Mukkamala Anudeep, Latini Jerilyn M, Cameron Anne P
Department of Urology, University of Michigan Hospitals and Health Centers, Ann Arbor, MI.
Can Urol Assoc J. 2013 Nov-Dec;7(11-12):E833-6. doi: 10.5489/cuaj.481.
We report a case of a 68-year-old man who presented with a urethrocutaneous fistula after off-label use of Tegress (C. R. Bard, Inc., Murray Hill, NJ) Urethral Implant for post-prostatectomy incontinence. He was treated for prostate cancer with an open radical retropubic prostatectomy and adjuvant external beam radiation therapy. He was treated unsuccessfully for stress incontinence with a Tegress Urethral Implant and presented to our clinic initially with extrusion of the material urethrally. Four years later he re-presented with a large bullous skin lesion on his suprapubic area. Contrast-enhanced magnetic resonance imaging and retrograde urethral cystogram demonstrated a urethrocutaneous fistula. Subsequent cystoscopy revealed the calcified extruded material in the same location as the site of Tegress injection. The patient underwent simple cystectomy with ileal diversion. He recovered well postoperatively. This appears to be the first reported case of urethrocutaneous fistula after use of a Tegress Urethral Implant for post-prostatectomy stress urinary incontinence.
我们报告了一例68岁男性病例，该患者在非适应证使用泰格斯（C.R.巴德公司，新泽西州默里山）尿道植入物治疗前列腺切除术后尿失禁后出现尿道皮肤瘘。他接受了开放性耻骨后根治性前列腺切除术及辅助性体外放射治疗以治疗前列腺癌。他使用泰格斯尿道植入物治疗压力性尿失禁未成功，最初因植入材料经尿道挤出而前来我们诊所就诊。四年后，他再次就诊，耻骨上区域出现一个大的水疱性皮肤病变。增强磁共振成像和逆行尿道膀胱造影显示存在尿道皮肤瘘。随后的膀胱镜检查发现钙化的挤出材料位于泰格斯注射部位相同位置。该患者接受了单纯膀胱切除术及回肠代膀胱术。术后恢复良好。这似乎是首例使用泰格斯尿道植入物治疗前列腺切除术后压力性尿失禁后出现尿道皮肤瘘的报道病例。
