Bjerklund Johansen eds. Prostatitis and Its Management Email: khbichler web. Naber Professor Corresponding author Email: kurt nabers. In addition to digital rectal examination DRE of the prostate gland and transrectal sonography TRUS , measurement of the antigen plays an important role in the diagnosis of prostate cancer. DRE did not show any induration suspect of cancer.
Clinical symptoms indicative of UTI or prostatitis were not mentioned in the medical record. In addition, the urologist prescribed medication to improve bladder voiding tamsulosin and treatment of BPH with a 5-alpha reductase inhibitor finasteride. After 4 months, the PSA level showed only a small decrease to The patient is unreasonable and does not agree. He did not want a physical examination but only a new prescription of his previous medication.
The subsequent biopsy discovered a carcinoma of the prostate Gleason 9. Radical surgery showed an advanced prostate tumor pT3b with tumorous tissue in both lobes of the prostate, infiltration of the seminal vesicles, and regional lymph node metastases. In summary, the patient was urologically examined because of his voiding problems due to BPH. A clearly elevated PSA level, leukocyturia, and bacteriuria without reported symptoms were found.
The DRE of the prostate was not suspicious of cancer. There was, however, no significant reduction of the PSA in the following several months and still no biopsies were performed for histological clarification.
Thereafter, the patient withdrew from urological follow-up. Exprimate urine contained many leucocytes. Because of highly suspected cancer, three sets of prostate biopsies were performed over the years, each time without any evidence of a tumor. The patient received repeated courses of antibiotic treatment.
