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Acute Postoperative Complications

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Emergencies in Urology

Abstract

Historically, major bleeding was a significant problem associated with radical retropubic prostatectomy and cystectomy, TUR, and nephrectomy. Nowadays, major life-threatening hemorrhage after urologic open and endoscopic surgery by expert surgeons is a rare event. In some cases, the patient typically becomes hemody-namically unstable soon after arrival in the recovery room. On the other hand, sometimes hemorrhage arises a few hours or days following the initial procedure. The surgeon must make a decision whether to return immediately to the operating room or treat the patient conservatively with blood and volume replacement (Kaufman and Lepor 2005). Reasons for a significant major bleeding later on in the postoperative period may be slipped ligatures or clips (e.g., from the renal pedicle or other major blood vessels) or in case of partial nephrectomy, ruptured kidney. Also, removal of drains days after surgery may induce significant bleeding, if the drains have been put primarily through a major blood vessel (e.g., epigastric). Reasons for early revisions may be insufficient ligatures or hemostasis.

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  1. Urologische Klinik und Poliklinik Klinikum der Universität München — Großhadern, Ludwig-Maximilians-Universität München, Marchioninstraße 15, 80336, Munich, Germany

    M. Seitz MD, B. Schlenker MD & Ch. Stief MD (Professor of Urology)

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  1. Department of Urology, Heidelberg University, Medical School, 69120, Heidelberg, Germany

    Markus Hohenfellner MD (Professor and Chairman) (Professor and Chairman)

  2. Detroit Receiving Hospital, 4160 John R., Suite 1017, Detroit, MI, 48201, USA

    Richard A. Santucci MD (Chief of Urology and Associate Professor) (Chief of Urology and Associate Professor)

  3. Wayne State University School of Medicine, 4160 John R., Suite 1017, Detroit, MI, 48201, USA

    Richard A. Santucci MD (Chief of Urology and Associate Professor) (Chief of Urology and Associate Professor)

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Seitz, M., Schlenker, B., Stief, C. (2007). Acute Postoperative Complications. In: Hohenfellner, M., Santucci, R.A. (eds) Emergencies in Urology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-48605-3_29

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