61 yr male with frequency urgency nocturia poor flow straining since 6 months . his USG report attached. urine r/m 2-3 pus cells. diagnosis and management?


61/M with LUTS. I wish images were clearer.. anyways, looks like prostatomegaly.. kindly mention size and echotexture.. do S.PSA and proceed with TRUS guided bx if high.. else, start with alpha blockers like tamsulosin/alfuzocin and can add 5ARI like dutasteride.. right now, do a urine culture and if positive, treat UTI.. if repeated UTIs/urinary retention/failure of medical management, do TURP. If malignancy (CaP), proceed accordingly

and yes, DRE findings and PVRU are important aid in diagnosing.. as mentioned by previous doctor..

Post void residual urine? PR finding, benign gland? BPH TURP

BPH with OAB. Get a uroflow done. if mild symptoms and slightly reduced flow medical management. If mod or severe symptoms and significant obstruction, evaluate for fitness and go for turp. s. psa is part of preop workup.

I agree with Dr. Rajat on the management. In addition, I am able to appreciate a hyperechoic shadow in the bladder which could be a small vesical calculus. plain X Ray would be helpful. If there is a vesical calculus, stone removal and TURP to be done. otherwise medical management for BPH would be my first choice if PSA is normal.

Is that an Intraprostatic cyst or prostate gland seen on USG? Looks more cystic than solid. films are not very clear.

Excellent.. I agree with Dr Rajat sir

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