Gross prostatomegaly with seminal vesicle hematoma presenting as acute retention of urine

MORCELLATED PROSTATIC CHIPS


MRI SHOWING PROSTATOMEGALY WITH GROSS SEMINAL VESICLE DILATATION WITH MASS WITHIN

A 65 year old gentleman came with acute retention of urine.He was catheterised with 18 Fr Foleys catheter; around 1.2 litres of urine drained out.His imaging showed gross prostatomegaly with seminal vesicle dilatation and mass in the seminal vesicle.He further underwent MRI pelvis which demonstrated prostatomegaly with seminal vesicular cyst and hematoma/mass inside.His PSA value was normal and his previous TURPs(he underwent two TURPswithin a span of 2 years for acute retention of urine).The Histopathological analysis showed benign prostatomegaly only.He was taken up for laser prostatectomy and was planned for review imaging after 3 weks for seminal vesicular hematoma/mass.The catheter was removed on second day post-operatively and he passed urine in good stream with low residual urine volume.His histopathological analysis was again benign.In the post-operative period he presented with seconary bleeding on 7 Th day; so was taken up for cystoscopy and clot evacuation.There was organised clot in the prostatic fossa measuring around 6X6 cm.The mass had to be morcellated with the morcellator.After the procedure he was comfortable with clear urine.He was given catheter free trial two days later and passed urine freely.Review Imaging showed no seminal vesicular mass/dilatation.The prostatic mass was probably decompressed seminal vesicular hematoma which probably would have resulted in resolution of seminal vesicular dilatation.