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

Abstract

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.

Case – Endoscopic management of severe ventral urine leak post-robot-assisted laparoscopic prostatectomy

“…1,4 More invasive measures including percutaneous nephroureteral stents placed on suction as well a "body flossing" technique described by Bajaj et al which consists of bilateral percutaneous nephrostomy tubes with subsequent externalization of stents through the penile urethra. 5,6 Both of these procedures require a multidisciplinary approach including interventional radiology and may not be the ideal management option for patients receiving anticoagulation.…”