Question

CHAPTER 5 GENITOURINARY DISORDERS CASE STUDY 55 Copyright © 2013 by Mosby, an affiliate of Elsevier Inc. Copyright © 2009, 2005, 2001, 1996, by Mosby, Inc. an affiliate of Elsevier Inc. All rights reserved.

S.M. is a 68-year-old man who is being seen at your clinic for routine health maintenance and health promotion. He reports that he has been feeling well and has no specific complaints, except for some trouble “emptying my bladder.” Vital signs (VS) at this visit are 148/88, 82, 16, 96.9° F (36.1° C). He had a CBC and complete metabolic panel (CMP) completed 1 week before his visit, and the results are listed below
.SM lab work

Laboratory Test Results
Sodium       140 mEq/L
Potassium   4.2 mEq/L
Chloride100   mEq/L
Bicarbonate   26 mEq/L
BUN       19 mg/dL
Creatinine   0.8 mg/dL
Glucose       94 mg/dL
RBC5.2       million/mm3
WBC       7400/mm3
Hgb       15.2 g/dL
Hct       46%
Platelets       348,000/mm3
Prostate-specific antigen (PSA)   0.23ng/mL
Urinalysis               WNL

9. S. M. asks, “Will this condition affect my relationship with my wife?” What should you tell him

10. What would you expect S.M. to report if the medication was successful?
CASE STUDY PROGRESS:
S.M. returns in 8 months to report that his symptoms are worse than ever. He has tried several different medications, but medication management failed, and he is told that surgical intervention is necessary.

11. What surgical options are available to S.M.?

CASE STUDY OUTCOME
S.M. elected to undergo a Gyrus transurethral resection of the prostate (TURP). He did well postoperatively and was discharged to home

Answer 1

Ans 9-pt have problem in bladder emptying and his psa (prostate specific antigen )Value is 0.23ng/ml

At that time psa value was in normal limits

Normal psa value age group b/w 60 to 69 years is upto 4.5 ng/ml

So this doesn't affect his relationship with his wife.and give him medication for urinary symptom

Tab.Urimax .4 mg od at bed time and tell him for follow up.

Ans 10 -if symptom is in control and psa value is in normal range we expect the pt take medication properly and follow up for investigation

Ans 11

Men looking for a safe and effective treatment for BPH and its associated symptoms should also consider the several minimally-invasive therapies that are available today. Minimally-invasive therapies include laser ablation (ie, GreenLight laser), transurethral needle ablation, transurethral microwave therapy (TUMT), high-energy focused ultrasound, and hot water thermotherapy.1 TUMT, which is one of the most common minimally-invasive therapies for BPH, uses microwave energy to deliver heat to the prostate via a urethral catheter. It causes cell death and decreases prostatic volume.The procedure is done in an outpatient or office setting using local anesthesia and takes less than an hour. Minimally-invasive treatments provide an alternative for high-risk patients who are unable to tolerate surgery or general anesthesia