Intravesical protrusion of giant median prostatic lobe: A case report

Giant intravesical prostatic protrusion mimicking bladder carcinoma: Navigating diagnostic and management challenges

“…Like in our case, both ultrasound and CT scan may all suggest bladder carcinoma [ 4 , 7 ]. Magnetic resonance imaging (MRI) and cystoscopy are useful investigation to differentiate IPP from primary bladder carcinoma [ 1 , 8 ]. We did not have facilities for MRI, however, cystoscopy was suggestive of giant IPP and therefore appropriate treatment was suggested.…”

“…IPP is classified/graded as grade 1, 2 and 3, which is equivalent to intravesical prostate length of <5 mm, 5–10 mm and >10 mm, respectively [ 1 ]. Our case had grade 3 IPP evidenced by the dimension of what was thought to be bladder carcinoma by the CT scan as well as abdominal ultrasound.…”

“…Medical treatment of giant IPP due to BPH with alpha-blockers and 5-alpha reductase inhibitors is ineffective in relieving the LUTS [ 9 ]. Hence, surgery remains the mainstay treatment with trans urethral resection of the prostate being the gold standard management of BPH [ 1 ] [ 9 ] [ 10 ]. However, for the prostate >80 g, open prostatectomy is the preferred surgical approach due to its less morbidity and mortality.…”

“…The transvesical is the preferred technique in the presence of giant IPP, bladder diverticulum or bladder stone [ 4 , 11 ] due to easy accessibility and removal of the abnormality. Some patients might experience difficulties in micturition post operatively that eventually improve with time [ 1 ]. Similarly, in this case report a transvesical approach was used to enucleate the prostatic adenoma and upon removal of the catheter on day ten post operatively the patient reported to be passing urine normally where, he had low post void residual urine volume of 10mLs.…”

“…Benign prostatic hyperplasia (BPH) is characterised histologically by increase number of prostatic epithelia and stromal cells. BPH is not uncommon condition among elderly men aged 50 years and above with prevalence that increases almost linearly and approaches 90 % at the age of 90 years [ 1 ], commonly presenting with enlargement of the lateral lobes. Globally, giant BPH of the median lobe is a rare occasion.…”