Two Cases of Lower Extremity Compartment Syndrome after Posterior Urethroplasty

Acute lower extremity compartment syndrome following surgery in the lithotomy position is uncommon but is a surgical emergency causing irreversible damage if suspected and requires emergent decompressive fasciotomy. This report describes compartment syndrome following bulbo-urethroplasty. Patient A developed lower extremity pain with absent dorsiflexion 9 hours after surgery and Patient B experienced calf pain immediately after surgery. One year after fasciotomy A had permanent drop foot and B had peroneal nerve distribution numbness. Shared risk factors that placed the patients at risk were obesity and prolonged surgical times. Emerging concepts aimed at improving care for patients with compartment syndrome are discussed.