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Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2008 June;74(6):277-80

Copyright © 2008 EDIZIONI MINERVA MEDICA

lingua: Inglese

Laser bladder perforation from photoselective vaporization of prostate resulting in rhabdomyolysis induced acute renal failure

Farag E. 1, Baccala A. A. Jr. 2, Doutt R. F. 3, Ulchaker J. 4, O’Hara J. 5

1 Department of General Anesthesiology and Outcomes Research, Cleveland Clinic, Cleveland, OH, USA; 2 Glickman Urological Institute, Cleveland Clinic, Cleveland, OH, USA; 3 Millersville University, Millersville, PA, USA; 4 Glickman Urological Institute, Prostate Center, Cleveland Clinic, Cleveland, OH, USA; 5 Department of General Anesthesiology, Cleveland Clinic, Cleveland, OH, USA


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Hyponatremia and its related comorbidities remain a concern after traditional transurethral resection of the prostrate (TURP). Photoselective vaporization of the prostate (PVP) laser coagulation therapy is a new, relatively bloodless procedure for treatment of benign prostatic hyperplasia (BPH). Perceived benefits with PVP laser TURP include excellent visualization of the operative field during urethral prostatic tissue vaporization and the reduced incidence of laser penetration through the prostatic capsular fibers once the capsule is reached. Theoretically, this would provide a low risk method of perforation during laser TURP. After literature review, we report this as the first case of laser bladder perforation as a complication arising from PVP therapy. This case report discusses the management of acute hyponatremic induced rhabdomyolysis with acute renal failure (ARF) and the recommendation to use sodium chloride vs. sterile water for bladder irrigation during PVP TURP procedures.

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