Intraoperative ventilation and hemodynamic change due to bladder perforation during transurethral resection of a bladder tumor - A case report -

Abstract

Transurethral resection is a common, effective urologic procedure performed to resolve urinary tract obstruction in benign prostatic hypertrophy, prostate cancer, and bladder cancer. However, its complications include hemorrhage, infection, transurethral resection syndrome (TURS), bladder perforation, urinary tract obstruction, urinary incontinence, and sepsis [1,2]. While bladder perforation occurs in up to 58% of all cases, cases of bladder perforation that require surgical treatment are rare [3,4]. Risk for bladder perforation CASE REPoRTAn 80-year-old male patient (weight 50 kg, height 158 cm) was scheduled to undergo transurethral resection of the bladder (TURB) for multiple masses, including a 3.8-cm mass in the left bladder wall, and prostatic hypertrophy. He had a history of hypertension with no other notable disease history, and had undergone three previous transurethral resection surgeries. Preoperative chest X-ray, pulmonary function test, electrocardiography, and echocardiography findings were normal. Two days before the operation, his hemoglobin and hematocrit counts were reduced to 8. Transurethral resection is the most efficacious and safest urologic procedure for the treatment of benign prostatic hypertrophy, prostate cancer, and bladder cancer. Complications of transurethral resection include hemorrhage, infection, transurethral resection syndrome, and bladder perforation. Early detection of bladder perforation is important because it can cause critical ventilation and hemodynamic changes. In this case, we detected bladder perforation as the cause of ventilation and hemodynamic change intraoperatively and treated it by immediate surgical repair.