Life-Threatening Hypovolemic Shock after Transrectal Ultrasonography Guided Prostate Biopsy: Treatment with Selective Arterial Embolization

Hong Seok Shin; Young Hwan Lee

doi:10.5534/kja.2011.29.3.254

Journal List > Korean J Androl > v.29(3) > 1033091

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Shin and Lee: Life-Threatening Hypovolemic Shock after Transrectal Ultrasonography Guided Prostate Biopsy: Treatment with Selective Arterial Embolization

Original Article

Korean J Androl 2011;29(3):254-257.

Published online: 22 December 2011

DOI: https://doi.org/10.5534/kja.2011.29.3.254

Life-Threatening Hypovolemic Shock after Transrectal Ultrasonography Guided Prostate Biopsy: Treatment with Selective Arterial Embolization

Hong Seok Shin¹, Young Hwan Lee²

¹Department of Urology, Catholic University of Daegu School of Medicine, Daegu, Korea

²Department of Radiology, Catholic University of Daegu School of Medicine, Daegu, Korea

Correspondence to: Hong Seok Shin Department of Urology, Catholic University of Daegu School of Medicine, 3056-6, Daemyung-4 dong, Nam-gu, Daegu 705-718, Korea Tel: 053-650-4673, Fax: 053-623-4660 E-mail: uroshin@cu.ac.kr

Received 8 November 201112 December 2011 Accepted 15 December 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Rectal bleeding is a frequent finding in patients after transrectal ultrasonography (TRUS)-guided prostate biopsy but is usually mild and stops spontaneously. We report herein a case of life-threatening hypovolemic shock due to rectal bleeding after TRUS-guided prostate biopsy that was successfully treated by selective arterial embolization. The aim of this report is to share our experiences of the management of massive rectal bleeding after prostate biopsy.

Keywords: Prostate, Biopsy, Shock, Therapeutic embolization

REFERENCES

1). Rietbergen JB, Kruger AE, Kranse R, Schröder FH. Complications of transrectal ultrasound-guided systematic sextant biopsies of the prostate: evaluation of complication rates and risk factors within a population-based screening program. Urology. 1997; 49:875–80.

2). Berger AP, Gozzi C, Steiner H, Frauscher F, Varkarakis J, Rogatsch H, et al. Complication rate of transrectal ultrasound guided prostate biopsy: a comparison among 3 protocols with 6, 10 and 15 cores. J Urol. 2004; 171:1478–80.

3). Djavan B, Waldert M, Zlotta A, Dobronski P, Seitz C, Remzi M, et al. Safety and morbidity of first and repeat transrectal ultrasound guided prostate needle biopsies: results of a prospective European prostate cancer detection study. J Urol. 2001; 166:856–60.

4). Jeon SS, Woo SH, Hyun JH, Choi HY, Chai SE. Bisacodyl rectal preparation can decrease infectious complications of transrectal ultrasound-guided prostate biopsy. Urology. 2003; 62:461–6.

5). Won YJ, Sung J, Jung KW, Kong HJ, Park S, Shin HR, et al. Nationwide cancer incidence in Korea, 2003-2005. Cancer Res Treat. 2009; 41:122–31.

6). Clements R, Aideyan OU, Griffiths GJ, Peeling WB. Side effects and patient acceptability of transrectal biopsy of the prostate. Clin Radiol. 1993; 47:125–6.

7). Aus G, Hermansson CG, Hugosson J, Pedersen KV. Transrectal ultrasound examination of the prostate: complications and acceptance by patients. Br J Urol. 1993; 71:457–9.

8). Chiang IN, Chang SJ, Pu YS, Huang KH, Yu HJ, Huang CY. Major complications and associated risk factors of transrectal ultrasound guided prostate needle biopsy: a retrospective study of 1875 cases in taiwan. J Formos Med Assoc. 2007; 106:929–34.

9). Rodríguez LV, Terris MK. Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. J Urol. 1998; 160:2115–20.

10). Van Rosendaal GM, Sutherland LR, Verhoef MJ, Bailey RJ, Blustein PK, Lalor EA, et al. Defining the role of fiberoptic sigmoidoscopy in the investigation of patients presenting with bright red rectal bleeding. Am J Gastroenterol. 2000; 95:1184–7.

11). Dobson CC, Nicholson AA. Treatment of rectal hemorrhage by coil embolization. Cardiovasc Intervent Radiol. 1999; 22:143–6.

12). Pichon N, François B, Pichon-Lefièvre F, Mathonnet M, Maubon A, Vignon P. Embolization of rectal arteries: an alternative treatment for hemorrhagic shock induced by traumatic intrarectal hemorrhage. Cardiovasc Intervent Radiol. 2005; 28:515–7.

Fig. 1.

(A) Superselective arteriography revealed a small pseudoaneurysm of a branch of the left superior rectal artery (arrow) and fistula like lesion of the left middle rectal artery (arrow head) in an internal iliac arteriogram. (B) There were no more pseudoan-eurysms of the branch of the left superior rectal artery or fistula-like lesions of left middle rectal artery after embolization.

TOOLS

Similar articles