Urgent Transurethral Resection of a Massive Bladder Clot in a Hemodynamically Unstable Patient

This case report describes a 58-year-old male with a history of chronic smoking who presented with severe hematuria and hemodynamic instability. Initial assessment revealed a massive bladder clot and critically low hemoglobin. Despite initial interventions, the patient suffered cardiac arrest requiring prolonged resuscitation. Emergency cystoscopy was performed, removing a 320-gram clot and resecting a 2 cm bladder tumor. Despite successful surgical intervention and post-operative intensive care, the patient succumbed to multi-organ failure six days later. This case highlights the potential severity of hematuria and the importance of prompt diagnosis and treatment of underlying causes. It also demonstrates the challenges in managing complex cases involving massive hemorrhage, hemodynamic instability, and the sequelae of prolonged cardiac arrest.