ArticleJournal of surgical case reports2026
Acute hemorrhage with huge extraperitoneal hematoma following transrectal prostate biopsy: indication for emergency prostatectomy - a case report.
Article in Journal of surgical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Prostate biopsy is generally safe, and extraperitoneal hematomas are extremely rare. We report the first known case of ongoing post-biopsy bleeding managed with emergency robot-assisted radical prostatectomy. A 77-year-old man developed acute hemodynamic instability several hours after a transrectal MRI/US-fusion biopsy. Computed tomography revealed a large left-sided extraperitoneal hematoma displacing the bladder without arterial extravasation. Despite resuscitation, hemoglobin continued to decrease, suggesting persistent venous bleeding. Preliminary histology confirmed well-differentiated acinar adenocarcinoma. Given hematoma size, instability, and confirmed malignancy, interdisciplinary consensus favored surgical management. Within 24 h, the patient underwent extraperitoneal bilateral nerve-sparing radical prostatectomy with complete hematoma evacuation. The procedure was uncomplicated, recovery stable, continence satisfactory, and final pathology showed pT2c Gleason 3 + 3 = 6 cancer with negative margins. This case underscores the need for vigilance regarding atypical post-biopsy symptoms and shows that emergency prostatectomy may offer both hemostasis and definitive oncologic treatment.
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