Safe management of patients with simultaneously occurring prostatism and abdominal aortic aneurysm

In patients who present with both an abdominal aortic aneurysm and signs or symptoms of urinary obstruction from prostatic hypertrophy, prostatectomy should be performed first if the patient's condition permits. Since bleeding from the site of prostatic resection is rare, the interval between prostatic and subsequent aneurysm operations need not be long. One to 2 weeks after hematuria disappears should be sufficient. If clinical conditions prompt emergency operation for a abdominal aortic aneurysm in a patient with prostatism, blood spectrum antibiotics should be used which include coverage for enterococci. Subsequent prostatectomy should be delayed as long as possible unless the patient cannot void or develops a urinary tract infection that cannot be cleared with appropriate antibiotics. Broad spectrum antibodies during and after prostate surgery, in this instance, are mandatory.