THE RISK OF RHABDOMYOLYSIS AND ACUTE-RENAL-FAILURE WITH THE PATIENT IN THE EXAGGERATED LITHOTOMY POSITION

Rhabdomyolysis with subsequent renal failure has been well documented as a complication of major trauma. However, this complication from ele ctive urological procedures is less well recognized. In 10 patients wh o underwent elective urethroplasty serum levels of creatine kinase and urinary myoglobin were examined preoperatively and postoperatively. T hese patients were placed in the lithotomy position for several hours and had minimal muscle dissection. Serum creatine kinase was noted to increase significantly postoperatively to greater than 1,000 units and in 1 patient myoglobin was detected in the urine. This finding indica tes that there is, indeed, a risk of muscle injury and potential rhabd omyolysis in these patients from the use of the exaggerated lithotomy position.