A case of giant prostatic hyperplasia

Wang, Luke; Davis, Paul A.; McMillan, Kevin

doi:10.1016/j.ajur.2015.10.004

Cited by 14 publications

(13 citation statements)

References 5 publications

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“…GPH is associated with more severe voiding symptoms and more complicated clinical treatment compared with smaller prostates (5). To the best of our knowledge, there are only several cases of prostate larger than 500 ml without a malignant component, and no more than ten cases of GPH reaching 700 ml that have been reported in the literature so far (6)(7)(8)(9)(10). We present a case of the fourth largest GPH, treated with open suprapubic prostatectomy approach.…”

Section: Introductionmentioning

confidence: 94%

Giant prostatic hyperplasia and its causes

Anglickis

Platkevičius

Stulpinas

et al. 2020

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We present a case of a 59-year-old male who was admitted to the emergency department with urinary retention, with a history of lower urinary tract symptoms, with the value of serum prostate specific antigen level of 100 ng/mL and an estimated prostate size of 800 mL, according to magnetic resonance imaging. A prostate biopsy showed benign prostatic hyperplasia. Transvesical prostatectomy was performed, following additional procedure of transurethral resection of the prostate. To the best of our knowledge, this is the fourth highest prostate volume reported in medical literature. In this paper, we examine the factors that may have influenced the development of giant prostate hyperplasia.

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Section: Introductionmentioning

confidence: 94%

Giant prostatic hyperplasia and its causes

Anglickis

Platkevičius

Stulpinas

et al. 2020

AML

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“…Consequently, the aromatase enzyme that mediates the production of estrogens from testosterone (3) could explain why testosterone levels in men drop by about 35% between the ages of 21 and 85, while estradiol levels either remain constant or increase. In rare cases, BPH can lead to a pronounced increase in prostate volume, resulting in a condition known as giant prostatic hyperplasia (4,5) .…”

Section: Introductionmentioning

confidence: 99%

Prostatic artery embolization for giant prostatic hyperplasia: a single-center experience

et al. 2021

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Objective: To describe the safety and efficacy of prostatic artery embolization (PAE) in patients with a markedly enlarged prostate. Materials and Methods: This was a retrospective study including 18 consecutive patients (mean age, 74 years) with benign prostatic hyperplasia, all with a prostate volume ≥ 200 cm3, who were enrolled to receive PAE for the treatment of moderate-to-severe lower urinary tract symptoms. Results: The PAE procedure was technically successful in 17 patients (94.4%). During follow-up, clinical failure (defined as an International Prostate Symptom Score [IPSS] ≥ 8) was observed in two (11.1%) of those 18 patients. At 3 months of follow-up, there was significant improvement over baseline in all relevant outcome measures: total IPSS (from 15.7 to 2.9); IPSS quality of life score (from 5.2 to 1.0); prostate specific antigen (from 11.4 to 1.82 ng/mL); peak urinary flow rate (from 7.45 to 18.6 mL/s); prostate volume (from 252.4 to 151.6 cm3); and post-void residual volume (from 143.7 to 28.3 mL)-p < 0.05 for all. Of the 18 patients, one (5.6%) presented detachment of prostate tissue and self-limited hematuria, which did not require specific treatment. Conclusion: In patients with a markedly enlarged prostate, PAE proved to be safe and effective, resulting in significant improvements in clinical, imaging, and urodynamic parameters.

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“…GPH is defined as prostate volume greater than 200 mL [1][2][3][4][5][6][7][8][9][14][15][16][17][18][19]. GPH has been described in several individual patients as case reports in a review of international scientific literature [1][2][3][4][5][6][7][8][9][14][15][16][17][18][19]. Individual cases of patients with severe LUTS from GPH whom underwent treatment with surgery or minimally invasive ablative urological treatment have also been reported [20][21][22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia

et al. 2020

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Background Patients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume greater than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference. This retrospective investigation examined the long-term efficacy and safety of prostatic arterial embolization (PAE) as a treatment option for severe LUTS due to GPH in a large patient cohort. Methods Of 529 patients who underwent PAE between January 2016 and January 2020, 72 patients had severe LUTS from GPH and were retrospectively evaluated. PAE was performed with two embolic agents in sequence: 100–250 μm particles followed by 2 mm and 3 mm coils. Clinical assessment was performed with international prostate symptoms score (IPSS), quality of life (QoL), peak flow rate (Qmax), post-void residual volume (PVR), and prostate specific antigen (PSA) measurements before and 12 months and 24 months after PAE. Prostate volume (PV) was measured by multiparametric magnetic resonance (MR) imaging before and 12 months and 24 months after PAE. Results Patients with severe LUTS from GPH experienced significant clinical improvements in IPSS, QoL, Qmax, PVR, PSA, and PV at 12 months and 24 months after PAE. Mean IPSS decreased from 26.5 to 18.0 (P < 0.01) to 10.5 (P < 0.01). Mean QoL decreased from 6.0 to 4.0 (P < 0.01) to 2.0 (P < 0.01). Mean Qmax increased from 8.0 to 14 mL/s (P < 0.01) to 18 mL/s (P < 0.01). Mean PVR decreased from 198.0 to 152.0 mL (P < 0.01) to 90 mL (P < 0.01). Mean PV decreased from 303.0 mL to 258.0 mL (P < 0.01) to 209.0 mL (P < 0.01). Mean PSA decreased from 11.2 ng/mL to 9.5 ng/mL (P < 0.05) to 7.9 ng/mL (P < 0.05). No major complications occurred. Conclusions PAE is a safe treatment with long term efficacy for severe LUTS from GPH. PAE may be a viable therapeutic option for patients with severe LUTS from GPH whom fail medical therapy and are not candidates for surgical treatments.

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A case of giant prostatic hyperplasia

Cited by 14 publications

References 5 publications

Giant prostatic hyperplasia and its causes

Giant prostatic hyperplasia and its causes

Prostatic artery embolization for giant prostatic hyperplasia: a single-center experience

Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia

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