70 years old, had DM, HTN, enlarged prostate 80gm, vaporized with thulium, twister fiber technique, had recurrent difficulty urination 3 months after. Cystoscopic evaluation revealed anterior lobe necrotic tissue decreasing the caliber of apical region, bladder neck is mildly high, and hypertrophied healing shelf of membrano prostatic urethra. 3 factors which contributed to the symptoms.
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