A 75 year old gentleman came with the history of lower urinary tract symptoms not responding to medical line of the therapy.The investigations showed the prostate was of 60 gm size and residual urine of 200 ml.
The patient was a case of cardiac illness and had pacemaker being inserted in 2009.He was on acitrom and clopilet for anticoagulation.
The clopilet was stopped 5 days before the surgery and the acitrom 3 days before the surgery and was started on clexane injection subcutaneously 60 mg once a day.The cefazolin was used pre-operatively as the surgical prophylactic medication.
The median lobe (prominently enlarged) was tackled with enucleation technique and lasovaporisation was done for rest the prostate.The procedure was uneventful with no bleeding.
Post-operatively there was no hematuria and 18 Fr double lumen was used without the need for irrigation.
This case is brought forward to show how safely LASER prostatecomy can be done in such cases.The routine TURP method in cardiac patient is frought with the danger of fluid overload,TUR syndrome and risk of bleeding.The present case was done with antiplatelt agent aspirin continuance.
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