History of present illness:
the patient was normal civil pilot until one year ago when accidentally discovered ultrasonically & by CT-scan a huge central abdominal cystic lesion.!! then under G.A. & after putting Foley catheter about nine litters of urine was evacuated so the abdominal distention was relieved..the problem now is inability to urinate without using a catheter..all investigations were normal.!! is there is any chance of cure? & how??
he was hypertensive before the bladder was evacuated,,now he has normal blood pressure.
Past surgical history:
now he is on a prophylactic dose of oral (antibiotic)norfloxacine.
was consuming a alcohol & smoker until one year ago..
within normal range in this age group.
Head, ears, eyes, nose & throat:
cant urinate without using a catheter..
was suffering from bleeding hemorrhoid before evacuation of the urinary bladder,,now there is no problem.
pus cells,R.B.C.s& epithelial cells in urine.
Plan of treatment:
training of urinary bladder by intermittent catheterization..(opening the catheter every four hours to evacuate then close it again)..
Results of treatment:
no progress till now apart from felling of urgency sometimes relieved by opening the catheter..
after excluding the neurological & organic causes of a tonic bladder it seems that the patient was ignoring the feeling urgency for along time-over years- during work..
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