Giant prostatic enlargement: A presentation of a rare asymptomatic case

Baurzhan Kilibayev 1 * , Gafour Khairli 1, Ulanbek Zhanbyrbekuly 1, Sherniyazdan Abdugalimov 2, Nurbol Keulimzhayev 1, Yerzhan Sharapatov 1, Rano Zhankina 1
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1 Department of Urology and Andrology, Astana Medical University, Astana, Kazakhstan
2 Department of Uroandrology, City Hospital 1 of Astana, Astana, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 20, Issue 4, pp. 71-75. https://doi.org/10.23950/jcmk/13493
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ABSTRACT

Benign prostatic hyperplasia is a histological diagnosis and the most frequent benign tumor in older men, and its incidence strongly correlates with advanced age. Giant prostate enlargement (GPE), also known as giant prostatic hyperplasia, is a term given for severely enlarged prostates that weigh more than 500g. GPE cases reported in literature is less than 30. We describe our experience of removing previously asymptomatic 528g prostate by open transvesical prostatectomy. According to transrectal ultrasound (TRUS) the prostate size is 482 ml and prostate‑specific antigen level of 5.1 ng/ml. Histological examination showed nodular prostatic hyperplasia, an adenomatous variant with foci of cystic atrophy, chronic prostatitis. The patient's post-operative recovery went without any relapses and complications.

CITATION

Kilibayev B, Khairli G, Zhanbyrbekuly U, Abdugalimov S, Keulimzhayev N, Sharapatov Y, et al. Giant prostatic enlargement: A presentation of a rare asymptomatic case. J CLIN MED KAZ. 2023;20(4):71-5. https://doi.org/10.23950/jcmk/13493

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