Death as a Complication of Urologic Surgery-2 Cases Identified at Autopsy

While routine medical procedures often impose some level of risk for the patient, death after routine urologic care is rare. In this series, we present 2 cases in which a relatively healthy patient ultimately died after complications, one from a prostate biopsy and one from a total nephrectomy. In case 1, a 58-year-old male died due to a 1500-mL to 2000-mL left retroperitoneal hemorrhage that occurred during insertion of a central line for sepsis treatment that resulted from an infection after a transrectal prostate biopsy. In case 2, a patient who underwent a total nephrectomy for renal cell carcinoma expired on postoperative day 7. Autopsy revealed a 1500-mL hemoperitoneum and an "unclasped" vascular surgical clip with the likely source of origin being the surgical resection site. Performance of an autopsy is essential to ascertain the cause and manner of death after medically related deaths because autopsy results can have implications on patient care, patient safety, and quality improvement.