INTEREST OF BIPOLAR PHOTOVAPORIZATION IN THE TREATMENT OF PROSTATE ADENOMA IN THE PRESENCE OF SEVERE THROMBOPENIA
A. HEDDAT, R. RABII
Department of Urology Cheikh Khalifa International University Hospital
Mohammed VI University of Health Sciences Casablanca
Severe thrombocytopenia in a patient with benign prostatic hypertrophy with a bladder catheter and who is to benefit from chemotherapy for leukemia is particularly difficult to manage. The advent of plasma bipolar vaporization is an interesting therapeutic alternative allowing a better result without bleeding risk.
Through a medical observation we will show the possibility of surgically treating benign prostatic hyperplasia in a patient at high risk of hemorrhage.
Patient aged 53 years, followed for acute monoblastic leukemia requiring chemotherapy, and who has acute retention of urine on a benign prostatic hypertrophy, not responding to medical treatment.
The objective rectal examination is a prostatic hypertrophy of benign appearance.
The biological evaluation showed a severe thrombocytopenia with 10000 platelet elements.
Vesico-prostatic ultrasound showed an enlargement of the prostate gland of 56 g and presence of a median lobe (figure 1).
In the management of its leukemia, oncologists opt for chemotherapy, however the presence of the bladder catheter leads to fear of a urinary infection, which requires urgent surgical treatment of the adenoma of the prostate.
After transfusion of platelet pellets, a transurethral resection in saline was performed with a platelet count of 40,000 cells, without intraoperative hemorrhage (figure 2).
The sequences were simple, no blood transfusion and ablation of the bladder catheter at day 1 postoperatively.
Bipolar photovaporization has become a very interesting therapeutic option in prostate surgical procedures particularly for patients with high haemorrhagic risk.