Bladder rupture due to intravesical explosion during transurethral endoscopic procedures: a systematic review

Abstract

Objective To evaluate intravesical explosion during transurethral endoscopic procedures and determine risk factors, and to develop strategies for diagnosis and treatment. Methods A literature review was conducted for the studies published in the English language in the databases of PubMed and in the Chinese language in the databases of WANFANG MED ONLINE (only ISTIC) between January 2005 and December 2015. The key words for digital literature search were limited to the following " urinary bladder" and " explosion" . Results In the total of 21 articles, there were 39 cases of bladder rupture due to intravesical explosion during ttransurethral endoscopic procedures, including 36 cases of benign prostate hyperplasia (BPH), 2 cases of prostatic carcinoma, 1 cases of urinary bladder neoplasms. Intravertebral anesthesia was used in all cases except for one case of inhalation anesthesia. The bladder was irrigated with physiological saline in PKVP(n=6), with glucose, mannitol, sterile water or glycine in TURP(n=33). There were 8 cases confirmed to be an extraperitoneal rupture, 15 cases confirmed to be an intraperitoneal rupture, and 16 cases no attention. There was 15 cases by conservative treatment, 23 cases by open laparotomy, and 1 cases by laparoscopic repair. Conclusions Intravesical explosion during transurethral endoscopic procedures is rare. The necessary measures to prevent intravesical explosion is to avoid bladder gas concentration achieve explosion limits and bladder gas direct contact with cutting ring. The satisfactory results can be obtained by using the conservative treatment or open repair according to the size of the bladder rupture. Key words: Prostatic Hyperplasia; Transurethral Resection of Prostate; Electrosurgery; Urinary Bladder; Rupture