Complications of transurethral resection of bladder tumors: prevention, recognition and treatment

Between 1931 and 1971, 373 patients underwent transurethral resection of bladder tumors for cure or for control of the neoplasms. Complications included perforation of the bladder wall (5 per cent), hemorrhage requiring transfusion (13 per cent), infection (24 per cent) and postoperative mortality (1.3 per cent). Patients in whom perforations occurred had approximately twice as many infections and twice as much hemorrhage as the entire group but there were no postoperative deaths of those with perforations. Morbidity and mortality can be reduced in patients with perforation by 1) using isotonic irrigating fluid, 2) avoiding over-distension of the bladder, 3) maintaining postoperative free drainage through the catheter and 4) diagnosing and treating hyponatremia.