Bladder explosions during transurethral surgery

Area of Science:

• Urology
• Biochemistry
• Surgical Safety

Background:

• Transurethral electrosurgery generates gases in all tissues.
• Hydrogen is a primary gas produced during this procedure.
• The source of this hydrogen gas is not fully understood.

Purpose of the Study:

• To investigate the origin of hydrogen gas liberated during transurethral electrosurgery.
• To understand the conditions under which surgical gases pose an explosion risk.

Main Methods:

• Analysis of gases produced during transurethral electrosurgery.
• Postulation of hydrogen gas derivation from intracellular water electrolysis.

Main Results:

• High concentrations of hydrogen gas are consistently produced.
• Electrolysis of intracellular water is postulated as the main source.
• The surgical gas mixture becomes explosive only with the addition of external oxygen.

Conclusions:

• Intracellular water electrolysis is the likely source of hydrogen gas during transurethral electrosurgery.
• Awareness of oxygen presence is critical for preventing surgical fires and explosions.