Document Detail

Electrical burn of urethra as cause of stricture after transurethral resection.
MedLine Citation:
PMID:  10772519     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: One of the most common complications of transurethral resection is urethral stricture. The exact etiology is still controversial. Postulated pathophysiology ranges from mechanical trauma to the urethra during the resection to inflammatory reaction secondary to local anesthesia. We propose electrical burn to the urethra as a contributory factor in some cases. MATERIALS AND METHODS: Electrical events during transurethral resection were simulated in vitro. The distribution of current was measured at the loop/rollerball and in the outer metal sheath. Both an intact loop/rollerball and loop/rollerball with faulty insulation were tested. Various power outputs simulating coagulation, cutting, and vaporization were used. Data were recorded both in settings where the outer metal sheath was and was not smeared with nonconductive lubricating gel. RESULTS: Approximately 20% of the total current output was shunted to the metal sheath when an intact loop/rollerball was used. One hundred percent of the current was short-circuited to the sheath when a loop/rollerball with faulty insulation was retracted into the sheath. Little current was detectable in the nonconductive lubricating gel. We then calculated the length of time required, in various settings, to reach tissue temperature of 45 degrees C, when protein denaturation starts. The higher the power output and the smaller the contacting surface area, the more likely it is for urethral burns to occur. CONCLUSION: Our in vitro experiment showed that urethral burns secondary to stray current in the resectoscope sheath are unlikely when an intact loop is used. However, urethral burns can occur when a loop/rollerball with faulty insulation is used, especially in combination with nonconductive gel that is dispersed unevenly within the urethra.
W Zheng; G Vilos; S McCulloch; P Borg; J D Denstedt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  14     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-06-21     Completed Date:  2000-06-21     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  225-8     Citation Subset:  IM    
Division of Urology, University of Western Ontario, London, Canada.
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MeSH Terms
Burns, Electric / complications*,  etiology*,  pathology
Electrosurgery / adverse effects*,  instrumentation
Equipment Failure
Liver / pathology,  surgery
Urethra / injuries*,  surgery*
Urethral Stricture / etiology*

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