Intractable haematuria due to giant prostatic hyperplasia in a resource-challenged centre: between the devil and the deep blue sea

Abstract

Massive prostatic enlargement greater than 500 g is a rare condition known as giant prostatic enlargement, which most literature refer to as giant prostatic hyperplasia (GPH). Hyperplasia of enormous size is very uncommon alongside the presentation of intractable haematuria, especially in a facility like ours with limited resources to investigate and the need for repeated blood transfusions combined with a deteriorating clinical state.

A case is reported of intractable haematuria with a giant prostate, weighing exactly 610 g, which was successfully removed at the Federal Medical Centre in Keffi, Nasarawa State, Nigeria, by a Pfannenstiel transvesical simple prostatectomy. A histological examination showed nodular hyperplasia with a predominant stromal component, however, the patient had an uneventful postoperative recovery necessitating discharge a week after surgery. A urethral catheter was removed after three weeks with a satisfactory outcome.

This case report highlights the presentation and the dilemma in decision-making regarding the established protocols in the management of such conditions and the lessons learnt from our approach to its intervention.