Case series: Bladder clot evacuation using a prostate morcellation device

  • Karen M. Doersch Texas A&M Health Science Center College of Medicine http://orcid.org/0000-0001-8374-9639
  • Andrew F. Navetta Baylor Scott and White Health, Temple, TX 76508
  • Erin T. Bird Baylor Scott and White Health, Temple, TX 76508
  • Marawan M. El Tayeb Baylor Scott and White Health, Temple, TX 76508

Abstract

Introduction: We sought to provide a technical update on the use of a prostate morcellator device (PMD) to manage organized blood clots of the bladder following laser prostatectomy.

Methods: Herein, we describe our experience in using the Wolf Piranha morcellator in managing organized bladder blood clots supplemented with a retrospective chart review of the patients in whom this procedure was performed.

Results: Six patients, all male with a mean age of 75 ± 8.9 years, had organized bladder clots following either holmium laser enucleation or photoselective vaporization of the prostate managed with a PMD. Clots were recognized based on hematuria or urinary retention a median of 3.5 days following the aforementioned procedures. Initial management was attempted with more conservative measures, including a three-way Foley catheter, followed by cystoscopy with an Ellik evacuator, or a glass Tommey syringe. Morcellation times were a mean of 10.2 ± 6.15 minutes (range 2‒18). This technique was able to manage clots that were an average of 173.3 ± 115.9 cc in size. The procedure was well-tolerated. No patients experienced intraoperative or morcellator-related complications.

Conclusions: Benign prostatic hypertrophy frequently requires surgical endoscopic management and can be complicated by hematuria and bladder blood clot formation. When these clots become organized, this can lead to urinary retention and the required management, evacuation, may be difficult. The use of a Wolf Piranha PMD is a safe, well-tolerated, and effective in evacuating organized blood clots of the bladder.

Author Biographies

Karen M. Doersch, Texas A&M Health Science Center College of Medicine
MD/PhD Student, Department of Microbial Pathogenesis and Immunology
Andrew F. Navetta, Baylor Scott and White Health, Temple, TX 76508
Resident, Division of Urology
Erin T. Bird, Baylor Scott and White Health, Temple, TX 76508
Chair, Division of Urology
Marawan M. El Tayeb, Baylor Scott and White Health, Temple, TX 76508
Division of Urology
Published
2017-07-11
How to Cite
Doersch, K. M., Navetta, A. F., Bird, E. T., & El Tayeb, M. M. (2017). Case series: Bladder clot evacuation using a prostate morcellation device. Canadian Urological Association Journal, 11(7), E311-4. https://doi.org/10.5489/cuaj.4219
Section
Case Series