We report on a 79-year-old male patient who presented with asymptomatic elevation of prostate-specific antigen and a concurrent papillary lesion, which raised the suspicion of synchronous bladder and prostatic malignancies. He underwent a trans-perineal prostate biopsy as well as transurethral resection of bladder tumour, which revealed a Gleason 9 adenocarcinoma of prostatic origin. While synchronous bladder and prostate cancer is a possibility, differential diagnosis in a patient presenting with lesions of the bladder neck should include advanced prostate cancer.
Surgery causes a physiological and psychological stress response which can lead to a decline in functional capacity (1). The adoption of prehabilitation into existing pathways can improve postoperative outcomes. HoLEP (Holmium laser enucleation of the prostate) is a minimally invasive surgical treatment for men with benign prostatic hyperplasia. We aim to assess the feasibility of providing multimodal prehabilitation to patients with an ASA score of 2 or more. The prehabilitation interventions include supervised cardiopulmonary exercise, muscle conditioning, dietary/lifestyle advice and exploration of psychosocial needs. Patients will also receive a medication review by a specialist pharmacist. Compliance is to be assessed with a phonecall 2 weeks into the program and 6 weeks post procedure. Viability of the project will be determined by the ability of the organisation to deliver and sustain the program. The data to be collected will include project costs, time spent, patient satisfaction, length of stay, early and later surgical complications and daycase rate. This project will assess feasibility of perioperative optimisation programmes for non-oncology surgical pathways for maximal patient benefit.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.