Intravesical Explosions as a Complication of Transurethral Electroresection: Report of Two Cases

Kretschmer, Herman L.

doi:10.1001/jama.1934.72750410002007a

Cited by 27 publications

(14 citation statements)

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“…As early as the 1930s, health-related literature reported the dangers of explosions within the bladder caused by the gases produced by cautery during prostate resections (Bobbitt, 1950;Hambleton, Lackey, & Van Duzen, 1935;Kretschmer, 1934). Currently, a multiplicity of chemical and biological hazards have been identified in surgical smoke.…”

Section: Research On the Hazardous Nature Of Surgical Smokementioning

confidence: 99%

Is It Time for a More Systematic Approach to the Hazards of Surgical Smoke?: Reconsidering the Evidence

Mellor

Hutchinson²

2013

Workplace Health Saf

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Section: Research On the Hazardous Nature Of Surgical Smokementioning

confidence: 99%

Is It Time for a More Systematic Approach to the Hazards of Surgical Smoke?: Reconsidering the Evidence

Mellor

Hutchinson²

2013

Workplace Health Saf

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“…Immediate operative repair (either transperitoneal or extraperitoneal approach) with postoperative catheter drainage for 5-10 days is usually successful and the final result being satisfactory [5,17,19]. Cystography may be useful in planning such surgery, but it should not be considered as a mandatory procedure [6].…”

Section: Treatment Of Intravesical Bladder Explosionsmentioning

confidence: 99%

“…In 1934, Kretschmer [5] reported two intravesical explosions with rupture of the bladder at the end of transurethral resection of the prostate. The majority of cases of bladder explosion have been reported with transurethral resection of prostate and bladder tumours [6].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intravesical explosions during transurethral endoscopic procedures

et al. 2006

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Every Urologist, during the course of fulguration treatment of bladder tumours, has at some time or another experienced small intravesical explosions usually manifesting as a "pop". Major intravesical explosions are rare but potentially devastating complications of transurethral endoscopic resections. The damage to the bladder can range from small mucosal tears to bladder rupture, which can either be intraperitoneal (requiring laparotomy and open bladder repair) or extraperitoneal. We review the literature on intravesical explosions to determine the aetiology of these explosions and suggest strategies to prevent these. A comprehensive literature search was performed using Medline and Ovid to obtain information using search terms: intravesical explosions, transurethral procedures, endoscopic procedures, diathermyIntravesical explosions occur due to the production of explosive gases during use of diathermy on human tissues. The most dangerous combination is hydrogen and oxygen. Hydrogen alone is not explosive and it only becomes explosive when admixed with oxygen. Oxygen is not produced in sufficient quantity during diathermy to cause explosions but can enter into the bladder from the atmosphere during endoscopic procedures. Careful operative technique (correct use of the Ellick evacuator bulb and reducing the frequency of manual irrigations of the bladder) with minimisation of the operative time and using the coagulation current at moderate power as well as judicious coagulation of tissues can reduce the risk of this dangerous complication arising.

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“…Intravesical explosion during transurethral resection of the prostate (TURP) is a recognized complication of TURP and was reported as early as 1934 by Kretschmer 1 . This is fortunately rare and is associated with various degrees of bladder injury ranging from simple mucosal tear to bladder rupture 1–4 …”

Section: Introductionmentioning

confidence: 99%