Abstract
Introduction
Transurethral resection of the prostate and open prostatectomy have been the standard of care for the surgical treatment of benign prostatic obstruction (BPO) over decades. New emerging techniques for the surgical management of BPO have been currently introduced, but might be associated with new, unusual complications.
Methods
We herewith report on two patients with a rectal perforation after aquablation treatment of BPO.
Results
In the first case, the diagnosis was made 2 days after the aquablation procedure due to unspecific postoperative symptoms. A complex combined open/endoscopic repair of the defect was carried out thereafter. As a consequence, a rectoscopy was routinely performed since then following each aquablation procedure. In the second case, intraoperative rectoscopy after uneventful aquablation revealed the rectal perforation. The perforation was clipped immediately with an over the scope-clip by colonoscopy.
Conclusions
These two cases of a rectal perforation after aquablation of the prostate demonstrate an unusual complication and its complex management. Diagnostic delay complicates its treatment. Therefore, immediate rectoscopy should be performed routinely after the aquablation procedure.
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AJG had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. AJG: project development, data collection, data analysis, manuscript writing/editing. MJL: project development, manuscript writing/editing. RB: project development. BB: data collection, data analysis. KV: Data collection. CMR: manuscript editing. CN: project development, data collection, data analysis, manuscript writing/editing.
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Andreas J. Gross certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: None. Our research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors report no conflict of interest.
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Gross, A.J., Lipp, M.J., Baumbach, R. et al. Rectal perforation after aquablation of the prostate: lessons learned the hard way. World J Urol 39, 3441–3446 (2021). https://doi.org/10.1007/s00345-021-03660-2
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DOI: https://doi.org/10.1007/s00345-021-03660-2