Nigerian Postgraduate Medical Journal (Jan 2020)

Management of a giant prostatic enlargement: Case report and review of the literature

  • Rufus Wale Ojewola,
  • Kehinde Habeeb Tijani,
  • Adedeji Lukman Fatuga,
  • Chigozie Innocent Onyeze,
  • Chike John Okeke

DOI
https://doi.org/10.4103/npmj.npmj_69_20
Journal volume & issue
Vol. 27, no. 3
pp. 242 – 247

Abstract

Read online

Giant prostatic enlargement often referred to as giant prostatic hyperplasia (GPH) is a rare condition described as a massive prostatic enlargement >500 g. Up until now, the total number of GPH reported worldwide in medical literature is < 30. To the best of our knowledge, only one case of a giant prostate has been reported in Nigeria. We report a case of a giant prostatic enlargement treated by open simple retropubic prostatectomy in a 73-year-old man who was suffering from lower urinary tract symptoms and persistent visible (gross) haematuria necessitating repeated blood transfusions. Transrectal ultrasound (TRUS) scan revealed a markedly enlarged prostate measuring 565 ml with a suspicious nodule and prostate-specific antigen level of 48.5 ng/ml. He had a 20-core TRUS-guided prostatic biopsy which showed benign prostatic hyperplasia. We performed a retropubic open simple prostatectomy for complete enucleation of the adenoma. Specimen weighed 512.5 g with dimensions of 17 cm × 16 cm and a volume of 528 ml. Histological examination showed prostatic fibromuscular hyperplasia with a focus of adenocarcinoma. The patient had an uneventful post-operative recovery and was discharged within a week post-surgery. Urethral catheter was removed after 2 weeks with satisfactory outcome.

Keywords