Severe bleeding after laparoscopic radical prostatectomy: successful management with transarterial embolization

Area of Science:

• Urology
• Interventional Radiology
• Surgical Oncology

Background:

• Laparoscopic radical prostatectomy (LRP) is a standard treatment for prostate cancer.
• Postoperative bleeding is a potential complication, though typically managed conservatively.
• Minimally invasive techniques are increasingly preferred for managing surgical complications.

Observation:

• A 54-year-old patient experienced significant postoperative bleeding after LRP.
• Hemodynamic instability (low blood pressure) and dropping hematocrit indicated active hemorrhage.
• CT angiography identified active bleeding originating from a capsular artery.

Findings:

• Transarterial embolization (TAE) was employed to manage the active bleeding.
• Superselective embolization successfully occluded the bleeding capsular artery.
• This represents the first reported case of LRP bleeding managed with TAE.

Implications:

• TAE is an effective endovascular option for managing refractory postoperative bleeding after LRP.
• This approach may reduce the need for reoperation and associated morbidity.
• Highlights the multidisciplinary approach in managing complex surgical complications.