DOI: 10.36347/sasjs.2023.v09i11.010

Pages: 919-923

Transvesical adenomectomy according to Fuller-Freyer- Hryntschak, although challenged by other endoscopic techniques, is one of the surgical options validated and recommended by the majority of urology societies for managing and operating on large prostate adenomas with volumes greater than 100 cc, such as the one described in this case report with an ultrasound-measured prostate volume of 238g. Long-term results are excellent, but it is important to note marked perioperative morbidity, including bleeding, and a significant complication that should be explained to the patient prior to the procedure: retrograde ejaculation. We present a case of a 60-year-old patient with a prostate volume of 238g with failure of dual alpha-blocker and 5-alpha reductase therapy, who underwent urodynamic assessment revealing a Qmax of 9ml and a post-void residual volume of 180ml, acute urinary retention requiring Foley catheterization with unsuccessful trial of voiding after Foley catheter removal. A comprehensive report of his evaluation is provided, including clinical history, physical examination, and para-clinical findings. We discuss the operative indication and review the relevant literature.