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Urethral bleeding after open radical prostatectomy treated with selective arterial embolization. A rare complication
R Molina Escudero1, F Herranz Amo, J Aragón Chamizo
1Servicio Urología. Hospital General Universitario Gregorio Marañón. Madrid. España.
Archivos Espanoles De Urologia
|July 23, 2014
Summary
Severe urethral bleeding after radical prostatectomy is rare but treatable. CT angiography and embolization effectively stopped bleeding in a patient, preserving continence and erectile function.
Area of Science:
- Urology
- Vascular Surgery
Background:
- Radical prostatectomy can lead to rare but significant postoperative bleeding.
- Gross hematuria and urethral bleeding occur in 0.5-1.5% of cases.
Observation:
- A 58-year-old male experienced severe hematuria on postoperative day 4 after radical prostatectomy.
- Bleeding persisted despite conservative management, including continuous bladder irrigation and blood transfusion.
Findings:
- CT angiography identified active bleeding from a bulbar artery, a branch of the internal pudendal artery.
- Selective embolization using absorbable material successfully halted the hemorrhage.
Implications:
- CT angiography and embolization are effective, minimally invasive treatments for post-prostatectomy urethral bleeding.
- This approach avoids open surgery, reducing patient morbidity and preserving urinary and erectile function.
