Just a surgical case discussion-

57/M came with C/o leaking urine from his operated site since 2 days.
Burning Micturition & a foleys in situ

History- pt was operated by an AYUSH person for laparoscopic right inguinal hernia 5 years ago, which failed
So he got operated for the same I.e open right inguinal hernioplasty 2 years later (with honestly the most horrible incision) after this surgery patient develops a swelling on the OP site after 3 years (now this is the recent history)
Now he developed a swelling at op site around 1 month from presenting complaints which was painful & was excised by the same person following which pt developed UTI & pt was catheterised & caused injury to urethra
Now the patient had a circumcision 7 days ago & transfer summary read “patient was operated for urinary bladder rupture 2 days back & is being transferred for leaking urine” since ofc he couldn’t cause more damage than this to a patient
This is how he looked
The doc also partially removed the infected mesh placed during hernioplasty
On admission his blood sugar was above 350, Hb less than 10 , cachexic , urine leaking like a waterfall.
In order to stabilise till OT his dressings soaked 6-8 gauze and gamjee twice and even thrice.
As we ran a few diagnostic tests like CT , upon seeing the videos a diagnosis was made of a 3mm rent left by the AYUSH in the bladder which caused accumulation and leakage of urine around for this poor man. Now the answer to this cannot be another surgery. He has had 3 recently
It would be really difficult to repair a fragile bladder & around.
My mentor Dr. Kailash Jawade, Dr. Kalpesh Chaudhary & us 3 residents on this case went ahead with as sir said
A guided catheter was placed in the bladder through the rent, skin sutures left open & penile foleys
The above video demonstrating the rent in bladder.
The patient was then done dressing for his open wound thrice a day, fb twice a day to alternate day to finally dressing at home for a few days.
Controlling sugars, building up albumin and good hygiene protocol is what helped
The drain was removed after some time and sutures kept open. The picture attached shall give you an over all view.
Patient was discharged on Post Op day 36 and there was no urinary leak. The dynaplast was removed.
It has been almost 2 months since this case and now the wound has completely healed. The patient is very happy and back with his family with good blood sugar levels & health.
Just wanted to say such blunders need to stop by other specialists , like do your own- homeo or ayurved
Don’t do what you’re not meant for, or if you are not confident in or not taught something.
This man’s life was ruined. The family was so disturbed , each passing day was tough & impatient for them. We developed the trust so things got better .

#MedTwitter #surgeonstwitter

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More from @aaminaa06

Jun 28
Life beyond what you think is life
From school to post graduation, from age 5 to 25 I think I’ve seen enough around me to know who am I, choose who I want to be.
School didn’t have social media, the friendships were real. It had chats & talks, nature trails , camps, singing & dancing.
By junior college friends changed, social media happened but it was still beautiful with travel and explore, eat ,talk and just sticking together during exams.
It even gave me the opportunity to see the negative side of peers, I saw underage alcohols, drugs and violence around me
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