Super-selective Bulbar Artery Embolization with Micro Coils for Severe Urethral Bleeding After Transurethral Resection of the Prostate: A Case Report.

BACKGROUND: Urethral bleeding resulting from a urethral injury is usually easily controlled with conservative management (placement of a catheter and pressure). The case of uncontrolled urethral bleeding is rare, and only a small number of uncontrolled urethral bleeding case reports after urological procedures have been reported in the literature.

CASE REPORT: Herein, we present an unusual case of a 67-year-old male with uncontrolled urethral bleeding after a transurethral resection of the prostate (TUR-P) for benign prostatic hyperplasia, who underwent a successfully, hyper-selective embolization of the bulbar artery with micro coils. Hyperselective embolization of the bulbar artery with micro coils was successfully. The patient was discharged home within 76 hours. At the regular follow-up, the patient was asymptomatic, his laboratory studies were stable, while no tissue ischemia with subsequent urethral strictures and erectile dysfunction was noticed.

CONCLUSION: Although urethral bleeding after transurethral procedures is common, the urologist should be aware of the management options for massive bleeding. End-vessel vascular embolization, such as the bulbar urethral artery with permanent metal coils, is an option in case of uncontrolled urethral bleeding when conservative treatment has failed.