Paul Charles J, Tobert Conrad M, Tracy Chad R
University of Iowa, Department of Urology, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Urol Case Rep. 2017 Jan 7;11:28-29. doi: 10.1016/j.eucr.2016.08.002. eCollection 2017 Feb.
Vesicourethral anastomosis leaks are not uncommon following radical prostatectomy. We present a case of a 59-year-old male who presented to our ED with hematuria, abdominal pain, and clot retention 17 days after a robotic-assisted laparoscopic prostatectomy. A 50% vesicourethral disruption was ultimately managed endoscopically and with hemostatic agents. At 9-month follow-up he is fully continent with normal erectile function. Vesicourethral leaks can typically be managed conservatively with gentle traction and prolonged catheterization. Persistent hematuria can complicate management, and hemostatic agents may allow for completely endoscopic management with minimal morbidity as seen in this case.
根治性前列腺切除术后膀胱尿道吻合口漏并不少见。我们报告一例59岁男性,在机器人辅助腹腔镜前列腺切除术后17天因血尿、腹痛和血块潴留就诊于我院急诊科。最终通过内镜和止血剂处理了50%的膀胱尿道破裂。在9个月的随访中,他完全控尿,勃起功能正常。膀胱尿道漏通常可通过轻柔牵引和延长导尿时间进行保守治疗。持续性血尿会使治疗复杂化,而止血剂可能允许如本例所见的以最小的发病率进行完全内镜治疗。