D.P. is a 63-year-old man who has been experiencing progressive difficulty with
ID: 127439 • Letter: D
Question
D.P. is a 63-year-old man who has been experiencing progressive difficulty with initiating the urinary stream and frequently needs to get up in the night three or more times to urinate. A prostate-specific antigen (PSA) is obtained and a prostate examination performed. The PSA is not significantly elevated. The prostate is enlarged.
Case Questions
What is the likely cause of DP's urinary problem?
What is the danger of leaving this untreated?
What further testing would be helpful in evaluating the degree of urinary obstruction?
How reliable is the PSA in distinguishing between benign and malignant enlargement of the prostate? Is further testing indicated
What are the treatment options for D.P.?
Explanation / Answer
1). D.P. might be suffering from benign or malignant prostatic hypertrophy. It may also occur if the patient has urinary tract infection or recent history of lower urinary tract instrumentation.
2). The BPH (benign prostatic hypertrophy) patients are at risk of developing prostate cancer. Or if the person already has prostate cancer, it progresses to severe malignancy. In any case, leaving the patient untreated causes severe damage to the urinary tract.
3). So, the person must be subjected to other diagnostic tests, such as the test for infection, biopsy, etc. It helps to identify the cause of prostate enlargement. Monitoring his PSA levels is also important.
4). Although the prostate-specific antigen (PSA) levels do not increase significantly, the values below 4 ng/ml (general cut-off to diagnose prostate cancer) may also occur in prostate cancer patients. The patient's symptoms are due to enlarged prostate that compresses bladder. The PSA testing is not specific for prostate cancer, it also gives positive results if the patient is having benign hypertrophy or infection.
Related Questions
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.