Bladder Explosion during Transurethral Resection of the Prostate

Abstract

A case of bladder explosion with wide rupture during transurethral resection of the prostate (TURP) is reported. Immediate cystography was performed and the patient was promptly operated; the postoperative course was uneventful. Intravesical explosion is caused by explosive gas formation and the more dangerous combination is the mixture of air and hydrogen; therefore, the introduction of air during TURP is necessary in order to produce a bladder explosion. This unusual complication of a common urological procedure is rare but serious, and should it arise always requires immediate surgical correction.

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

“…Nevertheless, some serious peri- and postoperative complications can occur requiring a proper and systematic approach to manage them [5]. Bladder perforation during TURP is a rare complication which usually results from mechanical injury by the resectoscope or from an increase in intravesical pressure leading to intravesical explosion which is an extremely rare complication [1-4]. The explosion is thought to be due to the contact of the resectoscope loop or an electrocautery spark with a mixture of inflammable gases produced during resection [6].…”

“…In all cases, a large explosive sound was heard usually toward the end of surgery and mainly when cauterizing the anterior prostatic fossa. Intraperitoneal injury was found in most of the cases, and only in 2 cases the injury was extraperitoneal [1, 2]. By definition, intravesical explosion during TURP is classified as a blast injury [7].…”

“…Bladder explosion during TURP is extremely rare and is thought to be due to the contact of the electrocautery with a mixture of gases produced during the resection procedure [1-4]. Fewer than 20 cases have been reported in the literature, and the majority were managed by laparotomy.…”

L'explosion intravesicale au cours des procedures de resection endoscopique: Un incident dangereux qui peut être évité

“…Di Tonno et al 3 ont prouvé que l'introduction de l'air dans la vessie est nécessaire pour produire une explosion vésicale en mixant de l'hydrogène à l'oxygène car l'hydrogène seul n'est pas explosif; cependant, quand il est mélangé à l'oxygène atmosphérique, il devient très combustible. L'introduction de l'air dans la vessie se fait au cours de la manipulation du résecteur ou au cours d'un lavage incorrect par la poire d'Elick ou même par l'irrigation.…”

Intravesical Explosion during Transurethral Resection of Prostate – A Reminder

“…We emphasize that, despite its rare occurrence, it is preventable and suggest measures to avoid it. plosion during TURP is extremely rare and less than 20 cases have been reported so far [4] .…”