Under certain conditions an explosion can occur within the urinary bladder during transurethral resection of the prostate (TURP). This can result in a sudden rise in pressure and rupture of the bladder wall.
Clinical scenario:
(1) A patient is undergoing a TURP.
(2) During the procedure there is an explosion within the urinary bladder.
(3) The explosion may be strong enough to rupture the urinary bladder. There may also be some degree of thermal and blast injury to the bladder mucosa.
Proposed mechanism:
(1) flammable gas is generated by electrocautery, including hydrogen, oxygen and hydrocarbons
(2) environmental oxygen is introduced into the bladder forming an air pocket
(3) activation of electrocautery ignites the gases, causing an explosion
Exclusion:
(1) mechanical perforation of the bladder wall
(2) instillation of a flammable gas during the procedure by accident
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