Editorial
March 22, 2024
A 23-year-old man comes to your consultation with a bladder infection. He says that urinating has been gradually becoming more and more difficult for a few years and that he has been afraid a few times that he will not be able to urinate at all. The jet is weak, sprays quite often and there is almost always some dripping. Straining doesn’t really help. Now that he has had a bladder infection, he has had enough.
Research
Physical examination reveals a normally developed genitalia. The meatus is smooth and wide and positioned in the normal position. The foreskin is easily retractable, the penis and scrotum are also normal. Rectal examination is somewhat painful, because the patient is very tense. However, control is good.
Patient does a urine test on a flow meter. This shows how the puddle progresses: the force of the jet is plotted against the time it takes to puddle, see image.
An ultrasound is then used to determine whether there is any residue: after urinating 271 ml, there is still 219 ml in the bladder, see image.
What is your diagnosis?
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