Post-Transurethral Resection of Prostate Recurrent Life Threatening Hematuria: A Case Report with Review of Literature

Herein, we present a case report of post-TURP (transurethral resection of prostate) recurrent severe
hematuria due to right internal iliac artery pseudoaneurysm protruding into bladder lumen. A 60-yearold
male presented with recurrent massive hematuria following TURP done elsewhere 15 days
before. His hemoglobin was 4gm/dL after 13 units of blood transfusion and repeated clot evacuations.
His blood urea, serum creatinine, and coagulation profile studies were normal. Ultrasonography of
abdomen showed multiple clots in the bladder. Cystoscopy revealed clots with a right posterolateral
wall unhealthy area. After stabilizing the patient, contrast enhanced CT urography revealed
intravesical pseudo aneurysm. CT angiography showed pseudo aneurysm of a branch of internal iliac
artery protruding into urinary bladder lumen. We referred patient to selective embolization of the lesion
but the procedure was unsuccessful. At last, ipsilateral internal iliac artery ligation relieved hematuria.
But on postoperative day 2, patient suddenly collapsed and deceased, presumably due to
cardiomorbidities.