Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, Changsha, China.
BMC Urol. 2019 Oct 30;19(1):105. doi: 10.1186/s12894-019-0524-y.
Benign prostatic hyperplasia (BPH) rarely occurs in children or young males. In this case report, a 29-year-old male patient diagnosed with BPH coexisting with ketamine-associated uropathy was reported to investigate the possible relationship between BPH and ketamine-associated uropathy as well as therapeutic strategies.
A 29-year-old male patient with a 3-year history of ketamine inhalation, complaining of dysuria with frequency and urgency, was admitted. Hydronephrosis, hydroureters, uneven bladder wall thickening and a tumour located in the outlet of the bladder were detected with computed tomography (CT). The patient agreed to cystoscopy under general anaesthesia. A spherical tumour with a diameter of approximately 2 cm was found to originate from the median lobe of the prostate and follicular lesions were diffusely distributed on the right bladder wall. The tumour and follicular lesions in the bladder were resected successfully, and pathology demonstrated BPH and chronic inflammation of the mucous membranes separately. The patient quit ketamine completely during the one-year follow-up. Dysuria was relieved completely and no tumour or follicular neoplasm recurrence was found.
Inflammation in the urothelium, as a direct or indirect consequence of ketamine, may contribute to the development of BPH. Both surgical interventions to remove obstruction and ketamine cessation are necessary approaches.
良性前列腺增生(BPH)在儿童或年轻男性中很少见。本病例报告报道了 1 例 29 岁男性患者,诊断为同时患有 BPH 和氯胺酮相关性尿路病,旨在探讨 BPH 和氯胺酮相关性尿路病之间的可能关系以及治疗策略。
1 名 29 岁男性患者,有 3 年氯胺酮吸入史,诉排尿困难伴尿频、尿急,入院。CT 检查发现肾积水、输尿管积水、膀胱壁不均匀增厚和膀胱出口处有 1 个肿瘤。患者同意在全身麻醉下行膀胱镜检查。发现 1 个直径约 2cm 的球形肿瘤,起源于前列腺中叶,右膀胱壁弥漫分布滤泡病变。成功切除了肿瘤和膀胱滤泡病变,病理分别显示为 BPH 和慢性黏膜炎症。在 1 年的随访期间,患者完全戒断了氯胺酮。排尿困难完全缓解,未发现肿瘤或滤泡性肿瘤复发。
尿路上皮炎症可能是导致 BPH 发展的直接或间接原因。手术干预以解除梗阻和戒断氯胺酮都是必要的方法。