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Bladder explosion during transurethral resection of prostate: Bladder diverticula as an additional risk factor

Vesical explosion during transurethral resection of the prostate (TURP) is a very rare occurrence. Very few cases have been reported in the literature. The literature was reviewed pertaining to the etiology of bladder explosion during transurethral resection. The underlying mechanism for intravesica...

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Autor principal: Vincent, D. Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308042/
https://www.ncbi.nlm.nih.gov/pubmed/28216933
http://dx.doi.org/10.4103/0974-7796.198887
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author Vincent, D. Paul
author_facet Vincent, D. Paul
author_sort Vincent, D. Paul
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description Vesical explosion during transurethral resection of the prostate (TURP) is a very rare occurrence. Very few cases have been reported in the literature. The literature was reviewed pertaining to the etiology of bladder explosion during transurethral resection. The underlying mechanism for intravesical explosion is the generation and trapping of explosive gasses under the dome of the bladder which eventually detonates when it comes into contact with the cautery electrode during TURP. Various techniques have been suggested to prevent this dreaded complication. A 75-year-old male with chronic retention of urine underwent TURP. There was Grade 2 trilobar enlargement of the prostate. There were multiple diverticula with one large diverticulum in the dome of the bladder. During hemostasis, there was a loud pop sound and the bladder exploded. Lower midline laparotomy was performed and the intraperitoneal bladder rupture was repaired. He had an uneventful postoperative recovery, and he is asymptomatic at 6 months of follow-up. Even though all the precautions were taken to avoid this complication, bladder rupture was encountered. The presence of multiple diverticula is being suggested as an additional risk factor for this complication as the bladder is thinned out and also possibly due to trapping of air bubble within the diverticulum. In such cases where there are multiple bladder diverticula, the employment of a suprapubic trocar for continuous drainage of the air bubble, could well be a practical consideration.
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spelling pubmed-53080422017-02-17 Bladder explosion during transurethral resection of prostate: Bladder diverticula as an additional risk factor Vincent, D. Paul Urol Ann Case Report Vesical explosion during transurethral resection of the prostate (TURP) is a very rare occurrence. Very few cases have been reported in the literature. The literature was reviewed pertaining to the etiology of bladder explosion during transurethral resection. The underlying mechanism for intravesical explosion is the generation and trapping of explosive gasses under the dome of the bladder which eventually detonates when it comes into contact with the cautery electrode during TURP. Various techniques have been suggested to prevent this dreaded complication. A 75-year-old male with chronic retention of urine underwent TURP. There was Grade 2 trilobar enlargement of the prostate. There were multiple diverticula with one large diverticulum in the dome of the bladder. During hemostasis, there was a loud pop sound and the bladder exploded. Lower midline laparotomy was performed and the intraperitoneal bladder rupture was repaired. He had an uneventful postoperative recovery, and he is asymptomatic at 6 months of follow-up. Even though all the precautions were taken to avoid this complication, bladder rupture was encountered. The presence of multiple diverticula is being suggested as an additional risk factor for this complication as the bladder is thinned out and also possibly due to trapping of air bubble within the diverticulum. In such cases where there are multiple bladder diverticula, the employment of a suprapubic trocar for continuous drainage of the air bubble, could well be a practical consideration. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5308042/ /pubmed/28216933 http://dx.doi.org/10.4103/0974-7796.198887 Text en Copyright: © 2017 Urology Annals http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Vincent, D. Paul
Bladder explosion during transurethral resection of prostate: Bladder diverticula as an additional risk factor
title Bladder explosion during transurethral resection of prostate: Bladder diverticula as an additional risk factor
title_full Bladder explosion during transurethral resection of prostate: Bladder diverticula as an additional risk factor
title_fullStr Bladder explosion during transurethral resection of prostate: Bladder diverticula as an additional risk factor
title_full_unstemmed Bladder explosion during transurethral resection of prostate: Bladder diverticula as an additional risk factor
title_short Bladder explosion during transurethral resection of prostate: Bladder diverticula as an additional risk factor
title_sort bladder explosion during transurethral resection of prostate: bladder diverticula as an additional risk factor
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308042/
https://www.ncbi.nlm.nih.gov/pubmed/28216933
http://dx.doi.org/10.4103/0974-7796.198887
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