A case of severe rectal bleeding following transurethral ultrasound (TRUS)-guided prostate biopsy is reported. Rectal bleeding is considered a minor, transient complication of this standard diagnostic procedure that can usually be controlled successfully by conservative measures. In this case where the patient had been taking acetylsalicylic acid (ASA), massive bleeding required hospitalization and blood transfusions. Conservative treatment attempts were not succesful, and profuse rectal bleeding was eventually treated by colonoscopy and endoclipping of the bleeding vessel. Although generally regarded as a less significant complication, rectal bleeding may rarely be encountered as a life-threatening situation. Furthermore, conservative therapeutic approach to this minor complication may be ineffective in patients taking ASA. Early endoscopic intervention may be necessary to prevent blood transfusion and prolonged hospitalization in severe rectal bleeding after TRUS biopsy.
Objectives:Acute urinary retention (AUR) in females is a poorly defined condition with undetermined epidemiology. This study aimed to evaluate female AUR in an outpatient population.Patients and Methods:One hundred and thirty-eight adult female outpatients who presented to the emergency room with symptoms of urinary retention were retrospectively analyzed. The women who were ultimately diagnosed with true, complete AUR were systematically reviewed for clinical characteristics and management.Results:In this outpatient cohort with urinary retention complaints, only 23% of the patients were diagnosed with objective AUR. Detailed medical and urological history in addition to urogenital, neurological, and pelvic examinations was essential; urine analysis and pelvic ultrasonography were necessary as baseline investigations. Further radiological and urodynamic tests were required in a minority. Specific etiology was established in 77% of the patients, whereas there was more than one probable cause in 16% of the patients, and no specific cause was found in 6.5% of the patients. Bladder decompression and correction of the underlying cause helped 92.6% of the reviewed patients to eventually achieve spontaneous micturition.Conclusions:The proportion of true, complete AUR among female outpatients presenting to the emergency department was 23% following urological evaluation. Acute condition was resolved by urgent catheterization in all, and the majority of women had eventually resumed spontaneous voiding.
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