Cystoscopy, transurethral resection of prostate abscess
The 26 French resectoscope was then inserted per urethra and was able to navigate beyond the bulbar stricture and into the prostate and bladder. The wire was removed. Using the bipolar loop I began resecting the bulging left lateral lobe where the prostate abscess was likely to be based on review of prior imaging. After only 2 swipes with the resecting loop pus began to drain from the abscess cavity. I resected open this further to fully drain the abscess cavity and leave a larger opening to prevent reaccumulation. I drained some pus and sent it for culture. Approximately 25 mL of pus was drained in total. I then inspected the base of the cavity and there were no fistulous tracts present. I fulgurated the base for hemostasis and to prevent recurrence of this abscess. I was able to spare the bladder neck urethral sphincter/verumontanum. The abscess cavity was wide open by the end along the left side of the prostate. I then navigated back into the bladder and placed a wire back into the bladder. I removed the resectoscope and placed a 18 French council tip Foley catheter over the wire and into the bladder.
The 26 French resectoscope was then inserted per urethra and was able to navigate beyond the bulbar stricture and into the prostate and bladder. The wire was removed. Using the bipolar loop I began resecting the bulging left lateral lobe where the prostate abscess was likely to be based on review of prior imaging. After only 2 swipes with the resecting loop pus began to drain from the abscess cavity. I resected open this further to fully drain the abscess cavity and leave a larger opening to prevent reaccumulation. I drained some pus and sent it for culture. Approximately 25 mL of pus was drained in total. I then inspected the base of the cavity and there were no fistulous tracts present. I fulgurated the base for hemostasis and to prevent recurrence of this abscess. I was able to spare the bladder neck urethral sphincter/verumontanum. The abscess cavity was wide open by the end along the left side of the prostate. I then navigated back into the bladder and placed a wire back into the bladder. I removed the resectoscope and placed a 18 French council tip Foley catheter over the wire and into the bladder.
