August 2023

UROLOGY

CASE REPORT: XGP IN A 65-YEAR-OLD MALE PATIENT

A 65-year-old male patient with past medical history of chronic kidney disease presented to the Northwestern Medicine Complex Urologic Infections Program (CUIP) for management of xanthogranulomatous prostatitis (XGP). This is rare condition that can mimic prostate cancer.
 
The patient first developed symptoms of dysuria in fall 2022 but did not undergo evaluation at that time. A month later, he had worsening symptoms of:
  • Dysuria
  • Difficulty passing urine
  • Pelvic pain
 
These symptoms prompted him to seek care at an emergency department. Urine studies were consistent with infection, and imaging with MRI demonstrated a pelvic mass originating from the prostate. He was seen by Urology and underwent cystoscopy and prostate biopsy. The biopsy revealed XGP.
 
Following that, the patient developed symptoms due to a complicated urinary tract infection requiring treatment with antibiotics. Then, he followed up with Urology with a plan for transuretheral resection of the prostate (TURP) and was referred to the CUIP for ongoing bacteruria. Medical comorbidities needing stabilization delayed surgical management. Thus, he was placed on long-term antibiotics while awaiting definitive surgery with a TURP to remove the nidus of recurrent infection and bacteriuria.
 
XGP is not a common diagnosis, so this case highlights the success of inter-departmental collaboration to develop a unique treatment plan that kept the patient stable and out of the hospital. He eventually underwent surgery without complication.
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