A 72-year-old man walked into the surgical outpatient clinic complaining of some frequency passing his urine. This was the surprising appearance of his abdomen when he lay on the examination couch.
On taking a detailed history from the patient, he had experienced increasing frequency of micturition, dribbling and a poor stream for the past 5 or 6 years, but put this down to ‘getting old’ and did nothing about it. In the past 3 months this was becoming a real nuisance.
He was now dribbling urine 30 to 60 min during the day and several times at night and sometimes wet himself, especially in bed and while asleep. Apart from this, he felt quite well and had come to the clinic straight from working in his shop.
On examination, as can be seen in the image, he looked well with a good colour and a moist tongue. Abdominal examination revealed this large smooth, painless swelling, which reached to just above the umbilicus and which was dull to percussion. On rectal examination, the prostate was considerably and smoothly enlarged and was rubbery in consistency.
What’s the diagnosis ?
