Cerebrovascular accident after transurethral resection of the prostate: A rare complication. (April 2022)

• Record Type: Journal Article
• Authors: Al-Hajjaj, Maher; Kanjo, Muhamad; Almoshantaf, Mohammad Badr; Swed, Sarya; Ezzdean, Weaam
• Is Part Of: International journal of surgery case reports. Volume 93(2022)
• Publication Date: 2022-04
• Subjects: Benign prostatic hyperplasia -- Cerebrovascular accident -- Transurethral resection of prostate; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2022.106948
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction: Benign prostatic hyperplasia is considered a worldwide disease among males in middle age. Transurethral resection of the prostate (TURP) is a wide used intervention for this condition. A few reports mentioned cerebrovascular accidents after TURP. Presentation of case: A 65-year-old male presented with recurrent urinary retention in the past two years. Clinical examination showed a full urinary bladder with abdominal discomfort. Abdominal ultrasound revealed an enlarged prostate (90 ml) with approximately 500 ml of urine. After that, we performed transurethral resection of the prostate (TURP). The surgery was uneventful. After three days of discharge, he presented with a loss of vision in the left eye and left lower limb pain. Computed tomography of the brain showed right occipital lobe infarction. Ultrasound of the left lower limb revealed deep venous thrombosis. Echocardiography showed a patent foramen ovale. As a result, he had deep venous thrombosis with patent foramen ovale that led to infarction. We started with anticoagulants for two weeks. Later, he reclaimed his vision completely. Clinical discussion: Cerebral vascular accidents are a rare complication of transurethral resection of the prostate. Early recognition and diagnosis of this condition will lead to good results. Searching for cardiac anomalies is the first step to reaching the diagnosis. Conclusion: Urologists should suspect cardiac anomalies in patients who underwent TURP surgery and develop cerebrovascular accidents. Collaboration with other specialties is considered basic to help with this complication. Highlights: Benign prostatic hyperplasia is a common condition as men get older. Transurethral resection is a routine surgery for patients with important enlargement of the prostate. Cerebrovascular accidents are a rare complication of the TURP surgery. Paradoxical embolism should be suspected in such conditions.