prostate puncture biopsy was performed. The patient came to our clinic for further treatment. Based on the patient’s complaint and the previous checklist, he was admitted to our department with prostate cancer and was treated after perfect examination.
II. Treatment process
The patient was admitted to the hospital and underwent magnetic resonance prostate scan enhancement and diffusion-weighted imaging. The patient was admitted to the hospital with MRI scan of the prostate and diffusion-weighted imaging, which revealed a nodule with enhancement in the left peripheral zone of the prostate, suspected to be prostate cancer; and prostatic hyperplasia with multiple hyperplastic nodule formation. The patient was then combined with the PSA results, and the local diagnosis of prostate cancer, and after communication with the patient and his family, they decided to perform surgery. The patient was given cefuroxime sodium intravenously to control postoperative infection.
III. Treatment effect
The patient’s intraoperative lesion was successfully removed and no residual intra-abdominal lesion was found. The postoperative condition was good, and although the healing rate was slightly slow, there were no symptoms of wound infection and inflammation. After the catheter was removed, the patient’s urinary function gradually returned to normal, and the abnormal symptoms such as difficult urination, frequent urination and incomplete urination that appeared before the operation basically disappeared. The patient also reported that she had no significant discomfort after surgery. The PSA was rechecked after the operation and the value decreased, indicating a good treatment effect, but continuous follow-up is still needed.
IV. Precautions
The patient’s condition was basically controlled after laparoscopic surgery, and I was happy that the patient basically recovered 2 weeks after surgery. However, since the patient was diabetic, I instructed the patient and his family to pay close attention to the healing of the incision and pressure sores after surgery. The patient was encouraged to stretch his limbs in bed and to move them as slowly as possible to avoid prolonged stay in the same position. After the pain subsides, you can move around indoors with your family to promote physical recovery. In addition, try to wear loose pants, and it is not recommended to wear tight autumn pants or cotton pants; meanwhile, you should also insist on exercising to improve your resistance after discharge from the hospital.
V. Personal insight
For patients with prostate cancer, not everything is fine after successful surgery, but postoperative care is also very important, especially for patients with underlying diseases like diabetes in this article, not only should they maintain their blood sugar level within normal range, but they should also pay attention to their postoperative incision recovery, once the redness, swelling and pain of the incision or postoperative fever occur, they should be treated promptly to avoid affecting their future recovery. In addition, patients should be followed up regularly after surgery to minimize the chance of recurrence.