Intravesical gas explosion after sequential greenlight laser prostate vaporization and plasma electrocoagulation: a case report and literature review.

BACKGROUND: Intravesical gas explosion resulting in full-thickness intraperitoneal bladder rupture is an extremely rare but potentially life-threatening complication following transurethral prostate surgery, with very few cases reported in the context of Greenlight laser vaporization of the prostate (LVP) and plasma electrocoagulation. CASE PRESENTATION: A 50-year-old man with chronic urinary retention and benign prostatic hyperplasia (BPH) underwent LVP. During hemostasis, a sudden loud popping sound was noted, followed by an intravesical explosion and subsequent bladder rupture. Emergent laparoscopic exploration confirmed a full-thickness intraperitoneal bladder rupture, which was surgically repaired. The patient required an 11-day intensive care unit stay and prolonged urethral catheterization due to reduced bladder capacity. At 1-year follow-up, the catheter had been successfully removed, and the patient remained under conservative follow-up. CONCLUSION: Intravesical gas explosion is a rare but potentially severe complication of transurethral prostate surgery. This case demonstrates that the complication may occur during hemostasis following LVP and highlights the importance of intraoperative vigilance and preventive measures.