Exaggerated lithotomy position-related rhabdomyolysis.

A case report and review of the exaggerated lithotomy position, in particular, and other position-related rhabdomyolysis is presented. The objective is to emphasize that the exaggerated lithotomy position, although providing good exposure for urethral and prostatic surgery, is associated with a low but definite risk of rhabdomyolysis and acute renal failure. Certain risk factors for the complication have been outlined. Close perioperative monitoring, including the use of pulmonary artery pressure and lower-extremity compartment pressure measurements in high-risk cases, is suggested for the prevention and the early detection of these cases. Prompt volume replacement and diuresis is the cornerstone of therapy in preventing acute renal failure in patients who develop rhabdomyolysis and myoglobinuria.