60 year hypertensive male underwent angioplasty 3 mnths back
c/o urgency, nocturia, more of dysuria x 1year
PSA <10
USG pelvis- normal volume, no hypoechoic foci
Had acute retention of urine, catheterization attempted, difficult, dilation and manipulation in small town
Underwent TURP with diagnosis of BPH by urologist with impression of false passage from bulbous urethra to veru-montenum
HPE: adenocarcinoma foci in <10% of tissue, gleason 3+3
Diagnosis: Low risk (? T stage) ca prostate
Planned for 3 mnthly PSA and pelvic MRI at 6 weeks postop
Issues:
1. Active surveillance vs adjuvant treatment (in view of inadequate surgery)
2. In view of dilation and manipulation chances of local spread and stage migration
3. How to arrive at life expectancy in this case?