Intravesical Explosion during Transurethral Resection of Prostate - a reminder

Bladder Explosion during Transurethral Resection of the Prostate Repaired Laparoscopically: A Case Report and Review of the Literature

OBJECTIVE

To report on a case of intravesical explosion during transurethral resection of the prostate (TURP) which was managed laparoscopically and to review the relevant literature.

CLINICAL PRESENTATION AND INTERVENTION

During TURP, a loud explosion was heard, and a jolt was felt in the abdomen. A bladder tear was seen endoscopically. Systematic laparoscopic exploration showed no injury to abdominal organs apart from the irregular large bladder tear which was repaired laparoscopically. The patient had an uneventful recovery.

CONCLUSION

Bladder explosion during TURP is an extremely rare and serious complication. It should be considered as a blast injury and systematic exploration of abdominal organs and vessels should be performed. The severity and urgency of the condition should not preclude the use of laparoscopy for exploration and repair.

Transurethral Resection of the Prostate, Bladder Explosion and Hyponatremic Encephalopathy: A Rare Case Report of Malpractice

We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability.

Bladder Explosion during Transurethral Resection of the Prostate with Nitrous Oxide Inhalation

Bladder explosions are a rare complication of transurethral resection of the prostate. We report a patient who suffered a bladder rupture following transurethral resection of the prostate. Although explosive gases accumulate during the procedure, a high concentration of oxygen is needed to support an explosion. This rare phenomenon can be prevented by preventing the flow of room air into the bladder during the procedure to maintain a low concentration of oxygen inside the bladder.

Explosion of the urinary bladder during transurethral resection of the prostate

Transurethral resection of the prostate (TURP) remains the gold standard for the surgical treatment of benign prostatic hyperplasia. Complications during the procedure are rare. An extremely rare complication is a rupture of the urinary bladder. This article reports a case where an explosion occurred during TURP, resulting in a large intraperitoneal rupture of the urinary bladder. The patient underwent emergency laparotomy to repair the bladder.

[Intravesical explosion with rupture of the bladder wall during transurethral resection]

A 74-year-old patient underwent transurethral electroresection for a bladder tumor located at the anterior wall close to the air bubble. Intraoperatively, an explosion occurred. Computed tomography documented laceration of the anterior bladder wall with numerous small gas bubbles dispersed in the perivesical area. The etiology of intravesical explosions is based on formation of hydrogen during electroresection. Hydrogen by itself is not explosive; a blast will occur only when atmospheric oxygen is admixed and then ignited by sparks from electroresection. To prevent such a complication, care must be taken not to activate the resection loop within the air bubble of the bladder.