title: Lower limb (well leg) compartment syndrome after urological pelvic surgery.
abstract: OBJECTIVE
  Well leg compartment syndrome (WLCS) is being seen more frequently as the complexity and duration of pelvic urological surgery increases, ie reconstruction/radical cancer surgery. The etiology of WLCS is multifactorial and prevention should form the mainstay of treatment. With significant morbidity and mortality, in particular lower limb morbidity secondary to fasciotomy wounds and long-term neurological sequelae, all urologists should be aware of this iatrogenic complication and how to prevent or treat it when it occurs.
  
  
  METHODS
  A retrospective review of the world literature using MEDLINE was performed from 1966 to 2002, searching for lower limb compartment syndrome (well leg compartment syndrome), and its association with the lithotomy position and pelvic surgery.
  
  
  RESULTS
  Although WLCS is not commonly reported in the urological literature, it has significant morbidity and mortality. The incidence of WLCS is probably under reported due to failed diagnosis or misdiagnosis. With increased awareness the incidence of this iatrogenic complication may be minimized or avoided altogether.
  
  
  CONCLUSIONS
  Because the lithotomy position is one of the most common positions used in urology, it is mandatory for urologists to be familiar with the complications associated with it. If this complication is recognized early, prompt treatment decreases morbidity and mortality. Minimizing the risk of WLCS will leave urologists less open to litigation, which may follow this significant iatrogenic complication.
authors.affiliation: Ninewells Hospital, Dundee, Scotland, United Kingdom. araza36624@aol.com
authors.forename: Asif
authors.initials: A
authors.lastname: Raza
authors.forename: Derek
authors.initials: D
authors.lastname: Byrne
authors.forename: Nick
authors.initials: N
authors.lastname: Townell
mesh_terms: D003161:Compartment Syndromes / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007430:Intraoperative Care; D007866:Leg; D011187:Posture; D011312:Pressure; D012189:Retrospective Studies; D013997:Time Factors; D013520:Urologic Surgical Procedures / Q000009:adverse effects*