Two unusual cases of gas embolism following urethral surgery under laser

Carbon dioxide embolism treated with hyperbaric oxygen

“…Following hyperbaric treatment at three atmospheres for 90 minutes, the patient regained consciousness and suffered no permanent neurological damage. 26 The recompression regimen was chosen based on published recompression schedules modified for the pressure limitations of a monoplace chamber and the presumption that carbon dioxide embolism could be more readily treated by a reduced compression schedule than an air embolism (Dr. J. Smith, personal communication). There are no controlled clinical trials evaluating the efficacy of the various recompression schedules in gas embolismY…”

Case of vascular air embolism during holmium laser enucleation of the prostate

“…To date, there have been 12 reported cases of air embolism during transurethral surgery (transurethral resection of the prostate, nine cases; transurethral bladder neck incision, one case; internal urethrotomy [with CO 2 gas], two cases) . The diagnosis is suggested by patients' complaints (seven cases with cough, chest pain or difficulty breathing) and changes in vital signs (five cases with decreased blood pressure, decreased heart rate or decreased blood oxygen saturation).…”

“…internal urethrotomy [with CO2 gas], two cases). [2][3][4][5][6][7][8][9][10] The diagnosis is suggested by patients' complaints (seven cases with cough, chest pain or difficulty breathing) and changes in vital signs (five cases with decreased blood pressure, decreased heart rate or decreased blood oxygen saturation). Causes of air embolism during transurethral procedures were as follows: using an evacuator (four cases); postural change (two cases); attaching the evacuation system in reverse (two cases); and increasing CO 2 gas pressure in the operation area (two cases).…”