Minimally invasive treatment of vesicourethral leak after laparoscopic radical prostatectomy

Elmor, Tiago Rivello; Rubinstein, Mauricio; Lima, Guilherme Cunha; Cruz, Antonio Cesar; Pereira, Clovis Fraga T.; Rubinstein, Isaak

doi:10.1590/0100-69912016003011

Cited by 7 publications

(4 citation statements)

References 11 publications

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“…Persistent vesicourethral anastomotic leakage is a significant loss of urine, usually above 100 or 200 ml, after the third day postoperatively. The prevalence of persistent vesicourethral anastomotic leakage is low, and there are only a few published cases reporting that the leakage is difficult to control and increases the possibility of extended hospital stay in addition to the risk of other complications [8][9][10].…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous embolization of contained iatrogenic vesicourethral fistula using AVP and NBCA: a case report

2021

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Purpose: Reports on percutaneous embolization of vesicourethral anastomotic fistula are limited. Case presentation:A 59-year-old male presented with persistent contained vesicourethral fistula following low anterior resection and radical retropubic prostectomy for rectal cancer. A contained fistula with urinary leakage of 350 ml/day through a Jackson-Pratt (JP) tube was found at the posterior aspect of the vesicourethral anastomotic site on cystography. After 1 month of failed conventional urinary drainage manoeuvre, percutaneous embolization of the contained fistula was successfully performed through the JP tube. An Amplatzer vascular plug (AVP) was used to block the fistula and N-butyl-2-cyanoacrylate (NBCA) was used to obliterate the urinoma cavity. Computed tomography scans at 1-month and 1-year follow-ups showed stable AVP position and complete obliteration of the cavity by NBCA. Conclusions:The contained vesicourethral anastomotic fistula was successfully managed with AVP and NBCA via a JP drainage tube. It is expected that AVP will block the fistula and NBCA will obliterate the urinoma cavity effectively.

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Section: Discussionmentioning

confidence: 99%

“…Treatment of vesicourethral anastomotic leakage is challenging, and this complication can indefinitely prolong the hospitalization period and add the risk of adverse events such as secondary infection by resistant germs [8].…”

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confidence: 99%

Percutaneous embolization of contained iatrogenic vesicourethral fistula using AVP and NBCA: a case report

2021

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“…In the last 2-10 years of PVAL, the practiced methods include; directing the flow of urine by endoscopically inserting 2 urethral catheters [6], similarly exteriorization of ureteral stents via the urethra to temporarily divert urine flow [8], injection of N-butyl-2-cyanoacrylate and by fibrin glue into the vesicourethral anastomotic gap via cystoscopy [12], or more recently, using a self-made fenestrated foley catheter [13].…”

Section: Discussionmentioning

confidence: 99%

“…The vesicouretheral anastomosis between the bladder neck and the membranous urethra for reconstruction of the lower urinary tract after removal of the prostate is a crucial point of RALP. Urinary leakage at the urethrovesical anastomosis is the most common short-term complications of RP but is usually self-limited and last about 2-3 days [6]. Persistent (not self-limiting within 2-5 days) vesicourethral anastomotic leaks (PVAL) is a rare occurrence with an unclear incidence, about which there is a paucity of published literature.…”

Section: Introductionmentioning

confidence: 99%

Successful body flossing via indwelling nephrostomy allowing for primary realignment of bladder rupture and placement of a foley catheter into the urinary bladder

Bajaj

Djadjo²,

Hillyer

et al. 2020

Radiology Case Reports

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Vesicourethral anastomosis leaks are one of the most common short-term complications following radical prostatectomy. We present a case of a 67-year-old Caucasian male who presented to our Emergency Department (ED) with abdominal pain and urinary incontinence 10 days after a robotic-assisted laparoscopic prostatectomy. Interventional radiology initially performed successful nephrostomy placement for bilateral hydronephrosis. Vesicourethral disruption was managed via a multidisciplinary approach with urology and interventional radiology in which a novel approach to realign a bladder rupture and appropriately place a foley catheter in the bladder. Vesicourethral leaks are often managed conservatively. In a few cases, such as this one, mini-invasive intervention is often required to repair the disruption.

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Description of a novel robotic early post-prostatectomy anastomotic repair technique and institutional outcomes

Strauss,

Cho,

Loecher

et al. 2024

Asian Journal of Urology

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Minimally invasive treatment of vesicourethral leak after laparoscopic radical prostatectomy

Abstract: o estudo mostrou que a FAVP após a prostatectomia radical laparoscópica pode ser tratada por via endoscópica com segurança e excelentes resultados.

Cited by 7 publications

References 11 publications

Percutaneous embolization of contained iatrogenic vesicourethral fistula using AVP and NBCA: a case report

Percutaneous embolization of contained iatrogenic vesicourethral fistula using AVP and NBCA: a case report

Successful body flossing via indwelling nephrostomy allowing for primary realignment of bladder rupture and placement of a foley catheter into the urinary bladder

Description of a novel robotic early post-prostatectomy anastomotic repair technique and institutional outcomes

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