What kind of treatment should I take?

Patient

Q: Had a Turp since 10 weeks ( 75 days ) ago; and had yesterday an ultrasound indicating : enlarged prostate gland with TURP defect : an enlarged prostate gland of 35.8 cc; pre-void and post- void scans measure 278.1 cc and 44.0 cc and having also an infection shoswing in the urinalysis WBC/hpf : 20-22 and RBC/hpf: 2-4/HPF what should I do?

Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,
This definitely is a failed TURP with secondary infection which has set in confirmed by pus cells and red blood cells in urine. The remaining 35.8 cc enlarged prostrate still remaining and causing urinary retention due to kinking of urethra and further infection.

It is suggested that presently urinary antibiotics should be started immediately and the infection should be neutralized completely first and then it can be followed by surgical options which are now limited to :-
1. Open prostatectomy (open surgery). This surgery is often done when the prostate is greatly enlarged, when there are complications, or when the bladder has been damaged and needs repair. In open surgery, the surgeon makes an incision and removes the enlarged tissue from the prostate.

2. Laser surgery. Laser surgery uses laser energy to destroy prostate tissue and shrink the prostate. Laser surgery may not be effective on larger prostates.
TURP should not be repeated as defect has already been created and repeat TURP would likely enlarge the defect further and increase failure. The surgery should be planned 3 weeks after treatment of infection. Yuma discuss the options with your surgeon and take an informed decision.

I hope i have answered your query in detail,
Wishing you good health,
Regards

Comments / Follow Ups

Patient: what do greatly enlarged and larger prostates mean? mine is now (after a TURP defect) is 35.8 cc, is considered as what?
Doctor: The normal prostate size for an adult male is 15cc to 30cc (one half ounce to one ounce). Men whose prostate gland is larger than 30 cc are more likely to be diagnosed with benign hyperplasia (enlargement). 35.8cc in moderately enlarged prostrate.
regards
Patient: So with turp defect and with the prostate gland at 35.8 cc; laser surgery will be acceptable or any prescribed oral medicine can be applied or any other more suitable type of surgery?
Doctor: you can opt for laser surgery.
Patient: if laser surgery is not available in where I am?
Doctor: Then the open surgery would be the option, but a repeat TURP shall be difficult.
Regards
Patient: how long do you need to stay in the hospital after a laser surgery and a open surgery for prostate enlargement respectively?
Patient: no oral medicine can apply for this TURP defect ?
Doctor: you may continue on tamsulosin if its been prescribed already for you till you are planned for repeat surgery.
regards

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