Roehmholdt Max J, Bentley Dennis F
Cleveland Clinic Foundation - Akron General Medical Center, 1 Akron General Avenue, Akron, OH, USA 44307.
Case Rep Urol. 2022 Mar 16;2022:7065865. doi: 10.1155/2022/7065865. eCollection 2022.
The UroLift® procedure is a minimally invasive technique used to treat benign prostatic hyperplasia (BPH) in the office or hospital setting. As of 2021, over 200,000 of these procedures have been performed, with an excellent safety profile. We present a case report of a patient who underwent the UroLift® procedure and was found to have a 16.5 cm pelvic hematoma within 16 hours. This study was done as a retrospective chart review. In addition, a comprehensive review of the literature was performed, and all relevant government and company websites were reviewed for thorough evaluation. The patient had an uncomplicated inpatient UroLift® procedure for BPH using 5 implants and was discharged from the hospital without incident. The patient presented to the emergency department with abdominal pain 16 hours after the procedure, and a 16.5 cm pelvic hematoma was found on computerized tomography (CT) scan. Since 2015, there have been 27 cases of pelvic hematoma after UroLift® reported to the United States Food and Drug Administration (FDA), and only 2 cases published in the literature. Our patient required hospital admission for 3 days and 3 units of packed red blood cells, but no surgical exploration or intervention. The procedure was technically successful as it improved the patient's voiding and lower urinary tract symptoms (LUTS) as of 2-month follow-up. Potential etiologies include implant firing depth beyond the extent of the prostate, as well as treatment of the median lobe.
UroLift®手术是一种微创技术，用于在门诊或医院环境中治疗良性前列腺增生（BPH）。截至2021年，已进行了超过20万例此类手术，安全性良好。我们报告一例接受UroLift®手术的患者，该患者在术后16小时被发现盆腔血肿达16.5厘米。本研究通过回顾性病历审查完成。此外，还对文献进行了全面综述，并查阅了所有相关政府和公司网站以进行全面评估。该患者因BPH接受了无并发症的住院UroLift®手术，使用了5个植入物，出院时无意外情况。患者在术后16小时因腹痛就诊于急诊科，计算机断层扫描（CT）发现盆腔血肿达16.5厘米。自2015年以来，美国食品药品监督管理局（FDA）共收到27例UroLift®术后盆腔血肿报告，仅有2例发表于文献。我们的患者住院3天，输注了3单位浓缩红细胞，但未进行手术探查或干预。截至2个月随访时，该手术在技术上是成功的，改善了患者的排尿和下尿路症状（LUTS）。潜在病因包括植入物发射深度超出前列腺范围以及中叶的治疗。
