病 案
Case Study:Benign Prostatic Hyperplasia1) and TURP2)
Mr Shen,male,age 60
Main complaint:The patient was having a decreased force of his urine stream and ejaculation，hesitancy，and sensation of incomplete bladder emptying.He had tried using prostate health herbal supplements without any real benefit for two years.He decided to make an appointment with an urologist3).
Examination:The urologist took a history and examined the patient.He reported no dysuria，hematuria，or flank pain.He had no history of urinary tract infection4)(UTI),epididymitis5),prostatitis6)，renal disease，or renal calculi.His medical history was otherwise not significant to his urologic complaint.
Rectal examination revealed a 50-g prostrate with slight firmness in the right prostatic lobe.The physician ordered a bladder ultrasound，which was performed later that week.The results indicated no intravesical lesions or prostrate protrusion into the bladder base.
A transabdominal ultrasound was ordered and showed a residual urine volume of 120Ml.a urinalysis revealed normal values except tor the following:WBC=8；RBC=10；bacteria=trace.
Mr Shen was diagnosed with benign prostatic hyperplasia(BPH)with bladder neck obstruction and was scheduled for a transurethral reaction of the prostate(TURP).His urologist explained the procedure and what to expect preand postoperatively.The office staff notified the hospital to schedule the surgery.The next day，the hospital admission department called Mr Shen，went through normal admissions procedures，and scheduled a surgery date.
Clinical Course
Mr Shen was NPO7) the night before the surgery.He was taken to the operating room and was given a spinal anesthetic for the procedure.It had already been explained to him that the surgery would take about an hour and that he would be awake during the procedure but would not feel any pain.A resectoscope8) was used to trim the enlarged prostatic tissue.At the end of the surgery,a Foley catheter9) was inserted into the bladder and left in place to drain the urine and permit irrigation of the bladder to remove any clots.Mr Shen tolerated the procedure well and was transferred to the recovery room and later to his hospital room.He was encouraged to drink plenty of fluids postoperatively.
Follow-up
On the morning of the second postoperative day，the Foley catheter was removed，and the patient was able to void on his own.He experienced dysuria and some burning when urinating，but otherwise did not have any postoperative complications.(https://www.daowen.com)
He was aware that the painful urination might persist for a few weeks.He remained in the hospital through the second day and then was discharged home with specific instructions.He was to follow up with his urologist in a week.
注释：
1）benign prostatic hyperplasia 良性前列腺增生
2）transurethral resection of prostate经尿道前列腺电切术
3）urologist 泌尿科医生
4）urinary tract infection 尿路感染，泌尿道感染
5）epididymitis［ˈepiˌdidiˈmaitis］附睾炎
6）prostatitis 前列腺炎
7）NPO 术前禁食
8）resectoscope 前列腺切除器
9）foley catheter 导尿管