[Prostatic adenomectomy in dialysis patients].

Area of Science:

• Nephrology
• Urology
• Internal Medicine

Background:

• Patients with end-stage renal disease (ESRD) often require dialysis and may face complications from benign prostatic hyperplasia (BPH).
• Urinary tract obstruction in ESRD patients on dialysis can lead to recurrent infections, sepsis, and anemia, complicating management.
• Kidney transplantation eligibility criteria have expanded, increasing the likelihood of encountering BPH in potential transplant recipients.

Observation:

• A 55-year-old male patient with ESRD on dialysis presented with a massive prostatic adenoma causing significant urinary tract obstruction.
• The patient experienced recurrent, treatment-resistant urinary tract infections (UTIs), septic fever episodes, and anemia relapses.
• These complications significantly impacted his overall health and management on dialysis.

Findings:

• Suprapubic transvesical adenomectomy was performed to relieve the prostatic obstruction.
• Post-surgery, the patient showed resolution of fever episodes and negative urine cultures.
• Significant improvement in the patient's anemic condition was observed following the adenomectomy.

Implications:

• Successful surgical management of prostatic adenoma is critical for improving the health of dialysis patients.
• Treating urinary tract obstruction is a prerequisite for successful kidney transplantation in patients with BPH.
• Addressing BPH in ESRD patients can reduce infection risk and improve outcomes, especially with increased immunosuppression post-transplant.