Surgical Management of the “Large” Prostate: The Robotic Simple Prostatectomy: NYU Case of the Month, October 2020

摘要

A66-year-old man presented with acute urinary retention. He first sought medical care for an enlarged prostate about 10 years ago. At that time, he was experiencing a slow urinary stream and was started on an alpha-blocker and a 5-alphareductase inhibitor (5-ARI). He stopped taking the 5-ARI because of unwanted effects on his libido and mild breast tenderness. A year ago, he had an International Prostate Symptom Score (IPSS) of 24 and a Quality of Life (Qol) score of 3 (“mixed”). His lower urinary tract symptoms (LUTS) had progressed steadily over the years, but he became more concerned about 3 months ago when he started to have urinary incontinence. In addition to urgency incontinence, he felt an increasing pelvic pressure and thought his abdomen was more distended. He began sitting to void and was increasingly bothered by nocturia (3 times/night).