Vesical Explosion during Transurethral Resection of Prostate: A dreadful Complication associated with Common Endoscopic Procedure

Abstract

Vesical explosion during transurethral resection of the prostate (TURP) is an extremely rare, serious and dreadful complication, which should be considered as a blast injury requiring urgent exploratory laparotomy and repair. Until 2019, only 38 cases have been reported in the International English literature. The underlying mechanism for this rare intravesical explosion is the generation and trapping of explosive gases under the dome of the bladder, which eventually detonates by sparks from the cutting electrode during TURP. Herein, we report a case of a 67- years- old man where an explosion occurred during TURP, resulting in a large intraperitoneal rupture of the urinary bladder. After confirmation of the diagnosis clinically, endoscopic ally and radio logically the patient underwent a successful emergency laparotomy to repair the bladder tear. He had uneventful postoperative recovery and he is symptoms free at 6months and one year of follow-up. Although uncommon, vesical explosion during TURP may occur and some preventive measures, discussed here, can be carried out to avoid this dreadful complication. In addition to the discussion of its mechanism, we will discuss the preventive measures of this dreadful event. To the best of our knowledge, this is the first case of a Vesical explosion reported in our department.