Major urologic surgery and rhabdomyolysis in two obese patients

Urologic surgery performed in the lithotomy position sometimes results in the serious complications of rhabdomyolysis and acute renal failure. Patients in which this occurs are almost always found to have compartmental syndromes. The two patients we present herein did not show any sign of a compartmental syndrome, but both were obese and underwent surgery for more than 6 h. The possible mechanism of rhabdomyolysis without compartmental syndrome (without local signs and symptoms of muscle damage) is discussed, and rhabdomyolysis and urologic surgery are reviewed.