Most procedures on the prostate will require high-energy instrumentation. This can lead to significant burns and possible perforation of the prostatic urethra. Perforation would result in extravasation of urine to outside the bladder neck area with increasing cicatrization, scarring, elevated creatinine, as well as significant dysuria, frequency, and urgency. If extravasation is suspected, immediate Foley catheterization is required to improve the clinical situation and minimize the risk of future complications. Scarring due to extravasated urine at the bladder neck can result in long-term bladder pain and voiding dysfunction.
High energy instrumentation of the prostate medical expert witness specialties include urology, urologic oncology, and general surgery.