Minimal invasive management for the relief of LUTS (lower urinary tract symptoms) or Urinary Retention
Why is it done?
- This procedure is performed when the prostate gland is causing LUTS and you want an alternative to long anaesthetic procedures
- Symptoms include: a weak stream, nightly urination, frequent urination, inability to urinate, (LUTS) and Urinary Retention
- This is alternative to an invasive procedure where long periods of anaesthetic is contraindicated.
- Usually for chronically sick patients who cannot undergo surgery, yet are active enough not to want a permanent catheter.
- Usually, a trial of alpha-blockers would be attempted and Step-up Therapy with 5 Alpha Reductase Inhibitors have been unsuccessful
- Any prostate size
How is it done?
- Patients will receive sedation with local anaesthetic gel placed in the urethra.
- A cystoscopy is performed by placing a camera in the urethra with the help of a lubricant jelly and an irrigant fluid.
- The measurements of the prostatic urethra are taken (length)
- Appropriate length coil is chosen.
- The device is placed through the cystoscopic sheath, to sit snug in the prostate urethra stretching from the bladder neck to the apex of the prostate
- Prophylactic antibiotics will be given to prevent any infections.
- Retrograde Ejaculation
- Possibility of Infertility due to retrograde ejaculation,
- Stress incontinence especially in the elderly and diabetic patients
- Urgency and urge Incontinence especially until Detrusor Hyperactivity dissipates
- Urge symptoms may persist due to detrusor fibrosis caused by long term bladder outlet obstruction
- May experience a slower stream initially due to swelling
- Possible infection due to cystoscopy (<2%)
- Migration of the device into the bladder, requiring a procedure to retrieve this.
- Long term yields the risk for encrustation and recurrent infections
- NB! Each person is unique and for this reason, symptoms vary!
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Copyright 2019 Dr Jo Schoeman