Dr Jo Schoeman
Urological Surgeon

        

Trans Urethral de-roofing of Prostate Abcess

Product Summary: AMA rates Opening up of the abcess to drain into the urethra

Item Number: 37211, 105

Non invasive opening of an abscess found in the prostate, Very similar to a TURP with the exception that the bladder neck is preserved

Why is it done?

  • This procedure is performed when you have been diagnosed with a prostatic abcess, usually after an MRI investigation.
  • You would have had a history of swinging low to high grade fevers, a history of catheterization or instrumentation of the urethra, possibly a prostate biopsy.
  • Not improving on Antibiotics.
  • You may possibly be very sick with High Dependancy Unit admission on intravenous antibiotics.
  • This procedure is done where the abcess or fluid collection in the parenchyma of the prostate is in the transitional zone of the prostate and easily accessible via endoscopic technique.
  • It is done under a General Anaesthetic with prophylactic antibiotics in place, or appropriate Antibiotics as per your serum cultures.

How is it done?

  • Patients will receive a general Anaesthesia unless otherwise indicated.
  • A cystoscopy is performed by placing a camera in the urethra with the help of lignocaine gel.
  • The inside of the prostatic urethra and bladder is viewed for pathology and especially signs of the abcess. If any suspicious lesions are seen, a biopsy will be taken.
  • The area of the prostatic urethra above the abcess is resected until the abcess is opened and drained.
  • The bladder neck and urethral sphincter is preserved.
  • Laser can also be utilized and is probably preferred due to lack of bleeding.
  • Prophylactic antibiotics will be given to prevent any infections.

What can go wrong?

  • Any anaesthesia has its risks and the anaethiatist will explain this to you.
  • You will wake up with a catheter in your urethra and bladder. This will remain in the bladder for 1-3 days depending on the technique used and incidence of post-operatve bleeding. And until signs of sepsis have cleared.
  • You may have a continuous bladder irrigant running in and out of your bladder to prevent clot formation.
  • Lower abdominal discomfort for a few days.
  • NB! Each person is unique and for this reason symptoms vary!

What next?

  • You will be hospitalised until all signs of sepsis have cleared.
  • You will a trial without catheter as soon as your urine is clear.
  • You will be discharged as soon as you can completely empty your bladder.
  • You may initially suffer from urge incontinence and will improve within the next 6 weeks.
  • Allow for 6 weeks for stabilization of symptoms.
  • You may have a change in ejaculate volume and could even suffer retrograde ejaculation.
  • There may be some blood in your urine. You can remedy this by drinking plenty of fluids until it clears.
  • A ward prescription will be issued on your discharge, for your own collection at any pharmacy.
  • A follow-up appointment will be scheduled for 6 weeks. Should your pathology be worrisome, you will be contacted for an earlier appointment.
  • Don’t hesitate to ask me if you have any queries.
  • DON’T SUFFER IN SILENCE, OR YOU WILL SUFFER ALONE!

Trans Urethral De-Roofing of Prostate Abcess Trans Urethral De-Roofing of Prostate Abcess (312 KB)