DATE OF PROCEDURE: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Persistent gross hematuria.
POSTOPERATIVE DIAGNOSIS: Large prostatic varices with hemorrhagic ascites.
PROCEDURES PERFORMED:
1. Cystoscopy.
2. Transurethral fulguration and resection of prostatic varices.
SURGEON: John Doe, MD
ANESTHESIA: General.
DESCRIPTION OF PROCEDURE: The patient was brought to the cystoscopy suite where general anesthesia was induced and maintained in the usual fashion without difficulty. The patient was then placed in the dorsal lithotomy position. The external genitalia were prepped and draped in a routine fashion. Foley catheter has been removed.
A 21-French ACMI panendoscope was assembled and inserted into the patient’s bladder without difficulty. Inspection revealed no abnormalities of the urethra. The prostate was not particularly enlarged, but there were many large blood vessels on the surface of the prostate. These looked markedly inflamed and to some extent are bleeding.
The bladder was entered. There was considerable inflammation and bleeding of the trigone. There were large blood vessels on the back wall of the bladder neck, and these were also bleeding somewhat. There were numerous clots within the bladder; although, they looked old.
The bladder was then carefully and systematically inspected. There was no tumor present. There was just inflammation. Diffuse hemorrhagic cystitis was noted. There was also diffuse trabeculation with many small cells and diverticula. Clots were irrigated from the bladder using an Ellik evacuator, and these were of course discarded.
A 24-French resectoscope sheath was now inserted into the bladder with obturator. Resection of the prostatic varices was now begun without any difficulty. These were destroyed and all bleeding came to a stop. Any debris was removed from the bladder with an Ellik evacuator at this point. There was no real specimen for pathology.
An 18-French Foley catheter was then inserted into the bladder without difficulty. The balloon was inflated to approximately 15 mL and the catheter remained clear. The procedure was completed. The patient was then awakened and taken to the recovery room in good condition.
