Question

During a transurethral prostatectomy performed with regional anesthesia, the patient's abdominal becomes rigid and swollen, the patient complains of nausea and abdominal pain and becomes hypotensive and the nurse notes a decrease in bladder irrigation solution. The most likely cause is?

1) Transurethral prostatectomy syndrome
2) Bladder perforation
3) Internal hemorrhage

Answer 1

The symptoms of abdominal rigidity, swelling, nausea, abdominal pain, hypotension, and decrease in bladder irrigation solution most likely indicate a bladder perforation during the transurethral prostatectomy. Option 2.

Step-by-step explanation:

The symptoms described in the question - abdominal rigidity and swelling, nausea, abdominal pain, hypotension, and a decrease in bladder irrigation solution - suggest that the most likely cause is bladder perforation option 2. This complication can occur during a transurethral prostatectomy and can lead to leakage of irrigation fluid into the peritoneal cavity, causing symptoms similar to those described. The symptoms are not consistent with transurethral resection of the prostate syndrome, which typically includes neurological and cardiovascular symptoms due to absorption of irrigation fluids. Internal hemorrhage would likely present with a rapid heart rate and an increase in bladder irrigation solution due to bleeding into the bladder rather than a decrease.