Transurethral resection of a big Prostatic Abscess

65 y old male patient known to be longtime diabetic with no regular follow up, presented for acute urinary retention and obstructive renal failure (bilateral ureterohydronephrosis) on ultrasound.
Urine analysis and culture from Foley Catheter insertion were both negative for infection.
Blood tests showed leucocytosis with neutrophilia, high CRP level, and high PSA level around 32 ng/ml, creatinin level at presentation was 3.5 mg/dl.
Digital rectal exam: suspicious right prostatic lobe hard nodule.
Patient was started on antibiotics, and daily blood tests showed a drop of creatinin to 1.8 mg/dl, a drop of CRP and leucocytosis one week after Foley Catheter insertion.
To mention that the patient never presented fever or chills.
MRI of the prostate was done to rule out adenocarcinoma of the prostate (PSA 32 ng/ml with suspicious DRE): 80 g prostate with a prominent median lobe, 15 x 10 x 8 mm right prostatic base formation in the transitional zone near the right seminal vesicle implantation. This formation had the characteristics of an abscess on MRI.
Decision was to do transurethral resection of the prostate along with the prostatic abscess.
This video shows the first steps of the TUR prostate procedure and the unroofing of the prostatic abscess that was already described on prostatic MRI.
Thank you for watching and waiting for your comments...