A 79 y gentleman underwent spine surgery and was put on LMW Heparin for DVT prophylaxis. On the post operative day 3, his PUC was removed and he went into retention. Foley's reattempted but failed leading to bleeding per urethra.
Urologist opinion was then sought.PUC was attempted only once by Urologist but could not succeed. Patient was counselled for SPC and risk of hematuria due to concomitant use of LMW Heparin therapy. Trocar SPC was done under LA at bedside and around 1 litre urine drained. Later he developed repeated SPC blockage due to clots which were flushed at regular intervals by bladder wash syringe.
Later it was decided to shift the patient to our center from outside facility,for cystoscopy and clot evacuation. On cystoscopy there was a false passage in bulbar urethra and obstructive prostate with huge clot in the bladder. As the bladder was already tense, any use of Elliks evacuator will increase the chances of bladder rupture. Hence the massive clot was removed by Morcellator completely under anaesthesiologist cover.
Urologist opinion was then sought.PUC was attempted only once by Urologist but could not succeed. Patient was counselled for SPC and risk of hematuria due to concomitant use of LMW Heparin therapy. Trocar SPC was done under LA at bedside and around 1 litre urine drained. Later he developed repeated SPC blockage due to clots which were flushed at regular intervals by bladder wash syringe.
Later it was decided to shift the patient to our center from outside facility,for cystoscopy and clot evacuation. On cystoscopy there was a false passage in bulbar urethra and obstructive prostate with huge clot in the bladder. As the bladder was already tense, any use of Elliks evacuator will increase the chances of bladder rupture. Hence the massive clot was removed by Morcellator completely under anaesthesiologist cover.
Thanks for sharing the information about the Large Bladder clot evacuated .
ReplyDeleteErectyle dysfunction treatment,Male Sexual Problem Treatment,Male Sexual Disorder Treatment