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ANALGESIA

Urethral Injury During Potassium-Titanyl-Phosphate Laser Prostatectomy Complicated by Transurethral Resection Syndrome

John A. Dilger, MD^*, Michael T. Walsh, MD^*, Mary E. Warner, MD^*, Lance A. Mynderse, MD, and Juraj Sprung, MD, PhD^*

From the Departments of *Anesthesiology, and Urology, College of Medicine, Mayo Clinic, Rochester, Minnesota.

Address correspondence and reprint requests to Juraj Sprung, MD, PhD, Department of Anesthesiology, College of Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN 55905. Address e-mail to sprung.juraj{at}mayo.edu.

Abstract

The green light potassium-titanyl-phosphate laser photoselective vaporization of the prostate is the latest modality for treatment of benign prostatic obstruction. Because of effective superficial tissue coagulation, intravascular absorption of fluid is minimal; therefore, development of transurethral resection syndrome is unlikely. To our knowledge, this is the first report of a patient undergoing photoselective vaporization of the prostate who developed full-blown transurethral resection syndrome because of intravascular absorption of sterile water. Absorption of hypotonic irrigant presumably occurred through the injury induced during insertion of the laser cystoscope.