Farag E, Baccala A A, Doutt R F, Ulchaker J, O'Hara J
Department of General Anesthesiology and Outcomes Research, Cleveland Clinic, Cleveland, OH 44195, USA.
Minerva Anestesiol. 2008 Jun;74(6):277-80. Epub 2008 Mar 10.
Hyponatremia and its related comorbidities remain a concern after traditional transurethral resection of the prostrate (TURP). Photoselective vaporization of the prostate (PVP) laser coagulation therapy is a new, relatively bloodless procedure for treatment of benign prostatic hyperplasia (BPH). Perceived benefits with PVP laser TURP include excellent visualization of the operative field during urethral prostatic tissue vaporization and the reduced incidence of laser penetration through the prostatic capsular fibers once the capsule is reached. Theoretically, this would provide a low risk method of perforation during laser TURP. After literature review, we report this as the first case of laser bladder perforation as a complication arising from PVP therapy. This case report discusses the management of acute hyponatremic induced rhabdomyolysis with acute renal failure (ARF) and the recommendation to use sodium chloride vs. sterile water for bladder irrigation during PVP TURP procedures.
在传统经尿道前列腺切除术（TURP）后，低钠血症及其相关合并症仍然是一个令人担忧的问题。前列腺光选择性汽化术（PVP）激光凝固疗法是一种用于治疗良性前列腺增生（BPH）的新型、相对无血的手术。PVP激光TURP的显著优点包括在尿道前列腺组织汽化过程中手术视野清晰，以及一旦到达前列腺包膜纤维，激光穿透包膜纤维的发生率降低。从理论上讲，这将为激光TURP期间的穿孔提供一种低风险方法。在文献综述之后，我们报告这是首例因PVP治疗引起的激光膀胱穿孔并发症。本病例报告讨论了急性低钠血症诱发横纹肌溶解合并急性肾衰竭（ARF）的处理，以及关于在PVP TURP手术期间使用氯化钠与无菌水进行膀胱冲洗的建议。
