Urinary Disorders Q 31 - Gyan Darpan : Learning Portal
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Wednesday, 6 April 2022

Urinary Disorders Q 31



Immediately post-op after a prostatectomy, which complications require priority assessment of your patient?
  
    A. Pneumonia
    B. Hemorrhage
    C. Urine retention
    D. Deep vein thrombosis
    
    

Correct Answer: B. Hemorrhage

Hemorrhage is a potential complication. Postoperative hemorrhage is a rare but severe complication in LRP. Bleeding generally originates from injured venous vessels in the prostatectomy area, which is always self-limiting due to tissue compression in the pelvic space. However, it is not easy for slightly larger arteries to stop bleeding automatically.

Option A: Pneumonia may occur if the patient doesn’t cough and deep breathe. Postoperative pneumonia is an important cause of morbidity and mortality and represents an important financial burden of $10.5 billion per year. Patients undergoing surgery, especially complex procedures, are at a greater risk due to intubation, post-surgical atelectasis, and long hospital stays exposing them to hospital-acquired pathogens. It has been estimated that approximately one out of four deaths within six days of surgery is due to its complications.
Option C: Urine retention isn’t a problem soon after surgery because a catheter is in place. Although leaving a temporary indwelling catheter is standard practice after radical prostatectomy to allow anastomotic healing, urinary catheterization represents a source of infection, significant discomfort, and anxiety for the patient following radical prostatectomy.
Option D: Thrombosis may occur later if the patient doesn’t ambulate. Historically, the reported rate of symptomatic VTEs is low in open prostatectomy series, as well as robot-assisted radical prostatectomy (RARP) series. As a result, it is unclear which patients are at the highest risk of VTEs developing and who would benefit from medical prophylaxis, given the low incidence of VTEs and a possible increase in complications with the use of heparin.

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