How to treat a patient with hypertension, Parkinson's disease, and enlarged prostate with a focal lesion?

Question

Hello doctor,

The patient is a 75-year-old male patient with a history of hypertension and Parkinson's disease history. He also has an enlarged prostrate with a focal lesion. He is on Maxvoid Plus 8. But PSA is low. Is surgery the only way?

Answer 1

Hello,

Welcome to icliniq.com.

The treatment for prostate enlargement, especially with patients with Parkinson’s disease, will be with medications and depending on symptoms. Parkinson’s disease will cause overactive bladder and also urinary retention. After treating Parkinson’s disease with drugs, it is essential to reassess the symptoms and treat with other medication besides Maxvoid. Surgery (TURP - transurethral resection of the prostate) is indicated only if he has difficulty passing urine after Maxvoid and Parkinson’s medical treatment. But if he has increased urine frequency and urgency symptoms after treatment, then the addition of Merabegron (medication to control bladder) may be needed.

If you have any more queries, please let me know.

Answer 2

Hello,

Welcome to icliniq.com.

The urge to pass urine can be slowly developing especially if done under spinal anesthesia if he failed to pass urine then the catheter needs to be inserted again and left for a few more days.

I hope this has helped you. Thank you.