You have accessJournal of UrologyBPH & Infection & Imaging (V06)1 Sep 2021V06-09 TRANSURETHRAL HOLMIUM LASER DEROOFING OF A PROSTATIC ABSCESS Alberto Coscione, Juliet Campbell, and Peter Acher Alberto CoscioneAlberto Coscione More articles by this author , Juliet CampbellJuliet Campbell More articles by this author , and Peter AcherPeter Acher More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002021.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There are multiple techniques for draining prostatic abscesses. The traditional transurethral approach consists in using a loop or knife with monopolar or bipolar diathermy to deroof the abscess.We present a video recording of our centre's technique for effective deroofing of a prostatic abscess using a Holmium Laser fibre and HoLEP kit. The patient presented with urosepsis not responding to antimicrobial treatment and a very tender and abnormal digital rectal examination. Magnetic resonance imaging confirmed a sizeable prostatic abscess and the decision was made to proceed to transurethral drainage using a Holmium laser fiber. METHODS: The procedure was performed using a 24 Fr Olympus resectoscope with a HoLEP bridge and a 550 micron Lumenis laser fibre connected to a 120Watt laser.The patient underwent transurethral deroofing of the abscess followed by urethral catheterisation with an 18Fr 2-way catheter over a guidewire to ensure the catheter did not end in the abscess cavity. Pus was sent for microbiological culture and sensitivity and targeted antimicrobial treatment was commenced. RESULTS: The patient made a good post operative recovery and was discharged on day 4 following his procedure with appropriate antibiotics. He did not experience severe urethral bleeding or other immediate surgical complications. CONCLUSIONS: We found this technique to be a safe and effective way to deroof a prostatic abscess. The benefits include high accuracy of the laser fiber allowing precise and effective incision and haemostasis. The improved vision expedited the procedure which is key in a septic patient receiving a general anaesthetic.A further benefit over traditional monopolar diathermy was the ability to use 0.9% Saline solution for irrigation as opposed to hypotonic irrigants such as glycine which we wanted to avoid given the patient's age and septic state. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e451-e451 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alberto Coscione More articles by this author Juliet Campbell More articles by this author Peter Acher More articles by this author Expand All Advertisement Loading ...