Case 1 - A 75-year-old married man leading a sedentary lifestyle developed bothersome LUTS, which coincided with starting medication for some breathing trouble diagnosed as COPD. On examination, DRE showed prostate of more than 40 grams. His kidney functions were normal. An ultrasound revealed a well-defined mass arising from the prostate and extending into the bladder (also called median lobe enlargement). He had high residual urine - 600 ml. He was catheterized and put on alpha blockers. After three weeks, it was found that trial without catheter was successful and he was advised regular follow up with local urologist.
Case 2 - A 65 year old widower noticed over a period of 2 years that his urine has become more frequent and he has to pass urine urgently. Occasionally he had bed wetting especially during cold season. On examination he had a palpable bladder and enlarged prostate. Investigations done revealed benign enlargement of prostate and chronic retention of urine with kidney insufficiency. He was catheterized for a period of 6 weeks when his kidney function became normal. He underwent TURP successfully with complete recovery of kidney functions.