Group 2

The skenario
One man - 55-year-old went to the doctor because
of difficult urination
keyword
Key words to note from the above scenario are:
1. Age 55 years
2. Man
3. difficult urination
 problem
1. What causes difficult urination?
2. Is there a relationship between age with difficult
urination?
3. Organ - any organ system-related urinalis?
4. How to diagnose it?
5. How to its management?
Discussion
restriction
BPH (benign prostate hyperplasia)
Prostate Ca
 Clinical Symptoms
Anamnesa
1. identity
Name: Jack
Age: 55 years
2. Main complaint
Difficult urination
3. History Now Diseases (RPS)
Difficult urination since 3 months ago
No treatment because not accompanied by pain during urination (BAK)
Initially when urinating, urine fell near the feet, so if you will have to push BAK
Patients mengeluha a lack of appetite
4. Formerly a history of disease (RPD)
First no complaints
5. Family History
father had hypertension
6. Social History
Work marketing
Smoking 4-5 sticks a day
 Physical Examination

1. General Condition
looks weak
GCS: 4/5/6
2. vital Sign
Blood pressure: 120/80 mmHg
Pulse: 80 times
Respiratory Rate (RR): 24 times
Temperature: 37 C
3. inspection
Head and Neck
- Anemia: -
- Jaundice: -
- Dyspnea: -
- Cyanosis: -
 thorax
a. Cor (Heart): In normal circumstances
b. Lungs:
- Motion breath symmetric
- Sound vesicular
- Ronchi: - / -
c. abdomen:
- Distanded (enlarged)
- meteorismus
- Bowel: Normal
- Liver / Lien: No palpable
- Gallbladder urinary: bladder augmentation palpable 2 cm
above the symphysis pubis
d. extremity
- Akral: Warm
- Edema: Negative
 Examination Support

Rectal toucher (Plug Rectum): Prostate

palpable hard and berdungkul-dungkul in
the posterior lobe
 DIFFERENTIAL DIAGNOSIS

BPH
Ca Prostat
Final Hipotesa
Based on the analysis of differential diagnose we
found that the final hypothesis is Ca Prostat
 Treatment
Surgery
1. Prostatektomi radical
removal of the prostate gland
2. Orkiektomi
removal of the testis
 Radiation Therapy
1. External radiation therapy
2. Transplants of Iodium and the other
iridium radioactive
Drugs
Manipulation of Hormone
Used for reduce of testosterone hormone
with synthetic drug similar to LHRH
Chemotherapy
Used for reduce the symptoms of cancer
that resistant with hormonal treatment
EX: Mitoxantronx, Prednison,
Paclitaxel, Estramustin, Adriamycin
 Prognosis and Complication
Prognosis
The most important indicator of Prognosis in
determining CA Prostate based on the degree of
differentiation, the size of the tumor, and the incidence
of penetration of the capsule. For A good differentiation
stage, without metastases can live long, When extensive
lesions survivor 5 years can reach about 85%. Patient
stadium B 20-25% with metastasis lymph glands,
survivor 5 years dropped obviously. Stadium C and D
castrati estrogen therapy (Orkidektomi) the
effectiveness of about 60-80%.
 Complications
1. Erectile dysfunction
Effect of prostate cancer treatment by radiation,
surgery, or using hormonal therapy
2. Incontinence
Inability of a bodily is to control the intestines, or
function the bladder. Incontinence usually temporary, or
can also is permanent
3. Painful

4. Depression