Intraprostatic hematoma with active bleeding post-prostate biopsy

Guo, Liting; So, Benny; Gray, Robin

doi:10.5489/cuaj.2135

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…A spontaneous prostatic haematoma is rare and has usually been described in the literature as a complication of advanced prostatic carcinoma 2. Large prostatic collections are usually caused by a prostatic abscess, traumatic prostatic haematoma, postintervention prostatic haematoma,3 prostatic infarction and complicated prostatic cancer 1. Spontaneous prostatic haematoma as a complication of BPH has rarely been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous prostatic haematoma in a case of benign prostatic hyperplasia

Bansal¹,

Seth

2019

BMJ Case Rep

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A 61-year-old man presented with urinary retention with obstructive uropathy (urea/creatinine: 126/9.2 mg/dL) secondary to a large prostatic haematoma while being medically managed for benign enlargement of the prostate. The patient did not have any fever or local symptoms and the prostate was enlarged and non-tender on examination. Ultrasound and MRI of the pelvis showed a 9.4×10.4×11.1 cm sized prostatic haematoma seen displacing and compressing the urinary bladder anteriorly with bilateral hydroureteronephrosis. The patient was managed with per-urethral catheterisation, haemodialysis and injectable antibiotics. Percutaneous pigtail placement into the prostatic haematoma led to gradual drainage of the haematoma with improvement in the renal parameters. Definitive surgery in the form of transurethral resection of the prostate was done at a later date. Intraoperatively multiple encapsulated cavities containing organised clots were deroofed. On follow-up, the patient did well and had good urinary flow and normal renal parameters.

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Section: Discussionmentioning

confidence: 99%

Spontaneous prostatic haematoma in a case of benign prostatic hyperplasia

Bansal¹,

Seth

2019

BMJ Case Rep

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“…Intraprostatic bleeding is very common in patients undergoing TRUS-guided prostate biopsy, but it is usually bland, and spontaneously stops in a short time. This is probably related to the tamponade effect by the prostatic capsule and the periprostatic tissues (6). Most symptomatic rectal bleedings are easily stopped by digital or balloon rectal compression, or using a rectal sponge too (7).…”

Section: Discussionmentioning

confidence: 99%

Rare Complication after a Transrectal Ultrasound Guided Prostate Biopsy: A Giant Retroperitoneal Hematoma

Chiancone

Mirone

Fedelini³

et al. 2015

Urologia

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Common complications related to transrectal ultrasound (TRUS) guided prostatic needle biopsy are hematuria, hematospermia, and hematochezia. To the best of our knowledge, we report the second case of a very large hematoma extending from the pelvis into the retroperitoneal space in literature.A 66-year-old man with a serum prostate-specific antigen (PSA) of 5.4 ng/ml was admitted to our department for a TRUS-guided prostatic needle biopsy. Laboratory values on the day before biopsy, including coagulation studies, were all normal. The patients did not take any anticoagulant drugs. No immediate complications were encountered. Nevertheless, 7 hours after the biopsy, the patient reached our emergency department with severe diffuse abdominal pain, hypotension, tachycardia, and confusional state. He underwent an ultrasonography and then a computed tomography (CT) scan that showed "a blood collection in the pelvis that extending to the lower pole of left kidney associated with a focus of active contrast extravasation, indicating active ongoing prostate bleeding." Consequently, he underwent a diagnostic angiography that showed no more contrast extravasation, without the need of embolization. Management of hematoma has been conservative and hematoma was completely reabsorbed 4 months later.

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