Sunday, December 19, 2010


A 72- year- old gentleman came with retention of urine and altered renal parameters (Blood Urea 100 mg% and serum creatinine 7.6 mg%).The bladder was distended above the umbilicus and ultrasound showed the upper tracts showing bilateral backpressure changes ( cortical thickness on both sides was papery thin).The catheter was intoduced and the bladder was decompressed slowly and he developed post obstructive diuresis which was managed with proper fluid institution.
His creatinine dropped to 5 mg%.His prostate was 80 gm in size and serum PSA was within normal limits.The patient was a case of hypertrophic cardiomyopathy and has ejection fraction of 50%.
He was taken up for Laser prostatectomy and trilobar enucleation and morcellation was done uneventfully.Post-operatively the patient did well.
This case shows the safety of LASER prostatectomy in chronic renal failure patients.The advantage of LASER in such cases would be lesser bleeding, less chance of dyselectrolytemia( NS irrigation is used in contrast to Glycine in TURP)

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