腹腔镜根治性膀胱切除术联合回肠新膀胱术治疗肌层浸润性膀胱癌，并一期预防性腹腔镜骶棘肌固定术以避免未来盆腔器官脱垂。
Laparoscopic Radical Cystectomy and Ileal Neobladder for Muscle Invasive Bladder Cancer in Combination with One Stage Prophylactic Laparoscopic Sacrospinal Fixation to Avoid Future Pelvic Organ Prolapse.
作者信息
Törzsök Péter, Bauer Sophina, Forstner Rosemarie, Sievert Karl-Dietrich, Janetschek Günter, Zimmermann Reinhold
机构信息
Department of Urology and Andrology, University Hospital of Salzburg , Salzburg, Austria .
Department of Radiology, University Hospital of Salzburg , Salzburg, Austria .
出版信息
J Endourol Case Rep. 2016 Mar 1;2(1):59-61. doi: 10.1089/cren.2016.0029. eCollection 2016.
BACKGROUND
Women who undergo cystectomy with orthotopic ileal neobladder are more likely to have urinary retention and neocystocele mainly because of anatomical reasons than stress urinary incontinence. The risk is even higher in case of neurologic comorbidities, as in case of our patient.
CASE PRESENTATION
We present a laparoscopic mesh insertion for sacrospinal colposuspension to prevent a neocystocele and pelvic organ prolapse in combination with laparoscopic radical cystectomy in a female patient suffering from bladder cancer and chronic episodic multiple sclerosis. After a 30-month follow-up, the patient is continent and voids without residual urine. A dynamic MR of the pelvis shows a minimal rectocele without any evidence of a cystocele.
CONCLUSION
Laparoscopic cystectomy combined with sacrospinal mesh fixation is technically feasible and could be an option to prevent neocystocele for female patients.
背景
接受原位回肠新膀胱膀胱切除术的女性更易出现尿潴留和新膀胱膨出，主要是解剖学原因而非压力性尿失禁。若存在神经合并症，风险会更高，如我们的患者。
病例介绍
我们展示了一例腹腔镜下网片植入骶棘韧带阴道固定术，用于预防新膀胱膨出和盆腔器官脱垂，该手术与腹腔镜根治性膀胱切除术联合进行，患者为一名患有膀胱癌和慢性发作性多发性硬化症的女性。经过30个月的随访，患者控尿良好，排尿后无残余尿。盆腔动态磁共振成像显示有轻微直肠膨出，无膀胱膨出迹象。
结论
腹腔镜膀胱切除术联合骶棘韧带网片固定术在技术上可行，可能是预防女性患者新膀胱膨出的一种选择。
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