Transurethral resection of the prostate, bladder explosion and hyponatremic encephalopathy: a rare case report of malpractice

Abstract

<jats:title>Abstract</jats:title><jats:p>We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability.</jats:p>

Intravesical explosion during transurethral resection of bladder tumor: A case report

“…In another case, the bladder repair was further complicated by bladder dehiscence due to the severe damage and this had required a second repair[ 8 ]. Additionally, improper treatment of fluid and electrolyte disorders can lead to patient mortality[ 9 ]. Therefore, in cases of bladder rupture, open or laparoscopic bladder repair must be performed on time, with additional attention paid to any injury of the intestinal tract or surrounding structures.…”

Bladder Explosion during Transurethral Resection of the Prostate Repaired Laparoscopically: A Case Report and Review of the Literature

“…By definition, intravesical explosion during TURP is classified as a blast injury [7]. Despite the fact that no adjacent abdominal organs or major vascular injury have been reported up to now, the effect can be severe enough to result in a loud scary explosion, in bladder perforation, and in devascularization of the ruptured bladder edges in some cases [4, 8, 9]. For instance, Seitz et al [3] had to excise a larger piece of bladder due to insufficient blood supply.…”

“…In another case, the bladder repair was further complicated by bladder dehiscence due to the severe damage and this had required a second repair [10]. Moreover, improper treatment of the associated fluid and electrolyte disturbances can result in death [8]. Therefore, the management of this complication should follow a systematic approach similar to the one used for abdominal explosions [11].…”

On a defective Mitraclip© system: Considerations on the medical device regulation in Europe

“…An adequate device monitoring, especially for cardiac and other high-risk devices [52][53][54][55][56], based on use of National databases, on specific applications, allowing a quick and effective action in case of malfunctioning, must be considered. A recent analysis about the transcatheter aortic valve implantation (T.A.V.I.)…”