Post-Surgery of Prostate resection

A 50 year old male presented to OPD with complaints of difficulty in passing urine He has been asked to self insert foley cathether 16 FR every morning to vacate his bladder to prevent closure of his urethra History He has taken course of levoflox 750mg for 15 days plus fosfomycin in the past Vitals His vitals are WNL and he was asked to repeat TLC to check for infection, but till now no increase in TLCs Investigations His all current USG shows cystitis with no significant PVRU Management My concerns are first - 1) Can someone explain me about what is evident from this scan? 2) What would be the next line of management for this patient?

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Dear Dr.Ajitji You did not mention in the history....Which surgery was performed..? By which technique? And when...As you labeled the post az Post Surgical complication. ! Pl.be specific If the surgery was performed for pelvo ureteric obstructive lession like urinary litheasis, than whole scene would be focused on different angel....If Prostatectomy...than to think other way.. Co morbid like DM also to be mentioned. Regards.

Sir, even I dont know which surgery he underwent poor guy. He dont have any discharge paper. Moreover, he has been asked to self insert foleys daily to prevent closure of urethra.
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Regarding the post may things remai unexplained what was the operation done and for what problem Pt was advised for self catheterisation to prevent closure of the urethra is also not understood Retrograde cysto urethrogram showing stricture of the proximal part may be due to injury urethra and to rule out bladder neck obstruction. Next line of management to seek opinion of urologist for urethroplasty

Thanks Dr Ajit Singh
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Sir, it's an Evidence of Trans urethral resection of prostate and urethral narrowing in bulbous (penile) urethra due to structure formation Management - urethral dilation with gradually increasing size of catheter under all aseptic precautions, adv pt to not to do himself, it may cause severe infection or injury to the urethra. Investigate for CBC, RFT and uroflometry test.

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Retrograde cysto-urethro graphy shows as simole as stricture post protectomy, divertcula / ?papilarymass, due to recurrent chr urethral truma/ growth, may be remmainent prostatic tissue,? needs follow complete history, biopsy histology rule out malignacey vesical papilomas. prostatic malignency.

Cystic diverticula rt side Self insertion of Foley catheter neither advisable and cannot be safe

Thanx dr Ajeet Singh
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? CYSTITIS.. ? UTI.. NEED'S.. URINE C AND S EXAMINATION.. BSR..HBA1C.. UROLOGISTS OPINION

Tnx Dr Pranab Bera
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I am agree with Dr Dineshchandra Sharma Sir and Dr Kute Ankush Sir.

Thank you Sir@Dr. Kute Ankush
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Stricture bulbar urethra,- post prostatectomy. Needs dilatation

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Check urethral dilatation will help

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