Giant prostatic enlargement: A presentation of a rare asymptomatic case

Baurzhan Kilibayev 1 * , Gafour Khairli 1, Ulanbek Zhanbyrbekuly 1, Sherniyazdan Abdugalimov 2, Nurbol Keulimzhayev 1, Yerzhan Sharapatov 1, Rano Zhankina 1
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1 Department of Urology and Andrology, Astana Medical University, Astana, Kazakhstan
2 Department of Uroandrology, City Hospital 1 of Astana, Astana, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 20, Issue 4, pp. 71-75.
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Benign prostatic hyperplasia is a histological diagnosis and the most frequent benign tumor in older men, and its incidence strongly correlates with advanced age. Giant prostate enlargement (GPE), also known as giant prostatic hyperplasia, is a term given for severely enlarged prostates that weigh more than 500g. GPE cases reported in literature is less than 30. We describe our experience of removing previously asymptomatic 528g prostate by open transvesical prostatectomy. According to transrectal ultrasound (TRUS) the prostate size is 482 ml and prostate‑specific antigen level of 5.1 ng/ml. Histological examination showed nodular prostatic hyperplasia, an adenomatous variant with foci of cystic atrophy, chronic prostatitis. The patient's post-operative recovery went without any relapses and complications.


Kilibayev B, Khairli G, Zhanbyrbekuly U, Abdugalimov S, Keulimzhayev N, Sharapatov Y, et al. Giant prostatic enlargement: A presentation of a rare asymptomatic case. J CLIN MED KAZ. 2023;20(4):71-5.


  • Lee C, Kozlowski JM, Grayhack JT. Intrinsic and extrinsic factors controlling benign prostatic growth. Prostate. 1997;31(2):131-138.<131::AID-PROS9>3.0.CO;2-Q
  • Auffenberg GB, Helfand BT, McVary KT. Established medical therapy for benign prostatic hyperplasia. Urol Clin North Am. 2009;36(4):443-459, v-vi.
  • Martin SA, Haren MT, Marshall VR, Lange K, Wittert GA, Members of the Florey Adelaide Male Ageing Study. Prevalence and factors associated with uncomplicated storage and voiding lower urinary tract symptoms in community-dwelling Australian men. World J Urol. 2011;29(2):179-184.
  • Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132(3):474-479.
  • Agarwal A, Eryuzlu LN, Cartwright R, et al. What is the most bothersome lower urinary tract symptom? Individual- and population-level perspectives for both men and women. Eur Urol. 2014;65(6):1211-1217.
  • Kupelian V, Wei JT, O’Leary MP, et al. Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) Survey. Arch Intern Med. 2006;166(21):2381-2387.
  • Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-178.
  • Fishman JR, Merrill DC. A case of giant prostatic hyperplasia. Urology. 1993;42(3):336-337.
  • McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185(5):1793-1803.
  • Ficarra V, Rossanese M, Zazzara M, et al. The role of inflammation in lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and its potential impact on medical therapy. Curr Urol Rep. 2014;15(12):463.
  • He Q, Wang Z, Liu G, Daneshgari F, MacLennan GT, Gupta S. Metabolic syndrome, inflammation and lower urinary tract symptoms: possible translational links. Prostate Cancer Prostatic Dis. 2016;19(1):7-13.
  • Maliakal J, Mousa EE, Menon V. Giant Prostatic Hyperplasia: Fourth largest prostate reported in medical literature. Sultan Qaboos University Medical Journal. 2014;14(2):e253.
  • Thorpe A, Neal D. Benign prostatic hyperplasia. Lancet. 2003;361(9366):1359-1367.
  • Zeng QS, Zhao YB, Wang BQ, Ying M, Hu WL. Minimally invasive simple prostatectomy for a case of giant benign prostatic hyperplasia. Asian J Androl. 2017;19(6):717-718.
  • Autorino R, Zargar H, Mariano MB, et al. Perioperative Outcomes of Robotic and Laparoscopic Simple Prostatectomy: A European–American Multi-institutional Analysis. European Urology. 2015;68(1):86-94.
  • Uffort EE, Jensen JC. Robotic-assisted laparoscopic simple prostatectomy: an alternative minimal invasive approach for prostate adenoma. J Robotic Surg. 2010;4(1):7-10.
  • Bhatia S, Kava B, Pereira K, Kably I, Harward S, Narayanan G. Prostate Artery Embolization for Giant Prostatic Hyperplasia. J Vasc Interv Radiol. 2015;26(10):1583-1585.
  • Ojewola R, Tijani K, Fatuga A, Onyeze C, Okeke C. Management of a giant prostatic enlargement: Case report and review of the literature. Niger Postgrad Med J. 2020;27(3):242.
  • Walker JWT. Hæmorrhage and post-operative obstruction in suprapubic prostatectomy : And an open operation for their prevention. British Journal of Surgery. 2005;7(28):525-536.
  • Middleton RP. How large is the hyperplastic prostate?: report of the largest hypertrophied prostate ever surgically removed. Journal of the American Medical Association. 1937;108(23):1967-1968.
  • Wadstein T. The largest surgically removed hypertrophied prostate. Journal of the American Medical Association. 1938;110(7):509.
  • Gilbert JB. One–stage suprapubic prostatectomy for a glande weighing713 grams (one and ane-half pounds). Urol Cutan Rev. 1939;43(3):309-10.
  • Nelson CJ, Diblasio C, Kendirci M, Hellstrom W, Guhring P, Mulhall JP. The chronology of depression and distress in men with Peyronie’s disease. J Sex Med. 2008;5(8):1985-1990.
  • OCKERBLAD N. F. Giant prostate; the largest recorded. The Journal of UROLOGY. 1946; 56, 81.
  • Bacon SK. Retropubic Prostatectomy: Early Technical Difficulties, Report of Removal of Giant Prostate1. Journal of Urology. 1949;61(3):571-574.
  • Lantzius-Beninga F. [A prostate of world record size]. Z Urol Nephrol. 1966;59(1):77-79.
  • Ashamalla GR, Ahmed AM. Giant Prostatic Hypertrophy. Archives of Surgery. 1972;105(5):769-770.
  • Kitagawa, R., et al. "The largest BPH and Japan." Case report and review of the literature. RinshoHinyokika 34 (1980): 467-471.
  • Tolley DA, English PJ, Grigor KM. Massive Benign Prostatic Hyperplasia. J R Soc Med. 1987;80(12):777-778.
  • Medina Pérez M, Valero Puerta J, Valpuesta Fernández I, Sánchez González M. [Giant hypertrophy of the prostate: 2,410 grams of weight and 24 cm in diameter]. Arch Esp Urol. 1997;50(7):795-797.
  • Hosseini SY, Safarinejad MR. Huge benign prostatic hyperplasia. Urol J. 2004;1(4):276-277.
  • Yilmaz K, Istanbulluoglu O, Guven S, Kilinc M. Giant prostatic hyperplasia: case report. Int Urol Nephrol. 2006;38(3-4):587-589.
  • Sood R, Jain V, Chauhan D. Giant prostatic hyperplasia: Surgical management of a case. Journal of Postgraduate Medicine. 2006;52(3):232.
  • Akpo, E., & Akpo, M. Giant benign prostatic hyperplasia in a nigerian: report of a case. The Internet Journal of Urology. 2010; 8(1).
  • Üçer O. •Giant prostatic hyperplasia: Case report and literature review. Dicle Med J. 2011;38(4):489-491.
  • Appiah AA, Amoah G, Azorliade R, et al. Case Report: Giant Benign Prostatic Hyperplasia in a Ghanaian. Journal of Medical and Biomedical Sciences. 2014;3(2):14-17.
  • Khan Z, Tahir M, Ashraf HS, et al. Giant Benign Prostatic Hyperplasia in a Pakistani Patient. Urol Case Rep. 2014;2(1):33-34.
  • Wroclawski ML, Carneiro A, Tristão RA, et al. Giant prostatic hyperplasia: report of a previously asymptomatic man presenting with gross hematuria and hypovolemic shock. Einstein (Sao Paulo). 2015;13(3):420-422.
  • Jm L, R B, L H, S S. Retropubic prostatectomy for giant benign prostatic hyperplasia. The Canadian journal of urology. 2015;22(5).
  • Domínguez A, Gual J, Muñoz-Rodríguez J, et al. Giant Prostatic Hyperplasia: Case Report of 3987 mL. Urology. 2016;88:e3-4.
  • Wang L, Davis P, McMillan K. A case of giant prostatic hyperplasia. Asian J Urol. 2016;3(1):53-55.
  • Egote AK, Ossei PPS, Taylor J, Bortier T. Enucleation of a Giant Prostatic Hyperplasia in Ghana: A Case Report and Mini Literature Review. Case Reports in Clinical Medicine. 2018;07(12):583.
  • Anglickis M, Platkevičius G, Stulpinas R, et al. Giant prostatic hyperplasia and its causes. Acta Medica Lituanica. 2019;26(4):237.
  • Aghamir SMK, Khatami F, Rahimi MR, Guitynavard F. Giant benign prostatic hyperplasia: A case report. Urol Case Rep. 2020;28:101051.
  • Cui D, Chen G, Luo J, Zhang M. The first case of bipolar transurethral resection of the prostate for giant prostatic hyperplasia: A case report. Medicine. 2022;101(51):e32455.