Successful embolisation of pelvic fistulating vessels to the prostate arising after TURP - a rare cause of postoperative bleeding

Transurethral resection of the prostate (TURP) is considered the gold-standard operation to treat lower urinary tract symptoms due to benign prostatic enlargement in men. Postoperative bleeding is a recognised complication and managing it is a core skill required by attending urologists. We report a...

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Bibliographic Details
Published inAnnals of the Royal College of Surgeons of England Vol. 102; no. 3; pp. e60 - e62
Main Authors Donati-Bourne, J F, Morris, S, Nour, S, McCafferty, I J, Smith, Y
Format Journal Article
LanguageEnglish
Published England BMJ Publishing Group LTD 01.03.2020
Royal College of Surgeons
Subjects
Aged
Bladder
Catheters
Embolization
Embolization, Therapeutic
Fistula - complications
Fistula - therapy
Hematuria
Hematuria - etiology
Hematuria - therapy
Hospitals
Humans
Male
Online Case Report
Postoperative Hemorrhage - etiology
Postoperative Hemorrhage - therapy
Postoperative period
Prostate
Prostate - blood supply
Prostatism - surgery
Surgery
Transurethral Resection of Prostate - adverse effects
Urogenital system
Urology
Varicose Veins - complications
Varicose Veins - therapy
Veins & arteries
United Kingdom > UK
TURP
Fistula
Transurethral resection
Prostate
Embolisation
Bleeding
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Summary:Transurethral resection of the prostate (TURP) is considered the gold-standard operation to treat lower urinary tract symptoms due to benign prostatic enlargement in men. Postoperative bleeding is a recognised complication and managing it is a core skill required by attending urologists. We report a rare case of postoperative bleeding caused by fistulating vessels to the prostate which developed after TURP. These fistulas arose from the right internal iliac vessels and communicated with pre-existing pelvic varices affecting the right paraprostaticand seminal vesicle tissues. The fistulating vessels were successfully embolised with liquid embolic agent. Surgeons should be aware that persisting haemorrhage can occur post-TURP from the rare presence of fistulating vessels communicating with pelvic varices. Early computed tomography angiographic assessment is warranted in cases where bleeding is prolonged and refractory to standard management in view of timely referral for percutaneous embolisation.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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ISSN:0035-8843
1478-7083
DOI:10.1308/rcsann.2019.0149