An extremely rare complication of transurethral resection of the prostate: A case report. (May 2022)

• Record Type: Journal Article
• Authors: Al-Hajjaj, Maher; Aljool, Ali Alali
• Is Part Of: Annals of medicine and surgery. Volume 77(2022)
• Publication Date: 2022-05
• Subjects: Transurethral resection of the prostate (TURP) -- Loss of vision -- Case report; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.103591
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: Benign prostatic hyperplasia (BPH) is worldwide condition in male patients after the fourth decade. Most patients present with lower urinary tracts symptoms related to BPH. Transurethral resection of the prostate (TURP) is considered the standard treatment for decades. Presentation of case: A 56-year-old male patient presented with three months of lower urinary tract symptoms with one time a life of complete urinary retention. Ultrasound showed an enlarged prostate (90 cc). We performed transurethral resection of the prostate. One week later, he presented with complete loss of vision in the right eye with pain in the left leg. Left lower limb ultrasound revealed deep venous thrombosis. Brain MRI demonstrated left occipital lobe infarction. We started anticoagulants therapy. Three days later, he reclaimed his vision acuity completely. Clinical discussion: Cerebrovascular accident after transurethral resection of prostate is considered an extremely rare event in urological practice. Full work-up to detect the cause should be performed. In most cases, cardiac anomalies are the main responsible of such events. Conclusion: Loss of vision is a rare entity after TURP surgery. Anticoagulant therapy should be started once the diagnosis of occipital lobe infarction is confirmed. Highlights: Transurethral resection of the prostate is a common procedure in urology. Occipital infarction is extremely rare after TURP surgery. Patients with such complication should be undergone to echocardiography to define the malformation. Patent foramen ovale (PFO) should be suspected in patients with cerebrovascular accident after surgery.